Assessment of treatment outcomes among bipolar patients at Mathari National Teaching and Referral Hospital, Kenya.

BACKGROUND

Bipolar disorder (BD) is a chronic psychiatric illness associated with significant morbidity and functional impairment. Although symptom control is a key goal of pharmacological treatment, functional recovery often remains elusive. In sub-Saharan Africa, and particularly Kenya, limited data exist on treatment outcomes for BD. This study assessed remission, functional recovery, and suicidality among bipolar patients at Mathari National Teaching and Referral Hospital, Kenya’s primary mental health institution.

METHODS

A cross-sectional descriptive design was carried out among 51 adult patients diagnosed with BD (Type I or II) and treated for at least 6 months. Manic and depressive symptoms were assessed at the time of evaluation by using the Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D); functional outcomes were measured using the Functioning Assessment Short Test (FAST). Suicidality was assessed through structured clinical interview questions.

RESULTS

Approximately 92.2% scored below the threshold for clinically significant manic symptoms at the time of assessment, and 74.5% for depression. However, only 45.1% achieved functional recovery (FAST score < 11). Occupational and interpersonal functioning were the most impaired domains. Suicidal thoughts or behaviors were reported by a minority of participants. Specifically, 15.7% (n = 8) reported suicidal ideation and 5.9% (n = 3) reported a history of suicide attempt.

CONCLUSIONS

Even though a high proportion of participants scored below symptomatic thresholds, indicating low current symptom burden, substantial functional impairment persisted, underscoring the need for integrative treatment strategies targeting psychosocial and occupational domains in BD management. CLINICAL TRIAL NUMBER: Not applicable.