Prevalence of severe mental distress and its correlates in a population-based study in rural south-west Uganda

BACKGROUND: The problem of severe mental distress (SMD) in sub-Saharan Africa is difficult to investigate given that a substantial proportion of patients with SMD never access formal health care.This study set out to investigate SMD and it's associated factors in a rural population-based cohort in south-west Uganda. METHODS: 6,663 respondents aged 13 years and above in a general population cohort in southwestern Uganda were screened for probable SMD and possible associated factors. RESULTS: 0.9% screened positive for probable SMD. The factors significantly associated with SMD included older age, male sex, low socio-economic status, being a current smoker, having multiple or no sexual partners in the past year, reported epilepsy and consulting a traditional healer. CONCLUSION: SMD in this study was associated with both socio-demographic and behavioural factors. The association between SMD and high risk sexual behaviour calls for the integration of HIV prevention in mental health care programmes in high HIV prevalence settings

Consultation liaison psychiatry at Kenyatta National Hospital, Nairobi

Objectives: To describe the psychiatric services offered at Kenyatta National Hospital and the types of patients and cases seen at Kenyatta National Hospital. Design: A retrospective study based on case notes and other hospital records. Setting: Kenyatta National Hospital, Nairobi, Kenya Subjects: All patients seen in the various psychiatric clinics and those who attended the Patient Support Centre Unit in the hospital in the year 2002. Results: In the year 2002, 598,119 patients were treated at KNH out of which 6,878 (1.15%) were seen in the psychiatric clinics: 1,709 adults and 1,412 children were referred to the various psychiatric clinics. At the hospital's Patient Support Centre (PSC) 3,454 patients were seen, mostly for pre and post-HIV test counselling. Consultations from the wards accounted for 332 (9.6%) of the cases referred to PSC. The main diagnoses among the latter in order of frequency were alcohol related psychiatric disorders, acute and transient psychoses, depressive disorders, dissociative and conversion disorders and dementia. Conclusion: In view of the high load of acute and transient psychotic states, as well as substance related disorders, it is recommended that the hospital should establish acute wards for the comprehensive management of such patients. An alcohol and drug detoxification and rehabilitation centre should also be developed at the hospital. Services to those with HIV related disorders should also be improved. East African Medical Journal Vol.82(2) 2005: 80-8