KAMPALA – Although there has been an ever-increasing discussion about mental illness and the disruptive effect it can have on people’s lives, Uganda’s situation is dismal. More than half of the youth presenting at psychiatric hospitals for first-time treatment have a psychotic illness. This implies that they experience reality in a different way to other people causing them to hear or see things that others do not. This is revealed in research conducted by the faculty of Makerere University’s Department of Psychiatry to determine the burden of psychotic disorders among patients receiving first-time treatment at Butabika National Psychiatric Hospital. The research is titled; ‘One-year prevalence of psychotic disorders among first treatment contact patients at the National Psychiatric Referral and Teaching hospital in Uganda.’
It involved 1685 patients who presented to the hospital for the first time between January 1 and December 31 2018. On average, there were five new patients accessing the hospital daily in 2018. Two-thirds of these patients, aged 24 to 36, had a psychotic disorder, mainly schizophrenia, where a person loses contact with reality and experiences a range of extreme symptoms including hallucinations, delusions and disorganized speech. The onset of psychosis was mainly attributed to drug and substance abuse. Moreover, psychotic disorders were found to be more prevalent among people of the Pentecostal faith. Dr Emmanuel Mwesiga, the Principal Investigator of the study, emphasizes that this finding does not mean that people of this faith are more at risk for psychotic disorders. Rather, it could imply that people of the pentecostal faith are more likely than other faiths to seek care for the national psychiatric hospital than other faiths.
One plausible explanation may be that due to the beliefs in supernatural causes of psychotic disorders, patients may resort to this faith because of its perceived ability to health mental disorders through prayer. These patients who join the faith eventually present to the hospital,” he explains.
Since religion is an important element in the recovery of individuals with psychosis, understanding this phenomenon in the Pentecostal faith compared to other religions requires further study
Globally, it is estimated that 970 million people have a mental health or substance abuse disorder with anxiety being the commonest mental illness (Our World in Data, 2018). It is estimated mental disorders are attributable to eight million deaths worldwide annually. If psychosis is not addressed timely and correctly, Dr Mwesiga notes that patients may have relapses and poor social functioning. Relapse is associated with disability in work and physical complications such as heart disease and respiratory illnesses.
Interestingly, despite the high burden of psychotic illness among first-time patients, mood disorders such as bipolar disorder were also significantly high. About 30% all new patients had bipolar and substance use disorders.
“This suggests that there may be a benefit in introducing specialized early intervention services for psychotic disorders, especially at the first episode of psychosis, at the hospital. This will lead to better outcomes for patients,” Dr Mwesiga says.
Early management, at the first episode of psychosis, has been associated with greater cognitive functioning, improved social functioning, fewer relapses and improved quality of life.