Prevalence of mental disorders in Uganda

Abstract

Introduction: Mental disorders encompass a wide range of mental and behavioural conditions with a varying degree of symptom severity (mild, moderate and severe), onset, course (episodic, clusters of attack and chronic), and impact on afflicted individuals. Mental disorders affect about one in five people worldwide at any one point in their life. The aim of the research presented in this thesis was to establish estimates of the prevalence of mental disorders in Uganda and differentiate prevalence in both children and adults. Methods: The methods presented in this thesis adhere to JBI methodology and international standards for the conduct of a systematic review. Chapter 2 presents the a priori protocol for the conduct of the systematic review; Chapter 3 presents the final systematic review with meta-analysis of prevalence. A comprehensive search for studies conducted in the last 10 years was performed across five electronic databases and grey literature sources. All eligible studies were critically appraised and relevant data extracted. Prevalence estimates from included studies for the overall population, children and adults were pooled statistically. Certainty of the findings of the review was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Results: The search returned a total of 632 records, of which 26 articles published from 24 unique studies conducted in Uganda, involving 3,803 child and 14,091 adult participants were included in the review. Most studies assessed mental disorders mapped to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), using valid instruments. Overall and with moderate level of certainty, the prevalence estimate of any mental disorders in Uganda was 22.9% in children and 24.2% in adults. The most prevalent disorder was depressive disorders, including major depressive disorders (22.2% in children and 21.2% in adults), followed by anxiety disorders (14.4% in children and 20.2% in adults), including predominantly posttraumatic stress disorder and generalised anxiety disorder. Eating disorder and psychotic syndrome disorder were also reported. Conclusion: Despite expected, significant heterogeneity, the results of this research show that about one in four persons in Uganda experience mental disorders. The findings also reveal the paucity of epidemiological studies investigating range of mental disorders in Uganda. Further countrywide epidemiological studies of mental disorders are required to explore prevalence of other mental disorders and its associated factors not captured by the present research, with increased sample sizes among children. The findings also highlight important health policy and practice applications to address the impact of mental disorders among the Ugandan population.