Prevalence of Psychiatric Disorders among Elderly In-Patients in Non-Psychiatric Wards of a Teaching Hospital in Northern Nigeria

M A Amedu,A J Yusuf,O Baiyewu

doi:10.46912/jbrcp.77

Abstract

The population of the elderly is increasing globally with enormous challenges particularly in developing countries. Aging increases the risk for both physical and psychiatric disorders with psychiatric disorders often unrecognized in non-psychiatric settings. This presents huge costs to both patient and society. The study aimed at estimating the rate of psychiatric morbidity in non-psychiatric wards of a tertiary hospital in Northern Nigeria. One hundred and forty (140) subjects were recruited into this cross-sectional descriptive study. Participants were initially screened using the Self Reporting Questionnaire (SRQ) and the Modified Mini-Mental State Examination (MMSE) after administering the Socio-demographic questionnaire. Subjects scoring >5 in the SRQ and or ≤13 in the Modified MMSE were then further interviewed using the Geriatric Mental State Schedule (GMS). Clinical Psychiatric diagnosis was also made based on ICD-10 diagnostic criteria from all information available and later compared with GMS diagnoses. Mean age of participants was 67.5, SD ±6.4. The rate of psychiatric morbidity using ICD-10 diagnosis was 47.9% with depression being the commonest disorder (18.6%) followed by delirium (17.1%) and dementia (10.7%). Depression and anxiety disorders were particularly under-recognized by non-psychiatric doctors. Identified risk factors for psychiatric morbidity included female gender, low socioeconomic status, low educational level and presence of multiple medical diagnoses. The rate of psychiatric morbidity among elderly in-patients in non-psychiatric settings has remained high in comparison to previous studies with huge gaps in recognition and treatment reflecting the need for more collaboration between medical teams.

Highlights

Advances in technology, medical care, new drugs and improvement in living conditions is producing an increase in the population of older adults globally, thereby altering the scope and depth of clinical practice.[1,2] Demographic forecasts predict that by 2030, one person in five will be over the age of 65..3 Already, projections have shown that by 2020, the population of those aged 65 and older will outnumber children younger than 5 years.[4]
Studies have suggested that standardized psychiatric instruments developed in the western world to detect psychiatric symptoms may potentially ignore culture specific idioms of distress when used in non-western African cultures and J
Studies have shown a male preponderance in most medical and surgical wards, and psychiatric wards.[14,15]. This has been attributed to the tendency in Nigeria and many developing countries for male patients to be taken to the hospital so that they can quickly resume their socio-economic functions as bread winners in the family.[15]

Summary

Introduction

Medical care, new drugs and improvement in living conditions is producing an increase in the population of older adults globally, thereby altering the scope and depth of clinical practice.[1,2] Demographic forecasts predict that by 2030, one person in five will be over the age of 65..3 Already, projections have shown that by 2020, the population of those aged 65 and older will outnumber children younger than 5 years.[4]. Projections have shown that by 2020, the population of those aged 65 and older will outnumber children younger than 5 years.[4] This rise in ageing of population will be pronounced in developing countries. The World Health report of 2003 estimated that by the year 2020 the population of the elderly will reach an alarming figure of 1.2 billion with majority of them living in the developing countries which are experiencing rapid shifts from high mortality and high fertility to much reduced fertility and greater longevity.[5,6] Nigeria is witnessing this demographic shift as reflected in the government vital document of economic and social development strategy.[7] The elderly are vulnerable to illnesses, psychiatric illness.

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Results

Discussion

Conclusion