title: Outcome of a working diagnosis of "psychosis" in relation to DSM-IV diagnostic criteria in a Kenyan in-patient cohort at Mathari hospital, Nairobi.
abstract: BACKGROUND
  When a patient presents with mental illness and displays psychotic symptoms which are not clearly delineated, a clinical diagnosis of psychosis is usually entertained.
  
  
  OBJECTIVE
  To determine the underlying Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) disorders in clinical entities admitted with a working diagnosis of "psychosis" at Mathari Psychiatric Hospital, Nairobi, Kenya.
  
  
  METHODS
  Descriptive cross-sectional quantitative study
  
  
  METHODS
  A total of 138 patients with a working diagnosis of "psychosis" on admission at Mathari Hospital during the period of this study were recruited over a one-month period. Their DSM-IV diagnoses were made using the Structured Clinical Interview for DSM-IV (SCID). Analysis of the results was done using SPSS version 11.5.
  
  
  RESULTS
  Nearly three quarters (72.5%) of the patients were male, 68.5% were aged between 20 and 34 years and 63.7% reported that they were single. Nearly half (49.2%) had attained up to 12 years of formal education and 90% were dependants of a member of the family. The most common DSM-IV diagnoses were schizophrenia, bipolar disorder, substance abuse, depression and anxiety disorders. Co-morbidity was recorded with an average of three DSM-IV disorders.
  
  
  CONCLUSIONS
  "Psychosis" as a working diagnosis was reported in relatively young adults. The patients whose working clinical diagnosis was "psychosis" met the criteria for an average of three DSM-IV diagnoses. There is need for a proactive policy in clinical practice so that definitive diagnoses rather than just "psychosis" are made and appropriate management initiated as early as possible.
authors.affiliation: Department of Psychiatry, University of Nairobi, and Africa Mental Health Foundation, Kenya, Africa. dmndetei@mentalhealthafrica.com
authors.forename: David M
authors.initials: DM
authors.lastname: Ndetei
authors.forename: Lincoln I
authors.initials: LI
authors.lastname: Khasakhala
authors.forename: Francisca A
authors.initials: FA
authors.lastname: Ongecha
authors.forename: Victoria
authors.initials: V
authors.lastname: Mutiso
authors.forename: Donald A
authors.initials: DA
authors.lastname: Kokonya
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006778:Hospitals, Psychiatric; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012959:Socioeconomic Factors; D055815:Young Adult