Psychiatric morbidity in HIV/AIDS: a 5-year retrospective study in Jos, Nigeria.

Abstract

Background
Most studies of psychiatric disorders associated with HIV/AIDS have been carried out in the USA and Europe in patients on anti-retroviral drugs. Few studies have looked at psychiatric disorders and substance use in Africa and a dearth of literature exists on HIV/AIDS and psychiatric morbidity in Nigeria.
Objectives
The objectives of the study were:
1. To determine the rate of referral for psychiatric consultation among patients with HIV/AIDS
2. To determine the psychiatric diagnoses at referral
3. To determine the rate of substance use among referred patients.
Method
A retrospective chart review conducted among HIV/AIDS patients referred to an urban Teaching Hospital in Jos, Nigeria from January 2000 to December 2004. The case notes of patients who presented at the General Outpatient Department (GOPD) and Accident and Emergency Units or those who were treated at the medical, surgical, and psychiatric departments were retrieved from the records department and scrutinized.
A semi-structured questionnaire was used to record the sociodemographic data, the diagnoses, substance(s) used, and the anti-retroviral treatment taken. The cases referred for psychiatric assessment were compared with available records of clients who attended the hospital for HIV/AIDS-related illnesses. Cases treated at the specialist clinic for HIV/AIDS were excluded.
Results
Available record showed that a total of 420 confirmed cases of HIV/AIDS were treated within the study period. 247 were in WHO stages 111&1V while 177 were in WHO stages 1&11. 120 patients were referred for psychiatric consultation giving a referral rate of 25%. The rate of referral was significantly associated with less advanced stage of the disease process (p<0.01). The commonest diagnosis was delirium, 40 (33.3%), followed by depression 35, (29.2%), and psychosis 17 (14.2%). 25% of the referred cases abused substances, mainly alcohol either singly or in combination.
Conclusion
The study revealed that psychiatric disorders are a common manifestation of HIV/AIDS in this environment. This highlights the need for routine psychosocial assessment of patients with HIV and underscores the need for a multidisciplinary approach to the treatment of HIV/AIDS to ensure better quality of life and compliance with anti-retroviral treatment.


Highland Medical Research Journal Vol. 5 (1) 2007 pp. 54-60