One year prevalence of psychotic disorders among first treatment contact patients at the National Psychiatric Referral and Teaching Hospital in Uganda

Abstract

Introduction Hospital based studies for psychotic disorders are scarce in low and middle income countries. This may impact on development of intervention programs. Objective We aimed to determine the burden of psychotic disorders among first treatment contact patients at the national psychiatric referral hospital in Uganda. Methods A retrospective patient chart-file review was carried out in March 2019 for all patients presenting to the hospital for the first time in the previous year. Patients were categorised into those with and without psychotic disorders. We collected sociodemographic data on age, gender, occupation, level of education, ethnicity, religion and home district. We determined the one year prevalence of psychotic disorders among first treatment contact patients. Using logistic regression models, we also determined the association between psychotic disorders and various exposure variables among first treatment contact patients. Results In 2018, 63% (95% CI: 60.2-65.1) of all first time contact patients had a psychosis related diagnosis. Among the patients with psychotic disorders, the median age was 29 years (IQR 24-36). Most of the patients were male (62.8%) and unemployed (63.1%). After adjusting for patients' residence, psychotic disorders were found to be more prevalent among the female gender [OR 1.58 (CI1.46-1.72)] and those of Pentecostal faith [OR 1.25 (CI 1.10-1.42)].

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

“…These services are unfortunately still of poor quality at Butabika hospital as there are a limited number of therapists employed by the hospital. 19 This may be because of human resource and financing limitations which are common in low resource settings like Uganda. 26 , 33 , 34 , 35 The lack of patients being supported in employment is because of the general lack of social support services in Uganda.…”

“…There are specialised clinics for addiction, child and adolescent mental health, occupational therapy and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) mental health. Although psychotic disorders are the most common disorders at Butabika Hospital, 19 there are currently no SEIS for psychotic disorders.…”

“…It is however unclear if the individual and group level interventions provided are of the prerequisite quality. Given that the largest mental illness burden in this setting is for psychotic disorders, 19 the interventions that have the biggest impact on patient outcomes must be provided with the utmost quality.…”

A Systematic Review of Brief Neuropsychological Tests in Use Among Patients With Psychotic Disorders in Low and Middle Income Countries.

“…While the brevity of such neuropsychological assessments is an advantage (Green et al, 2004, Ayres et al, 2007, Ngoma et al, 2010 (Green et al, 2004, Ayres et al, 2007, Ngoma et al, 2010, Mugisha et al, 2017. (Mwesiga et al, 2020). (Nuechterlein et al, 2008), their validity is unclear.…”

The COVID-19 pandemic has reinforced the need for community mental health-care models in Uganda

“…Between Jan 1 and Dec 31, 2018, the bed occupancy rate of Butabika Hospital was 149%. 2 Even with such a high demand for beds in Butabika Hospital, lower level regional psychiatric units were converted into isolation units for COVID-19. 3…”