"Outcome of a Working Diagnosis of ""Psychosis"" in Relation to DSM-IV Diagnostic Criteria in a Kenyan In-Patient Cohort at Mathari Hospital; Nairobi"

ABSTRACT

"Background: When a patient presents with mental illness and displays psychotic symptoms which are not clearly delineated; a clinical diagnosis of psychosis is usually enter-tained. Aim: To determine the underlying Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) disorders in clinical entities admitted with a working diagnosis of ""psychosis"" at Mathari Psychiatric Hospital; Nairobi; Kenya. Study Design: Descriptive cross-sectional quantitative study Method: A total of 138 patients with a working diagnosis of ""psychosis"" on admission at Mathari Hospital during the period of this study were recruited over a one-month period. Their DSM-IV diagnoses were made using the Structured Clinical Interview for DSM-IV (SCID). Analysis of the results was done using SPSS version 11.5. Results: Nearly three quarters (72.5) of the patients were male; 68.5were aged between 20 and 34 years and 63.7reported that they were single. Nearly half (49.2) had attained up to 12 years of formal education and 90were dependants of a member of the family. The most common DSM-IV diagnoses were schizophrenia; bipolar disorder; substance abuse; depression and anxiety disorders. Co-morbidity was recorded with an average of three DSM-IV disorders. Conclusion: ""Psychosis"" as a working diagnosis was reported in relatively young adults. The patients whose working clinical diagnosis was ""psychosis"" met the criteria for an average of three DSM-IV diagnoses. There is need for a proactive policy in clinical practice so that definitive diagnoses rather than just ""psychosis"" are made and appropriate management initiated as early as possible."