Psychiatric morbidity and related factors in the rehabilitation process of paraplegics at the National Spinal Injury Hospital in Nairobi, Kenya
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Date
2005Author
Kaguchia, Solomon K
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Many studies in the Western world have reported a high association
between paraplegia and psychiatric morbidity. Some complications of paraplegia and
characteristics of patients have been associated with psychiatric morbidity. No study in
this field has been done in Kenya.
The study was conducted at the National Spinal Injury Hospital in Nairobi,
Kenya.
O To establish the magnitude of psychiatric morbidity among paraplegics and to
assess association with socio-demographic characteristics, mode of injury, therapeutic
adherence and physical complications.
This was a descriptive cross sectional study.
All paraplegics undergoing rehabilitation at the National Spinal Injury
Hospital.
One hundred and twenty patients seen between the months of December 2003
and May 2004 met the study criteria and were recruited for the study. Paraplegic
complications and adherence to therapy were determined through examination and
reference to clinical notes. A socio-demographic data and treatment questionnaire was
administered followed by a standard psychiatric interview and diagnosis made using
DSM IV-TR criteria.
Physical complications of paraplegia, level of adherence to
therapy, and psychiatric morbidity.
Out of the 135 patients seen over a six-month period, 128 patients consented to
participate in the study. A large proportion of patients (70%) were below the age of 39
years. Road Traffic Accidents was the leading event causing injuries with most victims
being passengers. Seventy-two patients (56.25%) were diagnosed with psychiatric
disorder. Posttraumatic stress disorder was diagnosed in 23.4% of the subjects and was
the leading psychiatric complication. Others were depression (17.2%), alcohol
dependence (1.6%), generalized anxiety disorder (5%), cannabis abuse (8%) and
somatization disorder in 7.5% of the patients. Variables significantly associated with
psychiatric morbidity were female gender, relatively young age, non-adherence to
therapy,single or divorced and presence of physical complications.
Conclusions: In the paraplegic population studied, a majority of patients had psychiatric
morbidity.However, this co-morbidity was neither documented nor included in the
management plan.
Trauma and rehabilitation specialists dealing with paraplegics should
identify and treat co-existing psychopathology and evaluation for psychiatric
complications should be included in their rehabilitation and treatment algorithm.
Citation
Masters of Medicine (Psychiatry)Publisher
University of Nairobi School of Medicine