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. 2023 Apr;273(3):613-625.
doi: 10.1007/s00406-022-01478-6. Epub 2022 Aug 24.

Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

Richard Stephen Mpango  1   2   3   4   5 , Wilber Ssembajjwe  6   7   8 , Godfrey Zari Rukundo  9 , Carol Birungi  10 , Allan Kalungi  6   7 , Kenneth D Gadow  11 , Vikram Patel  12 , Moffat Nyirenda  6   7   13 , Eugene Kinyanda  6   7   10
Affiliations

Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

Richard Stephen Mpango et al. Eur Arch Psychiatry Clin Neurosci. 2023 Apr.

Abstract

While psychiatric and physical comorbidities in severe mental illness (SMI) have been associated with increased mortality and poor clinical outcomes, problem has received little attention in low- and middle-income countries (LMICs). This study established the prevalence of psychiatric (schizophrenia, bipolar affective disorder, and recurrent major depressive disorder) and physical (HIV/AIDS, syphilis, hypertension and obesity) comorbidities and associated factors among 1201 out-patients with SMI (schizophrenia, depression and bipolar affective disorder) attending care at two hospitals in Uganda. Participants completed an assessment battery including structured, standardised and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidities and potential risk factors. Bipolar affective disorder was the most prevalent (66.4%) psychiatric diagnoses followed by schizophrenia (26.6%) and recurrent major depressive disorder (7.0%). Prevalence of psychiatric comorbidity was 9.1%, while physical disorder comorbidity was 42.6%. Specific comorbid physical disorders were hypertension (27.1%), obesity (13.8%), HIV/AIDS (8.2%) and syphilis (4.8%). Potentially modifiable factors independently significantly associated with psychiatric and physical comorbidities were: use of alcohol for both syphilis and hypertension comorbidities; and use of a mood stabilisers and khat in comorbidity with obesity. Only psychiatric comorbidity was positively associated with the negative outcomes of suicidality and risky sexual behaviour. The healthcare models for psychiatric care in LMICs such as Uganda should be optimised to address the high burden of psychiatric and physical comorbidities.

Keywords: Association; Healthcare models; Physical and psychiatric comorbidities; Potential risk factors.

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Conflict of interest statement

Conflict of interest The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Conceptual framework on comorbidity in severe mental illness
See this image and copyright information in PMC

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