Diagnosis doubtful: a ten year old follow-up

In a period of one-year, 81 (1.7%) of the patients admitted to a Neuro-Psychiatric Hospital, Aro, Abeokuta, were discharged undiagnosed. These patients were followed up during a 10 year period and sixty-two were ultimately diagnosed while 19 remained undiagnosed. Sixty-one patients of similar age and sex, treated at hospital during the same period who had a definite diagnosis were studied. Comparison of the clinical features of the two groups showed the absence of nuclear symptoms amongst the study schizophrenics compared with the controls. Among the depressives, the prominence of physical symptoms and agitation differentiated the study group from the controls. Out of the 19 patients who remained undiagnosed, 42.1% could not be traced, and 10.5% had become schizophrenic, and three patients (15%) had died. Review of the clinical features at the initial presentation showed that 29 (72.5%) out of the 40 initially undiagnosed schizophrenics could be placed in the diagnostic category using ICD9 criteria.