Despite the high burden of mental illness worldwide, psychiatric studies in sub-Saharan Africa are sparse. Few have been conducted in Malawi and little information exists about inpatient psychiatric populations within the country.

To describe the spectrum of psychiatric diagnoses and treatment courses of patients admitted to Bwaila Hospital (BH), the inpatient psychiatric unit for the central region of the country.

We reviewed medical records of all patients admitted to BH in 2011 and extracted information about demographics, diagnoses, treatments and outcomes.

Inpatient care was provided to 457 patients. Patients had a mean age of 30 years and 298 (67%) were male. 258 (56%) had a known psychiatric diagnosis and 222 (49%) had been hospitalized for psychiatric care previously. The most common diagnoses were primary psychotic disorder (360), alcohol dependence (96) and mood disorder (37). The most common precipitating cause for admission was medication non-adherence (132), mostly in patients with psychotic disorders. The average length of presenting symptoms was 7 days, average length of stay was 21 days, and most commonly used treatments were chlorpromazine, diazepam, fluphenazine and carbamazepine. Outcomes included stabilization/release (308), transfer to another facility (75), removal by family against medical advice (40), abscondment (25) and death (7), which was mostly due to alcohol withdrawal.

Primary psychotic disorders and alcohol dependence are the most common reasons for inpatient psychiatric hospitalization at BH. Efforts to increase medication adherence in patients and emphasize the risks of alcohol consumption may lead to decreased psychiatric hospitalizations within Malawi.