Pattern of Presentation and Diagnostic Profile of Patients Attending a Mental Health Facility in North-Central Nigeria

Abstract

Despite significant advances in the diagnoses and treatment of mental illnesses, it remains shrouded in mystery, myth, and superstition particularly in sub-Saharan Africa. This is often reflected in delayed presentations, frequent relapse and non-treatment, with dire consequences on affected individuals, family, and society. The aim of this study was to evaluate the pattern of presentation and diagnoses of psychiatric illness among attendees of a psychiatric facility in a tertiary hospital in North-Central Nigeria. This was a descriptive, explorative, cross-sectional study. A pro forma was designed to obtain information about patients’ socio-demographic variables, diagnoses, duration of untreated illness, GAF Score and other clinical data, from case files, spanning over a three year period. A total of 720 case files were analyzed with 54% of the patients being male. Only 66(9.2%) comprised of children and adolescents with 83% making up the adult population and 7.5% being elderly (60 years and above). While 129(17.9%) were employed (government and self), most (88%) of the patients reside within the state. Only 12.2% were clinically stable at 6 months follow-up assessment even though most (79.3%) of the patients had absconded at 6months follow-up. Mean duration of untreated illness was 117.5 weeks (SD±226.3) (approximately 2.3years) with Psychotic disorders predominating 355(41.8%). Only 13.4% were diagnosed with depression and 0.6 % mental retardation. Mean GAF score at presentation was 43.23(SD±14.87), a reflection of illness severity at presentation. Mental illness is a common occurrence, however, the majority of patients only present when symptoms become severe or when patients become disruptive. Mental disorders of childhood and old age are particularly underrepresented, underscoring the need for more public enlightenment programs that are geared towards detection, early presentation, treatment and stigma reduction.