Abstract:
Background:
Mental disorders and HIV infection are globally among the serious health problems. In Rwanda, the Ministry of health has done a lot to ameliorate the quality of health service offered to HIV infected people and those who suffer from psychiatric disorders but the prevalence of HIV infection is still higher in people suffering from psychiatric diseases compared with the general population. Little is known about psychiatric disorders in Rwanda especially in relation to HIV but it is known that mental disorders are among the risk factors of contracting HIV.
Objectives:
This research work aimed to assess demographic features and clinical presentation among patients living with HIV diagnosed with mental disorders attending HIV care unit at Ndera Neuro-psychiatric Hospital.
Methods:
A retrospective descriptive study covering 10 years, from 01 January 2010 to 31 December 2020 was conducted at Ndera Neuro-Psychiatric Hospital, HIV care unit. HIV positive patients with psychiatric comorbidities were involved in this study. Data were extracted from the clinical files with electronic records of the patients. Descriptive analysis of demographic and clinical data were performed in form of frequencies using Microsoft excel 2007.
Results:
Data were collected from 117 clinical files of HIV positive patients with psychiatric comorbidities whom the majority were from Gasabo district n = 42 (35.89%). Based on gender, the majority of the patients were females n = 78 (66.67%) while the males were n = 39 (33.33%). According to their level of education, the majority of these patients had done primary school n = 64 (54.70%). Considering the age of these patients, the majority were in range of age of 46-55 years n = 38 (32.48%).The mean age was 41 years. The most common psychiatric comorbidity among 117 patients was schizophrenia n = 48 (41.03%) followed by unspecified psychotic disorders n = 33(28.21%. Adherence to HIV treatment was also assessed and 101 patients (86.32%) were in good adherence while 16 patients (13.68%) were in poor adherence, poor adherence was more
significant in patients with schizophrenia (43.75%) than those with other psychiatric disorders. Mortality rate was 9.40 % and was higher in patients with schizophrenia compared to those with other psychiatric disorders.
Conclusion:
This study showed that schizophrenia followed by unspecified psychotic disorder was the most common psychiatric comorbidity among HIV positive patients diagnosed with mental disorders at Ndera Neuro-psychiatric Hospital/HIV care unit. The highest rate of poor adherence to HIV treatment and mortality were found in HIV positive patients diagnosed with schizophrenia compared to those with other psychiatric comorbidities. The female patients were highly vulnerable to HIV compared to the male patients. Further research studies on the link between mental disorders and HIV could be done. Screening of HIV could be considered as routine laboratory exam to every patient admitted for mental disorders. Training on relationship between mental disorders and HIV could be reinforced.
