Psychiatric disorders among adult in-patients on medical and surgical wards in Mbarara regional referral hospital

Abstract

INTRODUCTION: Mental illness is a global health burden that remains poorly understood even by health care providers. It is important that all health care workers and stakeholders know about psychiatric disorders in terms of their presentation and management. However, there is limited information on psychiatric disorders on medical ans surgical wards especially in developing countries including Uganda. Research in developed countries has shown that knowledge of psychiatric disorders on the general wards would help the medical workers on these wards to regularly screen for mental illness in their patients and give appropriate management. OBJECTIVE: This study aimed to determine the prevalence, types and associations of psychiatric disorders as seen among admitted adult in-patients on medical and surgical wards of Mbarara regional referral hospital as a protype regional referral hospital. METHODOLOGY: This was a cross-sectional descriptive study using standardized questionnaires including a socio-demographic questionnaire (SDQ). The self report questionnaire. SRQ -25 , as a screening instrument for phychological distress and the MINI as the diagnostic instrument based on ICD 10 and DSM IV criteria. The MINI was administered to all patients scoring 6 or more on the SRQ-25. Two hundred fifty eight (258) participants were recruited. RESULTS: Of the 258 participants, 157 (60.9%) scored 6 or more on the SRQ-25 and 102 (42.2%) met the criteria for DSM IV for psychiatric diagnosis, psychological distress was significantly associated with being widowed or separated (p=0.003), ward for admission (0.000, odd’s ratio 0.283), physical illness (p= 0.0006), previous admission (p=0.02), past history of psychiatric disorder (p=0.049), only 6% of all psychiatrically diagnosed patients were recognized by their treating doctors as having mental illness and only 2.8% were referred for treatment. CONCLUSION: There was a high prevalence of psychiatric disorders of the general medical and surgical wards of mbarara regional referral hospital and over 90% were not recognized by staff on these wards. Depression and anxiety were the most common psychiatric disorders and they presented associated with somatic physical illnesses leading to hidden psychiatric morbidity. psychiatric morbidity often complicates physical illness and may lead to prescription of many drugs. It is concluded that psychiatric services shouldbe established on the general wards at the regional referral hospitals.