Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 9, pp 1405–1415

A comparative analysis of disability in individuals with bipolar affective disorder and schizophrenia in a sub-Saharan African mental health hospital: towards evidence-guided rehabilitation intervention

  • Dapo Adebowale Adegbaju
  • Andrew Toyin Olagunju
  • Richard Uwakwe
Original Paper

DOI: 10.1007/s00127-013-0654-6

Cite this article as:
Adegbaju, D.A., Olagunju, A.T. & Uwakwe, R. Soc Psychiatry Psychiatr Epidemiol (2013) 48: 1405. doi:10.1007/s00127-013-0654-6

Abstract

Purpose

Bipolar affective disorder (BAD) and schizophrenia are two severe psychotic conditions that are associated with disability. The present study was designed to compare the pattern of disability between clinically stable individuals with BAD and schizophrenia in a sub-Saharan mental health facility.

Methods

A total of 200 consecutive participants (made up of 100 each among clinically stable individuals with BAD and schizophrenia) were recruited. All participants had their diagnoses confirmed using Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID), after which the designed questionnaire and the 36-item World Health Organisation Disability Assessment Schedule interview (WHODAS II) were administered to them.

Results

In this study, the level of disability among participants with BAD was better compared to those with schizophrenia as determined by mean WHODAS score of 24.93 and 27.02, respectively. Similarly, there was a significant difference between participants with BAD and schizophrenia with respect to four domains of the WHODAS-II, viz, self-care (p < 0.001), getting along with others (p < 0.001), life activities (p < 0.001) and participation in the society (p < 0.001). The factors that were significantly associated with disability in the two groups (BAD and schizophrenia) were: unemployment status (p < 0.001) and remittance source of income (p < 0.001), while those that spent not more than ₦2,000 (13 dollars) per month on treatment (p = 0.004) were observed to be less disabled.

Conclusions

Overall, participants with BAD fared better in the level of disability and most of the measured domains of disability in comparison with those with schizophrenia. Both socio-demographic and treatment-related factors seem to define the pattern disability among participants. Thus, evidence-guided preventive and rehabilitative treatment strategies directed against functional impairment using prioritized model among individuals with BAD and schizophrenia are advocated.

Keywords

Bipolar affective disorder Comparative analysis Disability Schizophrenia Sub-Saharan Africa 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Dapo Adebowale Adegbaju
    • 1
  • Andrew Toyin Olagunju
    • 2
  • Richard Uwakwe
    • 3
  1. 1.Federal Neuropsychiatric HospitalLagosNigeria
  2. 2.Department of Psychiatry, College of MedicineUniversity of LagosLagosNigeria
  3. 3.Department of Mental HealthNnamdi Azikiwe University Teaching HospitalNnewiNigeria

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