Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria.
Soc Psychiatry Psychiatr Epidemiol. 2013 Sep;48(9):1405-15. doi: 10.1007/s00127-013-0654-6. Epub 2013 Feb 6.
Bipolar affective disorder (BAD) and schizophrenia are two severe psychotic conditions that are associated with disability. The present study was designed to compare the pattern of disability between clinically stable individuals with BAD and schizophrenia in a sub-Saharan mental health facility.
A total of 200 consecutive participants (made up of 100 each among clinically stable individuals with BAD and schizophrenia) were recruited. All participants had their diagnoses confirmed using Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID), after which the designed questionnaire and the 36-item World Health Organisation Disability Assessment Schedule interview (WHODAS II) were administered to them.
In this study, the level of disability among participants with BAD was better compared to those with schizophrenia as determined by mean WHODAS score of 24.93 and 27.02, respectively. Similarly, there was a significant difference between participants with BAD and schizophrenia with respect to four domains of the WHODAS-II, viz, self-care (p < 0.001), getting along with others (p < 0.001), life activities (p < 0.001) and participation in the society (p < 0.001). The factors that were significantly associated with disability in the two groups (BAD and schizophrenia) were: unemployment status (p < 0.001) and remittance source of income (p < 0.001), while those that spent not more than ₦2,000 (13 dollars) per month on treatment (p = 0.004) were observed to be less disabled.
Overall, participants with BAD fared better in the level of disability and most of the measured domains of disability in comparison with those with schizophrenia. Both socio-demographic and treatment-related factors seem to define the pattern disability among participants. Thus, evidence-guided preventive and rehabilitative treatment strategies directed against functional impairment using prioritized model among individuals with BAD and schizophrenia are advocated.
双相情感障碍（BAD）和精神分裂症是两种严重的精神病，会导致残疾。本研究旨在比较撒哈拉以南地区精神卫生机构中临床稳定的 BAD 和精神分裂症个体之间的残疾模式。
共招募了 200 名连续参与者（由临床稳定的 BAD 和精神分裂症患者各 100 名组成）。所有参与者均使用 DSM-IV-TR 轴 I 障碍的结构临床访谈（SCID）确诊，然后对他们进行设计的问卷和 36 项世界卫生组织残疾评估量表访谈（WHODAS II）。
在这项研究中，BAD 患者的残疾程度比精神分裂症患者好，平均 WHODAS 评分为 24.93 和 27.02。同样，BAD 和精神分裂症患者在 WHODAS-II 的四个领域存在显著差异，即自我护理（p<0.001）、与他人相处（p<0.001）、生活活动（p<0.001）和参与社会（p<0.001）。与两组（BAD 和精神分裂症）残疾显著相关的因素是：失业状况（p<0.001）和收入汇款来源（p<0.001），而那些每月治疗费用不超过 2000 奈拉（13 美元）的人则被观察到残疾程度较低。
总体而言，与精神分裂症患者相比，BAD 患者的残疾程度和大多数残疾测量领域的表现都更好。社会人口统计学和治疗相关因素似乎都定义了参与者的残疾模式。因此，提倡针对 BAD 和精神分裂症个体使用优先模式的基于证据的预防和康复治疗策略，以对抗功能障碍。
