Functional status and its associated factors in Nigerian adults with serious mental illnesses

Abstract

Patients with serious mental illness may be less likely to achieve functional goals than the general population. Assessment of the functional impact of the illness is useful to determine severity of illness, evaluate remission, and achieve optimal treatment success. The aims of this study are to determine and compare the prevalence of low functional status among outpatients with major axis 1 psychiatric disorders, assess the risk factors for low functional status, and determine the proportion of the variance in low functional status explained by low self-esteem and non-adherence to medication. A descriptive cross-sectional study was conducted among 308 outpatients of the psychiatric unit of a tertiary hospital. The Global Assessment of Functions (GAF), Morisky Medication Adherence Scale (MMAS-8) and the Rosenberg's Self-esteem Scale were used to collect data, which were analyzed using version 20 of SPSS. Level of statistical significance was set at 5% (P< 0.05). The overall prevalence of low functional status was 40.6%. Patients with schizophrenia had the highest prevalence of low functional status (53.4%). Educational attainment, employment status, self-esteem, medication adherence, and comorbidity had significant association with functional status. Poor medication adherence had the largest relative contribution (35.4%) to the variance in functional status, while self-esteem had an insignificant relative contribution of 3.4%. An appreciable proportion of the patients in this study had low functional status with more schizophrenic patients having impairment than patients with mood disorders. Poor medication adherence, among other variables, contributes significantly to low functional status. Physicians should give as much attention to functional recovery as they give to symptom resolution in the management of psychiatric patients.

Prevalence of Functional Disability and Associated Factors Among the Patients With Schizophrenia Attending Psychiatry Outpatient Clinics at Muhimbili National Hospital, Dar Es Salaam, Tanzania. Cross-sectional Survey

“…In western countries, the prevalence of functional disability among patients with schizophrenia is heterogeneous and it ranges between 20-54% according single country based researches and multinational studies (20,(22)(23). In sub-Saharan countries the prevalence of functional disability among patients with schizophrenia is higher compared to western countries and it ranges between 30-78%, lowest to highest in Ethiopia and Nigeria respectively (7,9,(24)(25)(26). The Tanzania disability reports (2008) shows that the mental illnesses is among the causes of disability in Tanzania, with the overall disability been 5.9 to 7.8% with higher prepotency in men and young age, however no speci c mental illness is mentioned (29).…”