A statistical study of factors associated with psychosis at Mathari Hospital, Nairobi
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Date
2015-11
Authors
Olwende, Wilfred Musanda
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Although there are known factors associated with increased risk of developing
psychosis, the exact etiology remains elusive. Psychosocial and biological factors are
known to interact in their development. Factors such as obstetric complications, season
of birth, drug abuse, migration and ethnicity, urbanicity, social adversity, and trauma in
childhood have been found to be related to psychosis. Unfortunately, studies done in
Kenya only look at these factors as secondary to other inquiries. This study sought to
identify the determinants of psychosis as presented by patients admitted at Mathari
Hospital. Mathari Hospital is Kenya's sole National Referral and Teaching psychiatric
Hospital with a capacity of 700 beds. This was a cross-sectional study of patients being
discharged from Mathari Hospital at the time. A questionnaire was designed to help in
collecting information from the patients, after obtaining permission from the Kenyatta
National Hospital/ University of Nairobi Ethics and Research Committee. First patient
was randomly selected, from a list of patients admitted at the time, after which every
odd number patient being discharged was approached for interview. The patient
included was to be able to respond to questionnaire items. Agitated patients were
excluded. Clinical notes at admission were incorporated for clinical history, as well as
primary caregiver accounts. Data analysis was performed in R 3.0.2 Software. Data
obtained was analysed in terms of descriptive statistics, and later logistic regression was
used to determine the important factors that affect psychosis and establish any
associations that are unique to the Kenyan scenario. Multiple linear regression was used
to establish factors that determine length of DUP. One-way ANOVA was used to test
the effect of social and biological factors on DUP and age at onset of psychosis. Simple
linear regression was done to model the relationship between age at onset 'of psychosis
and duration, in years, of drug abuse. A total of 145 patients completed the interviews.
Majority of the respondents were male patients (55.17%, n=80, N=145). 53.79% (n=78,
N=145) of the respondents had a working diagnosis of psychosis. The mean age at onset
of psychosis was 26.03±7.67 SD (n=67, N=145), the mean Duration of Untreated
Psychosis (DUP), in weeks, was 10.19±8.47 SD (n=67, N=145). It was established that
family history of psychosis and residence were significant in predicting the probability
of a patient having psychosis. Drug abuse and residence were significant in determining
the length of DUP.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Masters of Science (Biostatistics) in the School of Pure and Applied Sciences
of Kenyatta University. November 2015