Like in much of Sub-Saharan Africa, descriptive data about psychiatric inpatients and inpatient psychiatric care in Malawi is limited. This study describes the inpatient population at the Bwaila Hospital Psychiatric Unit in Lilongwe, Malawi, as well as treatments received and treatment outcomes. Records of 419 psychiatric inpatients hospitalized from January 1, 2011 to December 31, 2011 were reviewed. Patients were primarily male (73.0%) and were most commonly referred from district hospitals (46.4%). Nearly all patients were involuntarily hospitalized under Malawi's Mental Treatment Act (94.2%). Schizophrenia (30.1%), cannabis use disorder (27.9%) and alcohol use disorder (25.1%) were the most common diagnoses. Suicidal ideation was reported by 4.8% of patients and 2.4% had attempted suicide prior to admission. Homicidal ideation was reported by 7.3% of patients and 5.1% of patients assaulted another patient during their hospitalization. Mean length of stay was 22.1 ± 27.7 days (range: 1.0-243.0). Chlorpromazine (81.3%), diazepam (75.8%), carbamazepine (59.8%) and fluphenazine (56.0%) were the most commonly used medications on the ward. Stabilization and discharge to home was the most common outcome (68.0%), followed by transfer to another hospital (19.5%), discharge against medical advice (8.2%), abscondment (3.4%) and death (1.0%).
The purpose of this study was to investigate common mental disorders among Tajik migrant and non-migrant wives in a primary care center. Using a cross sectional design, quantitative surveys using standard questionnaires were administered to 300 married Tajik women aged 18-45 in Dushanbe. Descriptive and multivariate analyses described the demographic and mental health patterns, and comparison of key sub-groups, using Chi-square, T-test and regression. 26% of women in primary care had moderate or severe depression, 17% had moderate or severe anxiety and 20% had moderate or severe PTSD. Lifetime physical or emotional abuse was reported in 22% and women with lifetime physical or emotional abuse had higher depression, anxiety and PTSD scores. Significant multivariate associations predicted the following risk factors: for depression (R2=.40): higher number of people you live with, older age of woman, and migrant husband; for anxiety (R2=.41):more direct trauma and older age of woman; for PTSD (R2 =.48):lower number of people you live with, more direct trauma, older age of woman, highernumber of children, non-migrant husband, and lifetime emotional or physical abuse. Mental health interventions are needed in primary care settings for women with common mental disorders, including those exposed to trauma and migration.
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