Psychiatric diagnosis among referred patients in Ghana

Ninety six patients were referred between January and December 1988, to the psychiatric out-patient clinic at the Korle Bu Teaching Hospital in Accra. The majority (62.8%), were referred from the physician clinics, 14.9% from the surgical and allied surgical clinics. Fewer percentages were referred from the other departments. Nearly half of those referred were found to be suffering from mood (affective) and neurotic and stress related disorders; 13.2% from schizophrenia, schizotypal and delusional disorders. Approximately nine per cent of the referrals, all male students aged between 14 and 21 were diagnosed as suffering from mental and behavioural disorders due to the use of psychoactive substances, mainly cannabis and alcohol. Five and a half per cent of those referred were found to have no psychiatric illness. About 21.3% of the patients required immediate transfer to the Accra Psychiatric Hospital for treatment while 66.3% required out-patient psychiatric and/or psychological treatment within the teaching hospital, and 5.6% were treated in the general wards of the teaching hospital. Nearly seven per cent were referred back to the referring clinicians with advice on further management and investigation, with collaboration of the psychiatrist. The setting up of a psychiatric department as an integral part of the Korle Bu Teaching Hospital is strongly advocated.