Determining the Psychiatric Morbidity among Subjects with Vesicovaginal Fistula in Abakaliki, South East Nigeria

Background: Vesicovaginal fistula (VVF) imposes enormous challenges on those affected. VVF leaves a devastating effect on a woman’s personal hygiene, self-esteem, interpersonal relationships and environment thereby disrupting the woman’s health Subjects may have difficulties in coping and as a result may manifest specific mental disorders. Objective: This study determined the psychiatric morbidity and socio-demographic correlates in subjects with VVF. Materials and Methods: One hundred consecutive subjects with VVF were recruited from the National Obstetric Fistula Centre, Abakaliki Nigeria. A socio–demographic and clinical history questionnaire was used to assess the socio-demographic characteristics of subjects. The General Health Questionnaire version-28 (GHQ–28) was used to screen for psychiatric morbidity with a cut-off point of 5 indicating psychiatric caseness. All subjects with a score of 5 or more on GHQ-28 were interviewed using the Present State Examination (PSE) component of Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Results: The prevalence of psychiatric morbidity among subjects with VVF was 48%. Specific psychiatric disorders identified were major depression- 37%, generalised anxiety disorder- 4%, dysthymia- 5%, somatoform disorder- 1% and social phobia- 1%. Conclusion: Psychiatric morbidity may co-occur with vesicovaginal fistula. This may hinder complete recovery even after fistula repair. Early detection and treatment of the psychiatric disorders are advocated. It is recommended that health personnel working in such settings be trained to identify subjects with mental health problems and make appropriate referrals.