Gender and psychiatric diagnosis: a profile of admissions to mental hospitals in the Western Cape Province, South Africa

Summary

Objectives: This retrospective, epidemiological study aimed to identify gender patterns of admission to public mental hospitals, with regard to psychiatric diagnosis and management.

Methods: The hospital records of a random, stratified sample of all 7938 patients admitted to the three psychiatric hospitals in the Western Cape Province for a calendar year were studied for gender differences regarding demographic features, admission-related variables, DSM-IV diagnosis, as well as management during hospitalisation and on discharge.

Results: Findings were that more women than men were admitted overall. For women the main DSM-IV diagnoses were mood (41%) followed by psychotic disorders (29%); while for men the main diagnoses were psychotic disorders (47%) and substance abuse (23%). Significantly more women than men were labelled with mood, anxiety and adjustment disorders, and with avoidant, dependent, histrionic and borderline personality disorders. Significantly more men were diagnosed as substance abusers, schizophrenic and with cognitive disorders, and also anti-social personality disorder. More women were medicated, both during hospitalisation and on discharge; and more women also received ECT, while more men absconded from hospital.

Conclusions: While some results confirm international research, there are areas of variance, as in schizophrenic and bipolar disorders. The findings have psychiatric service implications and indicate the need for further research into the gendered development of psychopathology.