Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

Mpango, Richard; Ssembajjwe, Wilber; Rukundo, Godfrey Zari; Birungi, Caroline; Kalungi, Allan; Gadow, Kenneth D.; Patel, Vikram; Nyirenda, Moffat; Kinyanda, Eugene

doi:10.1007/s00406-022-01478-6

Cited by 7 publications

(6 citation statements)

References 72 publications

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“…This study established that risky sexual behaviors (aOR 2.19 95%CI 1.66-2.90; p < 0.001) were associated with physical victimization; relatedly, previous studies established that risky sexual behaviors (RSBs) are common among people with SMI (9,12). Patients in the acute phase of severe mental illness are more likely to practice RSBs, largely associated with the general impairment of reality testing and judgment common among this population (12,55); since some people with SMI (acutely ill patients) display disturbed behavior which evokes hostile reactions, attempts to control such patients often leads to conflict and physical victimization (23); thus a possible association between RSBs and physical victimization. Risky sexual behaviors were found to be associated with sexual victimization; findings from this study relate to a previous study which suggested a complex link between childhood sexual abuse and adult risky sexual behaviors among persons with SMI (61).…”

Section: Association Between Physical and Sexual Victimization With N...mentioning

confidence: 73%

“…People with severe mental illness are victims of physical and sexual abuse. The age group of > = 50 years was more likely to have suffered physical victimization; living in a rural area was protective against physical and sexual victimization; high socioeconomic status (SES) was protective against physical victimization; socioeconomic status (SES) refers to a person’s economic and social position in relation to others, based on income, education, and occupation ( 78 ), including possession of commonly available household items/resources ( 12 , 18 ). Females were more likely to have been sexually victimized; being a Muslim was protective against sexual victimization.…”

Section: Discussionmentioning

confidence: 99%

“…This is a cross-sectional analysis from the longitudinal study entitled, ‘ HIV clinical trials preparedness studies among patients with severe mental illness in HIV endemic Uganda-the SMILE Study ’ ( 12 , 13 ). Baseline recruitment included 1,201 individuals with severe mental illness (SMI) who were enrolled from the out-patient departments of Butabika National Referral Mental Hospital (urban central) and the Department of Psychiatry, Masaka Regional Referral Hospital (rural southwestern) Uganda between January–March 2018.…”

Section: Methodsmentioning

confidence: 99%

“…SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. The variables reported in this paper were organized under the sub-headings based upon the conceptual framework developed by the ‘SMILE study team’ ( Figure 1 ) ( 12 , 13 ): (i) socio-demographic factors (study site, gender, age category, religion, socio-economic status, and marital status), (ii) psychosocial factors (social support, mental health stigma, childhood physical victimization, childhood sexual victimization, physical victimization in adulthood and sexual victimization in adulthood), (iii) psychiatric illness factors (family history of psychiatric illness, past depressive episode, past manic episode, past psychotic episode, lifetime suicide attempt), (iv) psychotropic drugs (Antiparkinsonian medication, mood stabilizers, 1st generation neuroleptics, 2nd generation neuroleptics, tri-cyclic anti-depressants, selective serotonin reuptake Inhibitors) and (v) maladaptive behaviors (alcohol use, use of tobacco, alcohol drinking problem, use of marijuana or use of khat).…”

Section: Methodsmentioning

confidence: 99%

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Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda

Mpango,

Ssembajjwe,

Rukundo

et al. 2023

Front. Public Health

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PurposeThis study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.MethodsParticipants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.ResultsThe prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62–1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46–0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35–0.65; p < 0.001) victimization. High socioeconomic status (SES) (aOR 0.56; 95% CI 0.34–0.92; p = <0.001) was protective against physical victimization. Females were more likely to have been sexually victimized (aOR 3.38; 95% CI 2.47–4.64; p = <0.001), while being a Muslim (aOR 0.60; 95% CI 0.39–0.90; p = 0.045) was protective against sexual victimization. Risky sexual behavior was a negative outcome associated with physical (aOR 2.19; 95% CI 1.66–2.90; p = <0.001) and sexual (aOR 3.09; 95% CI 2.25–4.23; p < 0.001) victimization. Mental health stigma was a negative outcome associated with physical (aOR 1.03; 95% CI 1.01–1.05; p < 0.001) and sexual (aOR 1.03; 95% CI 1.01–1.05; p = 0.002) victimization. Poor adherence to oral anti-psychotic medications was a negative outcome associated with physical (aOR 1.51; 95% CI 1.13–2.00; p = 0.006) and sexual (aOR 1.39; 95% CI 0.99–1.94; p = 0.044) victimization.ConclusionThere is a high burden of physical and sexual victimization among people with SMI in central Uganda. There is need to put in place and evaluate complex interventions for improving detection and response to abusive experiences within mental health services. Public health practitioners, policymakers, and legislators should act to protect the health and rights of people with SMI in resource poor settings.

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Section: Association Between Physical and Sexual Victimization With N...mentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda

Mpango,

Ssembajjwe,

Rukundo

et al. 2023

Front. Public Health

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“…The hospital offers inpatient and outpatient care, community outreach programs, counseling, and rehabilitation services [22]. The institution is facing di culties such as a lack of nancing and a scarcity of mental health personnel [23].…”

Section: Background On Ugandan Mental Health Systemmentioning

confidence: 99%

Voices from the Ground: Ethnographic Perspectives on Strengthening the Ugandan National Mental Health System: An Ethnographic Needs Assessment

Dwanyen,

Luberenga,

Asiimwe

et al. 2024

Preprint

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Background Mental health capacity building is a critical need and a growing priority in Ugandan health and education systems. Despite increased governmental attention to community mental health and mental healthcare needs, no published assessments garner qualitative perspectives directly from stakeholders in the Ugandan mental health system. Addressing this gap, the goal of the current needs assessment study was to systematically explore stakeholders’ perceptions of strengths, challenges, and recommendations for enhancing capacity in the national mental health system in Uganda. Methods Using qualitative ethnographic methods, data was collected from key informants through interviews and focus groups. A total of 44 stakeholders, who were engaged in the mental health system, were included in our final sample. Results Thematic analyses of data yielded several themes in each category, including system strengths related to existing policy and action plan, free medications, private sector, partnerships and collaborations; system challenges including socioeconomic constraints, stigma, and limited family engagement; and recommendations for improvement including enhanced education and training, integrating systemic approaches, and policy advocacy. Conclusion The results of this study have clinical, research, and policy implications that may inform mental health capacity, not only in Uganda, but in other global settings, advancing capacity to respond to pressing community mental health needs.

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Mental Health and SDG3.3, 3d, 3.4 and 3.5

Mphande

2023

Sustainable Development Goals Series

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Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

Cited by 7 publications

References 72 publications

Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda

Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda

Voices from the Ground: Ethnographic Perspectives on Strengthening the Ugandan National Mental Health System: An Ethnographic Needs Assessment

Mental Health and SDG3.3, 3d, 3.4 and 3.5

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