Disability among patients with schizophrenia: A hospital-based study

Abstract

Background: Schizophrenia has been described as the most disabling mental disorder, and patients with schizophrenia have been said to be disabled mostly in self-care, occupation, sexual relation and social relationship domains. Previous authors have studied disability among this study population. However, the limitations of these previous works include non-report of the prevalence rates of disability, report on disability limited to only a particular domain of life and the utilization of disability instruments fraught with significant weaknesses. Aim: To determine the prevalence, severity, domains and correlates of disability among outpatients with schizophrenia at the Neuropsychiatric Hospital, Aro, Abeokuta in Ogun State, Nigeria. Methods: It was a cross-sectional study conducted among three hundred consenting adult outpatients with schizophrenia attending the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State. Each participant was interviewed with the sociodemographic questionnaire, Mini International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS) and the 36-item World Health Organization Disability Assessment Schedule. Results: The prevalence of disability was 78% (with 22% having no disability in any of the domains). Most were disabled in the mild to moderate range. Seventy-seven percent (77%) had mild to moderate disability while only 1% had severe disability. Excluding those free of disability, 98.7% of those with disability had mild to moderate form while only 1.3% had severe form. Highest prevalence rates for disability were reported in the ‘participation in society’ and ‘getting along’ domains while the lowest rates were reported in the ‘activities’ (household, work, school) and ‘self-care’ domains. Of all the sociodemographic and clinical variables explored, only the PANSS positive, negative and total scores demonstrated significant relationships with disability. Conclusion: Consistent with existing literature, disability is very prevalent among patients with schizophrenia and it is associated with higher levels of illness severity. Clinicians have a role in limiting disability by focusing on early and comprehensive treatment approaches.