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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

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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.

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Acknowledgments

We express our profound gratitude to the entire staff of Federal Neuropsychiatric Hospital, Yaba for their assistance in course of this study and acknowledge the role of Dr Olapade Omojokun in the preparation of the manuscript.

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Authors and Affiliations

  1. Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria

    Dapo Adebowale Adegbaju

  2. Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria

    Andrew Toyin Olagunju

  3. Department of Mental Health, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria

    Richard Uwakwe

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  1. Dapo Adebowale Adegbaju
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  2. Andrew Toyin Olagunju
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  3. Richard Uwakwe
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Correspondence to Andrew Toyin Olagunju.

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Adegbaju, D.A., Olagunju, A.T. & Uwakwe, R. 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. Soc Psychiatry Psychiatr Epidemiol 48, 1405–1415 (2013). https://doi.org/10.1007/s00127-013-0654-6

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  • DOI: https://doi.org/10.1007/s00127-013-0654-6

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