Prevalence and associated factors of axis I psychiatric disorders presenting at the accident and emergency department of Mulago hospital

Abstract

Title; Prevalence and factors associated with axis 1 psychiatric disorders presenting at the A&ED, Mulago Hospital, Kampala, Uganda.

Introduction Psychiatric disorders are a major public health problem and often present at the A&ED of hospitals. However, no studies have been done on the prevalence, types and associations of mental disorders as they present in the A&ED in Ugandan hospitals.

Objectives The aim of the study was to establish the prevalence and factors associated with DSM IV Axis 1 psychiatric disorders among patients attending the A& ED of Mulago Hospital, Kampala, Uganda.

Methods This was a cross- sectional study carried out at Mulago Hospital A&ED. The Self Reporting Questionnaire-25(SRQ-25) was used to measure significant psychological distress were administered to a total of 316 patients and those participants who scored 6 and above were then administered the Mini International Neuropsychiatric Interview (M.I.N.I) to make the psychiatric diagnosis. Data was analyzed using SPSS version 16.0.

Results. Males and Females were in equal proportions at a ratio of 1:1.3. Mean age of participants was 42.1 years (SD = 18.25). Of the 316 participants interviewed, 113 (35.8%) had significant psychological distress and 49 (15.5%) had a diagnosable Axis 1 disorder. The leading Axis1 disorders were, affective disorders (27.4%), Substance misuse (13.3%), somatoform disorders (11.5%), Suicidality (8.9%) and anxiety disorders at (8.0%). Being on medical ward was associated with psychological distress and being male and education level of secondary or tertiary were associated with substance use disorders

Conclusion. There is high prevalence of Axis1 psychiatric disorders at the A&ED. Depression, suicidal behavior and alcohol misuse disorders are the commonest Axis 1 diagnoses and ward of admission, sex and education levels being associated factors. This implies that proper assessment and management is needed to improve A&ED psychiatric service. There is also need for further studies on psychiatric co morbidity in medical disorders.