Patterns of Psychiatric Morbidity Among Elderly Inpatients in Non-psychiatric Wards at Kenyatta National Hospital, Kenya

Abstract

Introduction The population of Kenya’s elderly people is fast increasing just like the rest of the world with an estimated 2.6 million in 2020 and this number is likely to exceed 3 million by 2030. Mental illnesses have also become the third cause of morbidity after cancer and cardiovascular diseases. Due to age-related vulnerabilities and losses, psychiatric illnesses among the elderly is multiform and can negatively affect the general outcome of persons admitted with physical illnesses. Studies conducted on the burden of psychiatric illnesses among elderly inpatients have shown that almost half of the elderly patients in general hospitals present psychiatric comorbidities which are often unrecognized by non-psychiatric doctors. There is also a scarcity of research done on mental illnesses among the elderly in Kenya. Aim: To determine the patterns of psychiatric morbidity among elderly patients admitted in non-psychiatric wards in Kenyatta National Hospital, Kenya. Method: This was a cross-sectional analytic study where data was collected from 270 elderly inpatients. A consecutive sampling of all elderly patients admitted to KNH was done for two months. The socio-demographic questionnaire and the Mini International Neuropsychiatric Interview (MINI) version 7.0.0 were used to collect data. Data Analysis: Univariate analysis was conducted to show the prevalence of mental illnesses and the social and biological aspects of participants. Bivariate and multivariate analysis were done showing the correlation between socio-demographic, bio-psychological characteristics, and psychiatric morbidity. Statistical significance threshold was set at p < 0.05. SPSS version 21 was xv used for data analysis while narratives, tables, charts, and graphs were used to present the study findings. Results: This study found that psychiatric morbidity among elderly inpatients in KNH, Kenya was 38.5% and that the most prevalent psychiatric illness among them is depression (25.9%) followed by Alcohol Use Disorder (9.3%) and anxiety disorders (5.2%). The majority (55.8%) of those illnesses are moderate as what concern their severity and around a third (33.6%) of elderly inpatients in KNH were found with more than one psychiatric illness. Personal history of mental illness and history of adverse life events in the past year are significantly associated with overall psychiatric morbidity among elderly inpatients Moreover, it was found that elderly inpatients of the female gender have a lesser risk for AUD than their male counterpart but has a greater risk for GAD. Oldest elders (more than 80 years) have an increased risk of developing GAD than young elders (60-69 years). Finally, it was discovered that elderly admitted with a single physical illness had 2.5 times more chances of presenting MDD than elderly inpatients diagnosed with multiple physical illnesses. Conclusion: The findings from this research have added to the pool of knowledge on the burden of mental illnesses among elderly patients admitted to general hospitals. It will be an informative tool for non-psychiatric doctors because it will help them to understand the prevalence of psychiatric morbidity among patients admitted to general wards. It will also be used as a bargaining tool for the psychiatric department of Kenyatta National Hospital to request a specialized old-age psychiatric clinic