Prevalence of Functional Disability and Associated Factors Among the Patients With Schizophrenia Attending Psychiatry Outpatient Clinics at Muhimbili National Hospital, Dar Es Salaam, Tanzania. Cross-sectional Survey

Abstract Background The available literatures worldwide, mention the functional disability as the one of dangerous corollary of schizophrenia, while it is among the intrinsic complications of schizophrenia. Functional disability among the patients with schizophrenia is of greater concerns because patients remain dependent with hopeless life. Many factors are associated with functional disability such as age, sex, marital status, level of education, age at the diagnosis of schizophrenia, regimen of antipsychotics on use, frequency of admission and psychotherapy in among the patients with schizophrenia. Objective The study aimed to determine the prevalence of functional disability and associated factors among patients with schizophrenia attending psychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania. Design A cross-sectional survey Setting A psychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania. Participants 281 adults were confirmed to have diagnosis of schizophrenia using MINI International neuropsychiatric interview for psychotic disorders studies (MINI version 7.0.2). World Health Organization Disability Scale-short version 12-items (WHODAS-12) used to measure functional disability among participants. Results The overall prevalence of functional disability was 71.9%. About a third (33.5%), (30.6%) and about 1 in every 13 participants (7.8%) had mild, moderate, and severe functional disability, respectively. Increased odds of functional disability was independently associated with; the frequency of admission; 1-5 times (AOR=16.76, 95%CI: 4.74-59.33), ≥6times (AOR= 9.34 95%CI: 2.38-38.28), typical (AOR=2.76 95%CI: 1.29-5.89), mixed (atypical and typical) antipsychotics (AOR=13.92 95%CI: 2.20-80.04); Not receiving psychotherapy during treatment (AOR=2.62 95%CI: 1.27-5.41) and substance use for the past twelve months (AOR=3.00 95%CI: 1.24-7.24) but male participants had decreased odds (AOR=0.40 95%CI: 0.18-0.87) of functional disability. Conclusion Patients with schizophrenia have relatively higher prevalence of functional disability. Frequency of admission, male gender, using typical antipsychotics and mixed antipsychotics, not getting psychotherapy were independent predictors of functional disability. Routine assessment of functional disability among patients with schizophrenia attending clinic with early occupational therapy interventions is highly recommended.