Abstract
Hospital based studies for psychotic disorders are scarce in low and middle income countries. This may impact on development of intervention programs. We aimed to determine the burden of psychotic disorders among first treatment contact patients at the national psychiatric referral hospital in Uganda. 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. 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)]. Among first treatment contact patients in Uganda, there is a large burden of psychotic disorders. The burden was more prevalent among females as well as people of Pentecostal faith who seemed to use their church for faith-based healing. Incidence studies are warranted to determine if this phenomenon is replicated at illness onset.
Highlights
Hospital based studies for psychotic disorders are scarce in low and middle income countries
At bi-variate analysis, psychotic disorders were found to be more prevalent among the female gender [Prevalence ratio (PR) 1.54] as well as patients who reported to subscribe to the Catholic [PR 1.13 (CI 1.01-1.26)] or Pentecostal faiths [PR 1.36 (CI 1.19-1.54)]
Mental health service requirements for patients with psychotic disorders: Over twothirds (67%) of all admissions presenting to the hospital for the first time in 2018 had a psychotic disorder
Summary
Hospital based studies for psychotic disorders are scarce in low and middle income countries. This may impact on development of intervention programs. Psychotic disorders run a chronic course in the life of an individual. They usually present in early adolescence with a first episode of psychosis; and continue with some form of disability thorough out the life of the individual [6]. Correct management at initial presentation of psychotic disorders has been associated with lower relapse rates, greater functional recovery and improved quality of life [13, 14]
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