Prevalence and treatment of neurological and psychiatric disorders among tertiary hospitals in Pakistan; findings and implications

Tanveer Ahmed Khan, Shahzad Hussain, Aamer Ikram, Sidra Mahmood, Humayun Riaz, Ayesha Jamil, Amina Amin, Yaseen Ghulam Haider, Marva Sandhu, Atifa Mushtaq, Corrado Barbui, Chris F Johnson, Brian Godman

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Mental health and neurological disorders are prevalent in Pakistan. However, there are considerable concerns with their management due to issues of access, availability of trained personnel and stigma alongside paucity of such data. Consequently, there is a need to document current treatment approaches starting with tertiary hospitals in Pakistan where patients with more severe mental and neurological disorders are typically treated. Subsequently, use the findings to help direct future policies and initiatives. METHODS: Multi-centered, cross-sectional, prospective study principally evaluating current medicine usage among patients attending tertiary hospitals in Pakistan with psychiatric and neurological disorders. In addition, possible factors contributing to the prevalence of these disorders in this population to help with future care. All 23 tertiary care hospitals in the ten major Districts in Pakistan were included, which cover 75% of the population. RESULTS: 57,664 patients were evaluated of which 35.3% were females. Both females and males had multiple brain disorders and multiple co-morbidities. Schizophrenia was the most prevalent disorder overall among both females (25.2%) and males (30.4%). A median of six medicines were prescribed per patient, with antipsychotics and antidepressants the most prescribed medicines. Clozapine was the most prescribed medicine in males (12.25%) and females (11.83%) including for psychiatric disorders, with sodium valproate the most prescribed medicine in epilepsy in males (42.44% of all anti-epileptic medicines) as well as females (46.38%). There was a greater prevalence of both disorders among the lower classes. A greater prevalence of schizophrenia was seen in patients abusing alcohol and smokers. The divorce rate was higher among the studied patients and the prevalence of depression was higher among the widowed population. CONCLUSIONS: There were concerns with the quality of prescribing including the extent of polypharmacy as well as possible overuse of clozapine especially in patients with epilepsy, both of which need addressing.

Original languageEnglish
Pages (from-to)145-160
Number of pages16
JournalHospital Practice
Volume48
Issue number3
Early online date28 Apr 2020
DOIs
Publication statusPublished - 1 Aug 2020

Keywords

  • psychiatric disorder
  • neurological disorders
  • schizophrenia
  • depression
  • drug abuse
  • smoking
  • Pakistan

Cite this

Khan, T. A., Hussain, S., Ikram, A., Mahmood, S., Riaz, H., Jamil, A., Amin, A., Haider, Y. G., Sandhu, M., Mushtaq, A., Barbui, C., Johnson, C. F., & Godman, B. (2020). Prevalence and treatment of neurological and psychiatric disorders among tertiary hospitals in Pakistan; findings and implications. Hospital Practice, 48(3), 145-160. https://doi.org/10.1080/21548331.2020.1762366