Comparison of clinical profiles and treatment outcomes between vagrant and non-vagrant mentally ill patients in a specialist neuropsychiatric hospital in Nigeria

Abstract

Objective: Vagrant mentally ill patients are a highly marginalized group that receive limited care and attention from society. There is a dearth of information on the clinical status of this group in low-income countries. The aim of this study was to compare the clinical profiles and treatment outcomes between vagrant and non-vagrant mentally ill patients admitted to Aro Psychiatric Hospital, Abeokuta, Nigeria. Method: We conducted a retrospective review of clinical records charting vagrant and non-vagrant mentally ill patients treated over a five year period from January 2004 to December 2008. Results: The medical records of 61 vagrant and 122 non-vagrant mentally ill patients were reviewed and compared. The vagrant patients were more likely to be older, unmarried and alone, poorly educated, unemployed or performing unskilled labour, and diagnosed with schizophrenia. This cohort was also more likely to have physical co-morbidities compared with the non-vagrant mentally ill patients. The median time to improvement among the vagrants (211.0 days) was significantly longer than for the non-vagrant patients (34.0 days) suggesting more intractable illnesses. Other factors found to prolong the time to improvement among all patients were old age, education, being single, unemployment, the diagnoses of schizophrenia, and substance abuse. Conclusion: The clinical profiles and treatment outcomes were poorer among the vagrant mentally ill patients, underscoring a need for more comprehensive healthcare resources directed to this patient group in Nigeria.

Key words: Vagrant; mental illness; clinical profile; outcome; Nigeria