Patterns of remission from serious mental illness: a case study of patients receiving care at Butabika hospital, Uganda

Abstract

This study aimed to assess factors associated with time to remission from Serious Mental Illness (SMI) in Uganda, focusing on patients admitted to Butabika National Referral Hospital for mental health cases. The research employed a survival data analysis approach, utilizing secondary data from medical records of 200 patients diagnosed with SMI in January 2019. Information on socio-demographic characteristics, clinical conditions, and time to remission were tracked through 2021 or until discharge or death. We applied a univariate analysis and frequency distributions and life tables were generated to describe the probability of remission and distribution of other factors. At Bivariate analyses the log rank chi-square was employed to explore the association of various factors with time to remission. The Multivariable Cox hazard model was fitted to identify the factors associated with time to remission from a serious mental illness. The findings revealed that, a decreasing probability of remission over time, with 13.5% of patients attaining remission between 32 and 36 months. The Cox hazard model results show that patients with no drug disorder had a quicker remission than patients with drug disorder (HR = 1.922, 95% CI = 0.771951-1.9349). Patients with Secondary education and above showed a statistically significant quick remission compared to patients with no education (HR = 1.9701, 95% CI = 0.9034-1.1244). Patients with Schizophrenia were revealed to gain remission faster than patients with bipolar disorder, since (HR=1.8393733, 95%CI=0.0365277-1.9146). Additionally, the Cox proportional hazards model was extended to allow time-varying covariates (tvc) i.e., g(t)=log(t). Schizophrenia and whose level of education was secondary and above covariates were found to be statistically significant. The study recommends that the government of Uganda through the Ministry of Health should implement education awareness by targeting individuals with lower education. These programs can focus on improving their understanding of mental health, enhancing coping mechanisms and promoting early interventions. Furthermore, the study recommends that there should be improved access to treatment by ensuring access to appropriate treatment options including medication and therapy and this may increase the availability of mental health services This can contribute to advancing mental healthcare, improving remission rates, and enhancing the quality of life for individuals affected by SMI in the country.