Rates of Physical Illness in Patients with Mental Disorders seen at Nnewi, Nigeria

Abstract

Background: In many cultures and countries, mental and physical disorders have been found to occur concurrently with more than mere chance phenomena. Such co-morbidity increases poor outcome for both disorders and results in high mortality and health care costs. Studies in Nigeria along this line seem scanty.
Objective: To describe the rates of physical illness in patients with mental disorders in a tertiary health care institution in Eastern Nigeria.
Methodology: All first ever referrals to the Mental Health Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi within one year were recruited. A full and standard structured mental state and physical examination was objectively done for each participant. Necessary ancillary laboratory investigations were done. After three months (for outpatients) or following discharge (for in patients), the physical examinations were repeated. The medical records were checked a year later for service drop out and mortality.
Results: Of the 413 participants, aged 15 to 74 years, mean age, 37.2+8.2 SD years, 205 males (49.6%), 43% had at least one physical disease at objective examination, of which only 14% was known prior to the referral. The major physical diseases were: cardiovascular (15.1%), Diabetes mellitus (5.4%), gastrointestinal diseases (1.5%). Only 2 (0.5%) of the patients had obesity at presentation but this sharply increased after 3 months to almost 13%.
Conclusion: Cardiovascular, endocrine (metabolic) and other physical diseases commonly occur in patients with mental disorders, especially mood and psychotic disorders, with a low rate of detection before full assessment.

Keywords: Bipolar, co-morbidity, depression, disorders, Nigeria, schizophrenia-spectrum