Short-term diagnostic stability among re-admitted psychiatric in-patients in Eldoret, Kenya.

OBJECTIVE: To determine the prospective and retrospective consistency of diagnoses among readmitted psychiatric in-patients at the Moi Teaching and Referral Hospital in Eldoret, Kenya. METHOD: Admission and discharge diagnoses among a consecutive sample of 114 psychiatric in-patients readmitted at the Moi Teaching and Referral Hospital between August and December 2009 were compared. RESULTS: The commonest diagnoses at admission were schizophrenia spectrum disorders (47.4%) and bipolar spectrum disorders (30.7%). Overall diagnostic stability as measured by prospective consistency in this study was 72.8%.The most stable diagnostic category was Major Depressive Disorder (100% prospective and retrospective consistency), followed by Bipolar Disorders (91.4% prospective consistency, 69.6% retrospective consistency) and Substance-related disorders (87.5% prospective consistency, 50% retrospective consistency). Schizophrenia-spectrum disorders had a prospective consistency of 75.9% and a retrospective consistency of 87.2%. 'Other Psychotic Disorders' (acute psychotic episode and psychotic disorder not otherwise specified) had the lowest diagnostic stability, with both prospective and retrospective consistency being 0%. CONCLUSION: Mood disorders and substance-related disorders have the highest diagnostic stability among readmitted psychiatric inpatients in a low-income country.

Attention deficit hyperactivity disorder symptom self-report among medical students in Eldoret, Kenya.

BACKGROUND: To determine the prevalence of self-reported attention deficit hyperactivity disorder (ADHD) symptoms among medical students in Eldoret, Kenya. METHODS: A cross-sectional descriptive study of all medical students who gave consent to participate in the study. Undertaken at Moi University's School of Medicine in Eldoret, Kenya. Comprising two hundred and fifty three (253) undergraduate medical students, with a mean age of 23.7 years (19-42, s.d. 4.1), of whom 51% were female. Measuring ADHD symptomatology using the Adult ADHD Self-Report Scale (ASRS v1.1). RESULTS: The prevalence rate of self-reported ADHD symptoms using the ASRS screener was 23.7%. This was significantly associated with being in the age-group 17-20 years compared (p<0.05). The prevalence rate was higher among females (25.6%) than among males (21.8%), but this difference was not statistically significant. Preclinical students had a higher prevalence rate of ADHD symptoms (28.7%) compared to clinical students (19.6%), but this was also not statistically significant. Using a modification of the ASRS full symptom checklist to approximate a Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) ADHD diagnosis yielded a 'possible ADHD' prevalence rate of 8.7%. Of these, the inattentive type was the most common (40.9%). CONCLUSION: The prevalence rate of self-reported ADHD symptoms among medical students in Eldoret is very high and possibly interferes with the students' social and academic functioning. Further studies are suggested to generate information on the real ADHD prevalence in the general population and in special populations such as schools and colleges.

Self-reported attention deficit and hyperactivity disorder symptoms among university students in Eldoret, Kenya.

OBJECTIVE: To determine the prevalence of self-reported attention deficit and hyperactivity disorder (ADHD) symptoms among university students in Eldoret, Kenya. DESIGN: A cross-sectional descriptive study of all students who gave consent to participate in the study. SETTING: Moi University's Town Campus, comprising the Schools of Medicine, Dentistry and Public Health. SUBJECTS: Four hundred and fifty eight undergraduate students, with a mean age of 23.7 years (17-46, S.D. 4.1), of whom 236 (51.5%) were male. MAIN OUTCOME MEASURES: Presence of ADHD symptoms as measured by the adult ADHD self-report scale (ASRS versus 1.1). RESULTS: The prevalence rate of self-reported ADHD symptoms was 21.8%. This was significantly associated with belonging to a younger age-group (17-20 years) compared to the older age-groups (p<0.05). The prevalence was higher among females (25.2%) than among males (18.6%), but this was not statistically significant. There was no significant association between a positive ASRS screen and course of study. Using a modification of ASRS full symptom checklist to approximate a DSM IV TR ADHD diagnosis yielded a prevalence of ADHD symptoms of 9.2% in this cohort. CONCLUSION: The prevalence rate of ADHD symptoms among university students in Eldoret, Kenya is significantly higher than that reported in other studies. Further studies are needed to generate more information about this condition in the low-income countries, especially in college and university populations.

Neuroleptic induced tardive dyskinesia in a patient on treatment for schizophrenia: case report.

In this case, a thirty six year old patient on treatment for schizophrenia is described with severe tardive dyskinesia. The most likely cause is long term treatment with two highly potent typical antipsychotic medications. The patient was initially treated with Benzhexol, an anticholinergic agent with the potential to induce or aggravate the disorder. This case discusses the common presentation and management of neuroleptic induced tardive dyskinesia.