Psychotic Symptoms in Kenya – Prevalence, Risk Factors, and Relationship with Common Mental Disorders

Abstract

There have been few epidemiological surveys to establish prevalence and associated risk factors of psychosis in Sub-Saharan Africa. This paper reports a population- based epidemiological survey in rural Kenya of the prevalence of psychotic symptoms and their relationship with demographic, socio-economic and other risk factors. A random sample of 2% of all adults living in Maseno, Kisumu District of Nyanza province, Kenya (50,000 population) were studied, aiming for a sample size of 1,000 people. The psychosis screening questionnaire was used to assess the prevalence of psychotic symptoms in the preceding twelve months. The response rate was 87.6%. The prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms in this sample size. Psychotic symptoms were evenly distributed across this relatively poor rural population and were significantly associated with presence of common mental disorders, and to a lesser extent with poor physical health and housing type. We conclude that single psychotic symptoms are relatively common in rural Kenya and rates are elevated in those with CMD, poor physical health and poor housing.

Adult Psychotic Symptoms, Their Associated Risk Factors and Changes in Prevalence in Men and Women Over a Decade in a Poor Rural District of Kenya

“…Psychotic symptoms were assessed with the Psychosis Screening Questionnaire (PSQ) [ 22 ], which has also been used previously in Tanzania [ 23 ] and Kenya [ 7 ]. The PSQ assessed the past year presence of psychotic symptoms.…”

“…Three main methods have been used to conduct surveys of psychosis: firstly using clinician administered instruments [ 3 ] which can establish both psychotic symptom severity and diagnostic category; secondly using family reports [ 4 ]; and thirdly using systematic assessment of psychotic symptoms by detailed interviews administered by non-medical interviewers, leading to enumeration of symptom frequency and severity, and estimates of probable psychosis [ 5 , 6 , 7 ].…”

“…Repeat epidemiological surveys using different samples drawn from the same sample frame at different time points are useful to establish trends in prevalence over time. This paper reports the prevalence of psychotic symptoms and their risk factors in a survey of a new sample drawn in 2013 from the same sample frame as that used for the first epidemiological household study of psychotic symptoms in the same area of Kenya a decade earlier in 2004 [ 7 ].…”

Perspectives and concerns of clients at primary health care facilities involved in evaluation of a national mental health training programme for primary care in Kenya

“…This previous work includes: a detailed situation appraisal of context, needs, resources, provision and outcomes using the mental health country profile [8]; a household survey exploring the conceptual model underlying the views of the general population about mental illness [9]; a focus group study of 60 traditional healers in Maseno District exploring their views of mental illness, aetiology and treatment [10]; a national survey of views of district level staff about mental illness [11]; studies in Tanzania and Kenya of attitudes of primary care staff about mental illness [12,13]; epidemiological surveys of mental disorders in two samples of 1000 people in urban Dar es Salaam, Tanzania [14-16], and in Maseno, a town in a rural district near Kisumu [17,18]; and adaptation of the World Health Organization primary care guidelines for Kenya and Tanzania.…”

Cost-effectiveness of the Mental Health and Development model for schizophrenia-spectrum and bipolar disorders in rural Kenya

“…In Kenya 0.6% of the population report symptoms of psychosis (Jenkins et al, 2012). If symptoms translate to a diagnosis, then approximately 230,000 Kenyans are affected by psychosis.…”