Patterns of psychiatric morbidity among first time referred adult patients attending treatment at Mathari National, Teaching and Referral Hospital Nairobi-Kenya

Abstract

Psychiatric disorders are prevalent in the community and their burden is large compared with other illnesses as they occur early in life and are chronic. Timely and accurate diagnosis of mental illness and appropriate referral is critical in the management of these illnesses. The main objective of this study was to determine the patterns of psychiatric morbidities and sources of referral amongst first time adult patients attending treatment at MNTRH. The sample size obtained was 424 and the respondents were carefully chosen using purposive sampling method. Data collection was through a socio-demographic questionnaire and MINI v7.0.Ethical considerations were adhered to. Data entry and analysis was by SPSS v23.Data from 434 questionnaires was deemed fit for analysis with a response rate of 102%.Majority of the participants were males (63.4%), with a median age of 30 years. Most were single (58.1%) with secondary education (40.6%) unemployed (37.3%) with an income below 5,000(49.8%).Most were seen at outpatient (92.4%), referred by general public (72.6%) Referrals from other health facilities constituted 15.9%. The three most prevalent psychiatric morbidities were psychotic disorders(22.7%),substance use disorder(15.2%) and Mixed alcohol and substance use disorder(13.1%).11.3% of the respondents had more than 1 diagnosis and the most prevalent comorbidity was substance use disorder(non-alcohol) at 30.6%. Psychotic disorders had a significant association with sex, education level and income, while substance use disorder showed a significant association with age, sex, marital status, occupation and income. Barriers to accessing mental health services at the primary health level needs to be evaluated and appropriate measures put in place to overcome them.