Epidemiology and Pattern of Mental Health (Psychiatric) Disorders in Sierra Leone: A Retrospective Cross-Sectional Study of 4020 Cases.

Background: The organization of mental health services and management of mental health disorders are driven by the availability of information on patterns and prevalence of such conditions. To the best of our knowledge, no study has presented the pattern of mental illness in Sierra Leone disaggregated by ICD (International Classification of Diseases) categorization. This study aims to establish the socio-demographic profile and ICD11 diagnostic categorization of mental health patients in Sierra Leone. Methodology: All patients registered at SLPTH Kissy from 1st January 2021 to 31st July 2023 were eligible for the study. Data were retrospectively collected from the digital register of patients. Abstracted variables included patients' age, sex, marital status, district of residence, and diagnosis. Each of the diagnoses was further classified into one of the broad ICD-11 mental health diagnostic categories. Statistical analysis was done in Microsoft Excel and SPSS software. Result: There were 4020 individual patients, translating to an average of 130 new registrations monthly. The age range of patients was 4 to 96 years, with a median (IQR) age of 30(23 -40) years. About 87% of all patients were below 50 years of age. Of the 4020 patients, 2591 (64.5%) were males while 1429(35.5%) were females (P<.001). Disorders due to substance abuse accounted for 38.9% of all presentations, followed by schizophrenic and mood disorders at 25.1% and 19.0% respectively. Disorders of substance use, and Schizophrenia/primary psychotic disorders were significantly more prevalent in males, while Mood disorders were significantly more prevalent in females. Conclusion: Mental Health disorders in Sierra Leone showed comparable socio-demographic patterns with findings in regional studies. There are significant gender differences in the frequency of some ICD categories of mental disorders. Substance use is a foremost cause of severe mental illness; thus, campaign of demand reduction will improve the mental health situation of the country.