Psychiatric disorders of old age in Enugu, Nigeria. Sociodemographic and clinical characteristics.

Abstract

A retrospective study of the demographic and clinical characteristics of 73 consecutive patients aged 60 years and over admitted for the first time into a psychiatric hospital in Nigeria shows that they constituted about 5% of all admissions over a 2-year period. While the majority (58%) were aged below 70 years, 8% were aged over 80 years, with more females than males living to the older age groups. Single status, separation and divorce were more common among males; widowhood was more common among the females. A high illiteracy rate of 86% was recorded, with more males than females being literate. More than 84% belonged to the 2 lowest socioeconomic classes. There was a significant difference in the distribution of diagnostic categories, with senile dementia, affective psychosis, neurotic disorders and paranoid states more common among the females, while arteriosclerotic dementia and schizophrenia were diagnosed more often among the males. Functional psychosis (49%) was the largest diagnostic category, followed by organic psychosis (30%), while neurotic disorders (10%) ranked third. Within the functional psychoses, paranoid states (30%) predominated, followed by affective disorders (14%) consisting mainly of depressive symptoms; 6% presented with schizophrenic illness; and 11% presented with physical illness with associated psychiatric manifestations. There was a long delay before referral to hospital, associated with use of alternative medical facilities (traditional and spiritual healers). The probable sociocultural antecedents and medical and social implications of these findings are discussed.