6 Detecting Bubbles and explosive behavior in bitcoin prices
6.1 Testing for a single bubble
cxiii
This syndrome was isolated from cluster 7 and it is distinguished from the other syndromes by the presence of the symptoms of dizziness with at least two other complaints that are related to the Head / neck. That somatic complaints cluster around the head has long been recognised and syndromes which have been described earlier include; Brain – fag syndrome (Prince 1962)41, Ode – Ori (Makanjuola 1987)15 and Cephalic complaint syndrome (Mume 1998)43. The major thing that is common to these syndromes are complaints of unpleasant head symptoms which might be heat, pain, crawling sensations, vacancy feeling (feeling of emptiness or as if there is nothing in the brain) amongst others. On the basis of these unpleasant head symptoms, the syndrome of Dizziness with Head related complaints resembles Brain – fag syndrome but differs from it in the sense that in addition to the unpleasant head symptoms in Brain – fag, It has been observed to be common among people whose occupation require intensive reading (e.g. student)41. But of the five patients with the syndrome of Dizziness with Head - related complaints, only one is a student. This study did not seek for other prominent symptoms of Brain – fag syndrome such as cognitive impairment. With regards to
“Ode – Ori”, the syndrome of Dizziness with Head related complaints differs from it by occurring in subjects who are not psychotic (some patients diagnosed of Ode – Ori had psychotic features)15. The prominence of the feeling of dizziness is the only distinguishing feature between this syndrome (Dizziness with Head related complaints) and the Cephalic complaint syndrome. Apart from this, the two syndromes are alike in some ways including in the demographic characteristics of the subjects identified with the syndromes. For example, while the mean age of
cxiv
patients diagnosed of Cephalic complaint syndrome was 34.4 years, the mean age of those diagnosed in this study of the syndrome of Dizziness with Head related complaints was 34.0 years. Also, both syndromes were found to affect more males than females (the male to female ratio in cephalic complaint syndrome = 1.6:1;
same values were also obtained for male to female ratio in the syndrome of Dizziness with Head related complaints). Given the above, one can observe that the syndrome of Dizziness with Head related complaints is distinct from (though similar to) the Brain – fag syndrome, Ode – Ori, and Cephalic complaints syndrome.
cxv
CONCLUSION
This study has shown that quite a large number of patients attending the General out patients clinic at the University of Calabar Teaching Hospital have Somatic symptoms. Most of them whose symptoms are not attributable to organic pathology might have psychiatric disorders which if not recognised, would go untreated. For this reason, physicians working at this level should look out for psychiatric disorder in patients that present to them with somatic symptoms which are not attributable to organic pathology. Because of the large number of patients to attend to and the busy schedules of these physicians, they may not have enough time to administer a standardised diagnostic instrument. It is therefore recommended that they refer such patients to psychiatric service for proper evaluation and management by a psychiatrist.
Going by the observation of this study that most patients with somatic complaints have a psychiatric disorder, it is my recommendation that the evaluation of an individual’s somatic state be included in the Mental State Examination of Nigerian patients. Another observation of this study is that somatic symptoms do occur in clusters and that the symptoms in the clusters can form specific syndromes. This observation supports the findings of Mume in his study of symptoms in non-psychotic psychiatric patients in western Nigeria.
The western diagnostic categories of mental illness could not identify with these syndromes satisfactorily. This is because, the patients that were identified with the same syndrome attracted different types of ICD-10 diagnosis and in some of the patients, no ICD-10 diagnosis was possible. This calls for question about the use of
cxvi
an etic approach (yard stick and diagnostic categories developed in the western culture) to diagnose somatizing patient in Nigeria.
In line with the foregoing, one can neither conclude that these somatizing patients had somatoform disorders, anxiety states or depression, nor can one conclude that about a quarter of these patient (who were not diagnosed by the SCAN using ICD-10 criteria) had no psychiatric disorder. To draw such conclusion will amount to
“Category fallacy” 97 which refer to the warning by some medical and social anthropologists that misleading conclusions are likely to be reached if diagnostic concepts that are familiar in one culture are applied in another culture. This is because the diagnostic concept will systematically exclude what does not fit into its tight criteria. Based on the above observation, this author is recommending that the Association of Psychiatrists in Nigeria in conjunction with the faculty of psychiatry, National Postgraduate Medical College should constitute a committee with a view of fashioning out an indigenous way of classifying patients presenting with somatic complaints.
cxvii
LIMITATIONS OF THIS STUDY This study is limited by the following:
1. The patients recruited into this study were those whose symptoms were presumed by the General practitioners to lack evidence of an organic pathology. It is important to note that the declaration of lack of evidence of organic pathology by the general practitioners may not mean that none exist since it could result from either lack of adequate technology for investigation or lack of clinical experience by the general practitioner. Therefore undiagnosed (latent) medical conditions may have been responsible for the complaints presented by some of the recruited patients.
2. The method of recruiting patients into this study was supposed to be by random sampling but this may not have been strictly followed as it was discovered during the early part of the study that this author had to remind some of the General practitioners before they sent some patients that were recruited.
3. Observation of the dendrogram would show that the clusters which were extracted consisted of other smaller clusters. This author did not consider separately every small cluster that emerged else; the resultant number of clusters to be considered would be numerous and this might affect the type of syndromes identified.
4. As earlier stated, eight of the sixty somatic complaints in the somatic symptom severity questionnaires were not among the ones subjected to cluster analysis. This was because, they had no positive respondents, If these
cxviii
eight symptoms had positive respondents, it would probably have affected the number of clusters and the type of syndromes arrived at in this study.
5. The sample size of 100 patients was not large enough considering the population of GOPC attendees that reported somatic symptoms therefore generalization of findings should be with caution.
cxix
REFERENCES
1. Kleinman, AM; (1978). Culture and depression. Culture, Medicine and Psychiatry; 2: 295 – 296.
2. Fink, P; Toft, T; Hansen, SM et al: (2007). Symptoms and Syndromes of Bodily Distress: An Exploratory Study of 978 Internal Medical, Neurological, and Primary Care Patients. Journal of Psychosomatic Medicine; 69: 30 – 39.
3. Vikram, P; Athula, S; (2006). Psychological approaches to somatization in developing countries. Advances in psychiatric treatment; 12: 54-62.
4. Basky, AJ; Klerman, GL; (1993). Overview: Hypochondriasis, bodily complaints and somatic styles. Am J Psychiatry; 140: 273 – 283.
5. Hollifield, M; Vogel, AV; (1996). The Somatising Patient. In: Medicine, A Primary Care Approach.(Eds Rubin RH, Vos C, Derksen DJ, Gateley A, And Quenzer RW). WB Saunders, Toronto. pp 389 -392.
6. Hollifield, M; Paine, S; Tuttle, L et al; (1999). Hypochondriasis, somatisation and perceived health and utilization of health care services. Journal of Psychosomatics; 40: 380 – 386.
7. Katon, W; (1984). Panic disorder and Somatisation. Am J Medicine;
77: 101 – 106.
8. Reids, S; Wessely, S; Crayford, T et al; (2002). Frequent attenders with medically unexplained symptoms: Service use and costs in secondary care. British J Psychiatry; 180: 248 – 253.
9. Prince, RH; (1962). Western Psychiatry and the Yoruba. The problem of insight psychotherapy. Proceedings 8th NISER conference, Ibadan.
Nigerian Institute of Social and Economic Research: 213 – 221.
10. Ohaeri, JU; Olatawura, MO; (1988). The Resilience of somatization symptoms to physical methods of treatment. Psychopathologie Africaine; XXII 1: 65-78.
11. Morakinyo, O; (1985). Phobic states presenting as somatic complaints syndromes in Nigeria: sociocultural factors associated with diagnosis and psychotherapy. Acta Psychiatrica Scandinavica; 7: 356 – 365.
12. Binitie, AO; (1981). Clinical Manifestation of Depression in Africans.
Psychopathologie Africaine; 17: 36 – 40.
cxx
13. Ebigbo,PO; Ihezue, UH; (1982). Uncertainty in the use of western diagnostic illness categories for labelling mental illness in Nigeria.
Psychopathologie Africain; 3, XVIII, (1): 59 – 74.
14. Okulate, GT; Olayinka, MO and Jones OBE; (2004). Somatic symptoms in depression: evaluation of their diagnostic weight in an African setting. British Journal of Psychiatry; 184: 422 – 427.
15. Makanjuola, ROA; (1987). “Ode-ori”: A culture bound disorder with prominent somatic features in Yoruba Nigerian Patients. Acta Psychiatrica Scandinavica. 75: 231 – 326.
16. Shorter, E; (1992). From Paralysis to Fatigue. In: A history of psychosomatic illness in the modern era. The Press Macmillan, New York.
17. Mayou, R; (2003). Somatoform disorders and other causes of medically unexplained symptoms. In: New Oxford Textbook of Psychiatry. Vol. 2. (eds Gelder MG, Lopez-Ibor J. and Andreasen N.) Oxford University Press.
18. Kaplan, HI; Sadock, BJ; (1988). History of Psychiatry. In: Synopsis of Psychiatry, fifth edition (ed Collins N). Williams and Wilkins, Baltimore. pp 1 - 7.
19. Hare, E; (1991). The history of “nervous disorders” from 1600 to 1840 and a comparison with modern views. Br. J. psychiatry; 159: 37 – 45.
20. Heinrich, TW; (2004). Medically Unexplained Symptoms and the Concept of Somatization. Wisconsin Medical Journal (Vol. 103); 6: 83-87.
21. Gelder, M; Mayou, R and Cowen, P;(2001). Somatoform Disorders.
In: Shorter Oxford Textbook of Psychiatry fourth edition. Oxford University Press. pp 249 – 268.
22. American Psychiatric Association (1987). Diagnostic And Statistical Manual of Mental Disorders 3rd edition revised. Washington, DC.
American psychiatric Association.
cxxi
23. Stern, J; Murphy, M and Bass, C; (1993). Attitudes of British Psychiatrists to the diagnoses of somatization disorder: A questionnaire survey. Br. J. Psychiatry; 162: 463 – 466.
24. Dino, F. “Modules on Freud: on Neuroses”. Introductory Guide to critical Theory. Purdue U (2nd August, 2004). www.purdue.edu/guide to theory/Psychoanalysis/Freud 4.html.
25. Kowaleski – Wallace E (1997). Encyclopedia of Feminist literary theory. Vol. 1582. Taylor and Francis. pg. 285.
26. Steinberg, H; (2007). The birth of the word ‘Psychosomatics’ in medical literature by Johann Christian Heinroth. Forthschr Neurol Psychiatry : 75 (7): 413 – 417.
27. World Health Organisation (1968). Manual of the International Statistical Classification of Diseases, Injuries and causes of death, 8th Edition, Geneva.
28. Kaplan, HI; Sadock, BJ. (1988). Psychological factors affecting physical conditions (psychosomatic disorders) In: Synopsis of psychiatry 5th edition. Williams And Wilkins, Baltimore, USA. PP 412-428
29. World Health Organization (1992). Neurotic, stress related and somatoform disorders. In: ICD – 10 Classification of Mental and Behavioural Disorders, WHO Geneva.
30. American psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition. Washinton DC: American psychiatric Association.
31. Escobar, JL; Ribio-Stipee, M and Caninjo, G et al: (1989). Somatic Symptom Index (SSI): A new and abridged somatisation construct. J Nerv Ment Disease; 177: 140 – 146.
32. Ebigbo, PO; Onyema, WPJC; (1982). Alternative Diagnostic Method:
The use of the Enugu Somatization Scale in the investigation of female psychopathology. Paper presented in a conference of Association of Psychiatrists in Nigeria. Enugu.
cxxii
33. Sadock, BJ; Sadock, VA; (2000). Theories of Personality and Psychopathology. In: Comprehensive Textbook of Psychiatry 7th edition. Williams and Wilkins, Philadelphia; pp 563 - 651
34. Morakinyo, OA; (1983). Phenomenological study of Functional Abnormal Bodily sensations in African Psychiatric Patients.
Psychopathologie Africaine; XIX, 3, 343 – 355.
35. Rief, W; (2009). Is Somatisation a habituation disorder? Physiological reactivity in somatisation syndrome. Psychiatry Research; vol.101, 1:
63 – 74.
36. Weilgosz, AT; Earp, JA; (1986). Perceived vulnerability to serious heart disease. Journal of Psychosom Med.; 48: 118 – 124.
37. Ockene, IS; Shay, MS; Alpert, JS et al; (1980). Unexplained chest pain in Patients with normal arteriogram. New England J. Med;
303:1249 – 1252.
38. Gureje, O; Simon, GE; Ustun, TB et al; (1997). Somatisation in cross cultural perspective: A World Health Organisation study in Primary Care. Am J Psychiatry; 154: 989 – 995.
39. Jegede, RO; (1983). In: Clinical Psychology in Africa (eds. Karl Peltzer and Peter O. Ebigbo). Chuka, Enugu, Nigeria.Pg 279
40. Jacobi, F; Wittchen, HU; Holting, C et al; (2004). Prevalence, Co-morbidity and correlates of mental disorders in the general population:
Results from the German Health Interview and Examination Survey.
Psychological Medicine; 34 (4): 597 – 661.
41. Prince, R; (1962). The “Brain-Fag Syndrome”. In: Clinical Psychology in Africa (eds. Karl Peltzer and Peter Ebigbo). Chuka, Enugu, Nigeria.
Pg 276 – 284.
.
42. Ebigbo, PO; (1982). Developing a culture specific (Nigeria) screening scale of somatic complaint indicating psychiatric disturbances.
Culture, Medicine and Psychiatry; 6: 29 – 43.
43. Mume, CO; (1998). Cluster Analysis of Functional Bodily Symptoms in African Psychiatric Patients. Dissertation submitted to the National Postgraduate Medical College of Nigeria .
cxxiii
44. Funk, P; (1995). Psychiatric Illness in patients with persistent somatization. British J Psychiatry; 166: 98 – 99.
45. Simon, G; Gater, R; Kisely, S et al; (1996). Somatic Symptoms of distress; an international primary care study.Journal of Psychosom Med.; 58: 481 – 488.
46. Kroenke, K; Spitzer, RL; William, JB et al: (1994). Physical Symptoms in Primary Care. Predictors of Psychiatric disorders and functional impairment. Arch Fam Med.; 3: 744 – 749.
47. Katon, WJ; Lin, E; Vonkorff, M et al; (1991). Somatization; a spectrum of severity. Am J psychiatry; 148: 34 – 40.
48. Vonkoff, M; Simon, G; (1996). The relationship between pain and depression. Br J Psychiatry; 30: 101 – 108.
49. Kirmayer, LJ; Robbins, JM; Dworkind, M et al; (1993). Somaitization and the recognition of depression and anxiety in Primary care. Am J.
Psychiatry;150: 734 – 741.
50. Ebigbo, PO; (1988). The mind, the body and society: An African perspective. In: Clinical Psychology in Africa (eds. Karl Peltzer and Peter Ebigbo). Chuka, Enugu, Nigeria. Pp 89 – 102.
51. Ifeabumuyi, OI; (1981). The Dynamics of central Heat in Depression.
Psychopathologie Africaine; 17: 36; 127 – 133.
52. Raguram, R; Weiss, MG; Channabasavanna, SM et al: (1996).
Stigma, Depression and Somatization in South India. Am J Psychiatry; 153: 1043 – 1049.
53. Cheung, F; Lau, BW and Waldmann, E; (1981). Somatization among Chinese depressives in general practice. Int. J. Psychiatry Med.; 10:
361 – 374.
54. Simon, GE; Vonkorff, M; Piccinelli, M et al; (1999). An International study of the relationship between Somatic Symptoms and Depression. The New Engl. J. of Med.; 341: 1329 – 1335.
55. Bridges, RN; Goldberg, DP; (1985). Somatic presentation of DSM III Psychiatric disorders in primary care. J. Psychosom Res; 29: 563 – 569.
cxxiv
56. Parker, G; Abeshouse, B; Morey, B et al; (1984). Depression in general practice. Med. J. Aust; 141: 154-158.
57. Goldberg, DP; Bridges, K; (1988). Somatic Presentation of Psychiatric Illness in Primary Care setting. J. Psyhcosom Res; 32: 137 – 144.
58. Wilson, DR; Widmer, RB; Cadoret, RJ et al; (1982). Somatic Symptoms a major feature of depression in a family practice. J Affective Disorder; 5: 199 – 207.
.
59. Katon, W; Kleiman, A and Rosen, G; (1982). Depression and somatization, a review. Am J Med; 72: 127 – 135.
60. Wilson, DR; Cadoret, RJ; Widmer, R et al; (1987). Anxiety in family Practice. J Affective Disorder; 12: 179 -183.
61. Macleod, C; Mathews, A; Tata, P; (1986). Attentional bias in emotional disorders. J Abnormal Psychology; 95; 15 – 20.
62. Noyes, R; Reich, J; Clancy, J et al: (1986). Reduction in hypochondriasis with treatment of panic disorder. Br. J Psychiatry;
149: 631 – 635.
63. Lipowski, ZJ; (1998). Somatization: the concept and its clinical application. Am J Psychiatry; 145; 1358 – 1368.
64. Coryell, W; House, D; (1984). The validity of broadly defined hysteria and DSM III conversion disorder: outcome, family history and mortality. J. Clin Psychiatry; 45: 252 – 256.
65. Janakiramiah, N; Subbakrishna, DK; (1980). Somatic neurosis in muslim women in India. Social Psychiatry; 15: 203 – 206.
66. German, GA; Arya, OP; (1969). “Psychiatric Morbidity amongst a Uganda Student Population”. In: Clinical Psychology in Africa(eds Karl Peltzer and Peter Ebigbo). Chuka. Enugu, Nigeria. Pg 276
cxxv
67. Peltzer, K; (1987). “Some contribution of traditional healing practices towards Psycho Social Health care in Malawi’’. In: Clinical psychology in Africa (eds. Karl Peltzer and Peter Ebigbo). Chuka. Enugu, Nigeria.
Pg 276.
68. Guiness, EA; (1992). Profile and Prevalence of the brain fag syndrome: Psychiatric Morbidity in school population in Africa. Br .J.
Psychiatry; 160: 42 – 52.
69. Morakinyo, OA; (1980). Psycho physiological Theory of a Psychiatric illness (The brain fag syndrome) associated with study among Africans. J Ner Ment Dis; 168: 84 – 89.
70. Cross River State Tourism Bureau: Brief notes on old Calabar.
Downloaded from www.Crstb.com on 10th January, 2009.
71. Federal Republic of Nigeria. Official Gazette; 2007: 94 (24) : B183.
Lagos, Nigeria
72. Milton, JS; Tsokos, JO; (1983). Statistical Methods in the Biological and Health Sciences. McGraw-Hill International books company.
73. Ebigbo, PO (1982); Enugu Somatization Scale. In: Clinical psychology in Africa (eds. Karl Peltzer and Peter Ebigbo). Chuka, Enugu, Nigeria.
PP 243 – 247.
74. Wilkinson, G; William, P; (1986). Development of Scales to Measure Treatment Attitudes in Psychiatry. British Journal of Psychiatry;148:
581- 586
75. Bond, A; Lader, M; (1974). The use of analogue rating scale in rating subjective feelings. British Journal of Medical Psychology; 7: 211-218.
76. Selby, PJ; Campbell, JAW; Etezadi, AJ et al;(1984). The development of a method for assessing the quality of life of cancer patients. British Journal of Cancer; 50:13 – 22.
77. Bailey, KD; (1994). Numerical taxonomy and Cluster Analysis. In:
Typologies and Taxonomies: an Introduction to Classification techniques. Illustrated Edition. SAGE. Pg 34
78. Ballinger, BR; Reid, AH; Heather, BB; (1982). Cluster Analysis of symptoms in Elderly Demented Patients. Brit. J. Psychiat.; 140: 257 – 262
cxxvi
79. Andriana, F; Mark, O; Marc, G et al; (2001). Medically Unexplained Symptoms in an Urban General Medicine Practice. J. Psychosom; 42:
261 – 268.
80. Ohaeri, JU; Odejide, OA; (1994). Somatization symptoms among patients using primary health care facilities in a rural community in Nigeria. American journal of psychiatry; 151: 728 – 731.
81. Ayonrinde, A; (1977). Heat in the head or body: A Semantic confusion. Afr J. Psychiatry; 1:59-63.
82. Okhomina, FOA; Ebie, JC; (1983). “Heat in the head as a psychiatric symptom”. In: Morakinyo O. A Phenomenological study of functional abnormal bodily sensation in African Psychiatric Patients.
Psychopathologie Africaine; XIX, 3: Pg 344.
83. Brown, FW; Golding, MJ; Smith, RG; (1990). Psychiatric Comorbidity in Primary Care Somatization Disorder. J Psychosom Med; 52: 445 – 451.
84. Morakinyo, O; (1983). “Somatic complaints syndrome and depression in Nigeria”. In: Clinical Psychology in Africa(eds. Karl Peltzer and Peter Ebigbo). Chuka. Enugu, Nigeria. Pg 220
85. Silver, H; (1987). Physical complaints are parts of the core depressive syndrome: evidence from a cross-cultural study in Israel. J. Clinical psychiatry; 48: 140 – 142.
86. Hamilton, J; Campos, R; Creed, F; (1999). Anxiety, Depression and management of Medically Unexplained Symptoms in medical clinics.
J Royal College of Physicians London: 30(1): 18-20.
87. Olatawura, MO; (1973). “The problem of Diagnosing Depression in Nigeria”. In: Clinical Psychology in Africa(eds. Karl Peltzer and Peter Ebigbo). Chuka. Enugu, Nigeria. Pg 218
88. Ihezue, UH; kumaraswamy, N; (1986) “Prevalence of depressive symptoms among patients attending a general outpatient clinics” In:
clinical psychology in Africa(eds. Karl Peltzer and Peter Ebigbo).
Chuka. Enugu, Nigeria. Pg 218
89. Binitie, A. A factor analytic study of depression across cultures (African and European). British journal of psychiatry, 127, 559 – 563.
90. Ilechukwu, STC. Psychiatry in Africa: Special problems and unique features. Transcultural Psychiatric Research Review, 28, 169 – 218.
cxxvii
91. Awaritefe, A. Clinical anxiety in Nigeria. Acta Psychiatrica Scandinavica 77 (6): 729 – 735.
92. Robles, TD; Romm, S; Combs, H et al: (2008). Delusional disorders in dermatology: a brief review. Dermatology on line Journal; 14(6): 2.
93. Poli, R; Agrimi, E; (2009). Ekbom’s Syndrome: Two Case Reports Treated with Olanzapine. Clinical Neuropsychiatry; (6), 3: 124 – 127.
94. Chakroborty, A; (1973). Origin of a common psychiatric symptom (burning sensation) among Indian patients: study of a myth with reference to Ayurveda. In: Clinical Psychology in Africa(eds. Karl Peltzer and Peter Ebigbo). Chuka. Enugu, Nigeria. Pg 284.
95. Wood, P. DaCosta’s Syndrome (or Effort Syndrome). British Medical Journal May 24 1941; 767 – 772.
96. Marcovitch, H; (2005). Black’s Medical Dictionary 41st Edition. A&C Black, London. pg 117.
97. Kleinman, A; Good, B; (1985). Culture and Depression: Studies in the Anthropology and Cross Cultural Psychiatry of Affect and Disorder.
Los Angeles, CA, University of California Press.
cxxviii APPENDIX 1
PART 1
1. Occasionally, I experience heat sensation in my head
(Not at all) (very severe)
2. I do have peppery feeling in my head
(Not at all) (very severe)
3. I have a feeling as if water is flowing down my head
(Not at all) (very severe)
4. I feel as if worms or insects were crawling in my head
(Not at all) (very severe)
5. My head feels bigger than normal
(Not at all) (very severe)
6. Some spots in my head are so painful
(Not at all) (very severe)
7. I feel heaviness in my head
(Not at all) (very severe)
8. I have frequent headache
(Not at all) (very severe)
9. My eyes are painful
(Not at all) (very severe)
cxxix 10. I can no longer see properly
(Not at all) (very severe)
11. My eyelids are so heavy
(Not at all) (very severe)
12. I have heat sensation on my eyes
(Not at all) (very severe)
13. I have been feeling very dizzy
(Not at all) (very severe)
14. I have needle-like pinching in my head
(Not at all) (very severe)
15. The beating in my head is like that from a hammer
(Not at all) (very severe)
16. I have a feeling that something is blocking my throat
(Not at all) (very severe)
17. When I swallow something, it appears to travel very slowly down to the stomach
(Not at all) (very severe)
18. My shoulder is heavy
(Not at all) (very severe)
19. I have frequent backache
(Not at all) (very severe)
cxxx 20. I feel pain in my chest
(Not at all) (very severe)
21. I feel heat internally all over my body
(Not at all) (very severe)
22. I feel heat only in selected parts of my body
(Not at all) (very severe)
23. Sometimes, I have difficulty in breathing
(Not at all) (very severe)
24. Occasionally, my heart cuts
(Not at all) (very severe)
25. Frequently, my heart beats fast
(Not at all) (very severe)
26. I have biting feeling all over the body
(Not at all) (very severe)
27. I feel pains inside the bones of my hands and or legs
(Not at all) (very severe)
28. Often, I sweat very much without having done adequate physical exercise
(Not at all) (very severe)
29. I feel as if worms or insect were crawling in my body/skin
(Not at all) (very severe)
cxxxi
30. The thing that worries me is not steady, it moves to different parts of the body at will
(Not at all) (very severe)
31. My problems include shaking of my hands
(Not at all) (very severe)
32. I cannot sleep properly
(Not at all) (very severe)
33. I feel weakness in all parts of my body
(Not at all) (very severe)
34. Very often, my stomach turns and makes noise
(Not at all) (very severe)
35. I feel very light in my body
(Not at all) (very severe)
36. I don’t have erection at all/ sexual arousal in situations where I used to be sexually aroused.
(Not at all) (very severe)
37. I have very weak erection / sexual arousal
(Not at all) (very severe)
38. I experience Itching sensation in differently parts of my body.
(Not at all) (very severe)
39. I feel numbness in my body
(Not at all) (very severe)
cxxxii 40. I feel that I have lost weight
(Not at all) (very severe)
41. I feel very heavy weight pressing me down when ever I sleep
(Not at all) (very severe)
42. My problem is that I don’t have appetite to eat.
(Not at all) (very severe)
43. I have peppery sensations on my body
(Not at all) (very severe)
44. I feel pains all over my stomach
(Not at all) (very severe)
45. I feel pain in my neck
(Not at all) (very severe)
46. I feel biting sensation in my feet
(Not at all) (very severe)
47. I feel biting sensation in my chest
(Not at all) (very severe)
48. I feel something moving in my stomach
(Not at all) (very severe)
49. I have constant waist pain
(Not at all) (very severe)
cxxxiii 50. Often, my feet feel cold
(Not at all) (very severe)
51. I feel biting sensation in my head
(Not at all) (very severe)
52. I feel needle-like pinching in my hands/legs
(Not at all) (very severe)
53. I feel tightening sensation all over my body
(Not at all) (very severe)
54. I feel tightness only around my head
(Not at all) (very severe)
55. I feel needle-like pinching in the chest
(Not at all) (very severe)
56. I feel coldness in my brain
(Not at all) (very severe)
57. I feel that something is rolling inside my head
(Not at all) (very severe)
58. While walking, it appears as if I am not balanced
(Not at all) (very severe)
59. I feel pains all over my body
(Not at all) (very severe)
cxxxiv 60. I feel sensation of electric shock on my body
(Not at all) (very severe)
cxxxv PART 2
1. HOW OLD ARE YOU ? [………..years]
PLEASE TICK OR CIRCLE AS APPROPRIATE
2. SEX: [MALE] [FEMALE]
3. MARITAL STATUS: [Single] [Married and still live together]
[Married but separated]
[divorced]
[Widowed]
[Others…]
4. RELIGION: [Christianity] [Islam] [Others…]
5. HIGHEST EDUCATION QUALIFICATION:
[1] No Education [2] Primary Education [3] Secondary Education [4] Polytechnic Education [5] University Education
[6] Others (Please specify)………
6. WORK STATUS: [1] Student [2] Unemployed
[3] Self employed ……….(Please state employment) [4] Employed ……….. (Please state employed)
cxxxvi
APPENDIX 2
DETAIL STATISTICAL ANALYSIS OF TABLE 28 (RELATIONSHIP BETWEEN CLUSTER MEMBERSHIP AND SCAN DIAGNOSIS)
A. DEPRESSIVE DISORDERS.
Number with depression
Number without depression
Cluster 2 4 3
Non cluster 2 44 49
Statistics X2 = 0.252, Df = 1, P = 0.616 Number
with depression
Number without depression
Cluster 3 1 6
Non cluster 3 47 46
Statistics X2 = 3.43, Df = 1, P = 0.064 Number
with depression
Number without depression
Cluster 4 10 14
Non cluster 4 38 38
Statistics X2 = 0.507, Df = 1, P = 0.476 Number
with depression
Number without depression
Cluster 5 4 10
Non cluster 5 44 42
statistics X2 = 2.46, Df = 1, P = 0.117 Number
with depression
Number without depression
Cluster 6 13 2
Non cluster 6 35 50
Statistics X2 = 10.6, Df = 1, P = 0.001 Number
with depression
Number without depression
Cluster 1 7 5
Non cluster 1 41 47
Statistics X2 = 0.583, Df = 1, P = 0.445
cxxxvii Number
with depression
Number without depression
Cluster 7 2 3
Non cluster 7 46 49
Statistics X2 = 0.135, Df = 1, P = 0.713
Number with depression
Number without depression
Cluster Nil 7 9
Non cluster Nil 41 43 Statistics X2 = 0.138, Df = 1, P =
0.710
B. ANXIETY DISORDERS Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 1 1 11
Non cluster 1 20 68
Statistics X2 = 1.319, Df = 1, P = 0.251 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 2 2 5
Non cluster 2 19 74
Statistics X2 = 0.260, Df = 1, P = 0.610 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 3 1 6
Non cluster 3 20 73
Statistics X2 = 0.205, Df = 1, P = 0.651 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 4 1 23
Non cluster 4 20 56
Statistics X2 = 5.394, Df = 1, P = 0.020 Number
with
Number without
cxxxviii Anxiety D/O Anxiety D/O
Cluster 5 8 6
Non cluster 5 13 73
statistics X2 = 12.818, Df = 1, P = 0.000 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 6 1 14
Non cluster 6 20 65
statistics X2 = 2.185, Df = 1, P = 0.139 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster 7 3 2
Non cluster 7 18 77
statistics X2 = 4.825, Df = 1, P = 0.028 Number
with Anxiety D/O
Number without Anxiety D/O
Cluster Nil 4 12
Non cluster Nil 17 67
statistics X2 = 0.184, Df = 1, P = 0.668
C. SOMATOFORM DISORDER.
Number with Soma.
D/O
Number without Soma. D/O
Cluster 1 3 9
Non cluster 1 7 81
statistics X2 = 3.409, Df = 1, P = 0.065 Number
with Soma.
D/O
Number without Soma. D/O
Cluster 2 0 7
Non cluster 2 10 83
statistics X2 = 0.836, Df = 1, P = 0.360
Number with Soma.
D/O
Number without Soma. D/O