Detection of Psychiatric Disorders by Physicians Attending to People Living with HIV/AIDS (PLWHA) in a Nigeria University Teaching Hospital

Abstract

People living with HIV/AIDS were found to have high co-morbid psychiatric disorders. These are usually not detected by managing non-psychiatrist physicians. The aim of this study was to determine the rate of detection of psychiatric disorders among People Living with HIV/AIDS attending outpatient clinics by their primary physicians. This study was carried out at the HIV clinics of the University of Ilorin Teaching Hospital, Ilorin among 300 consenting adult HIV positive patients. Physicians attending to these patients were requested to fill a form to indicate if these patients had psychiatric disorders and the types, during their routine review of the patients in the clinic. These patients were also assessed for the presence of psychiatric disorders by the researchers using Mini International Neuropsychiatric Interview (MINI). Diagnoses of psychiatric disorders were based on DSM-IV diagnostic criteria. The psychiatric morbidity rate in the studied population was found to be 38.3% (115 psychiatric cases) using MINI interview and DSM-IV diagnostic criteria. Diagnoses of psychiatric disorders were however correctly made in only 39 (13%) of the patients by the attending physicians (X² = 47.96; p-value= < 0.000). Overall, 66.1% of patients with psychiatric disorders were not detected by the managing physicians. None of the cases detected by the attending physicians was offered psychological intervention and no case was referred to the psychiatric unit for management of associated psychiatric disorders. Psychiatric disorders among PLWHA were under-diagnosed by their primary doctors. There is need to improve the ability of the doctors to detect and manage common mental health problems usually found among people living with HIV/AIDS.

Keywords: Psychiatric morbidity; PLWHA; Primary care physician; Nigeria.