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.

Keywords: Functional capacity; Psychiatric patient; Correlates; Benin-City