Academic journal article Indian Journal of Psychiatry

Patient Health Questionnaire for Screening Psychiatric Disorders in Secondary Healthcare

Academic journal article Indian Journal of Psychiatry

Patient Health Questionnaire for Screening Psychiatric Disorders in Secondary Healthcare

Article excerpt

Byline: Ankur. Barua, George. Jacob, Syed. Mahmood

Background: The adult population often suffers from a number of physical and mental problems. This study was conducted to determine the proportion of mental illnesses in adult population visiting the outpatient departments at Dr. TMA Pai Rotary Hospital, Karkala and to study the socio-demographic correlates of psychiatric disorders. Materials and Methods: A cross-sectional study was conducted during March 2004 among 193 adult individuals of 18 years and above at Dr. TMA Pai Rotary Hospital, Karkala, Karnataka. Data was analyzed by the statistical package for social sciences version 10.0 for windows and results were expressed in terms of proportions and their 95% confidence intervals (CI). Chi-square test, multiple logistic regression with adjusted odds ratio and its 95% CI. Results: The proportion of psychiatric disorders in adult population was determined to be 39.9%. Proportion of psychiatric morbidity among males and females were 36.2 and 42.2%, respectively. Conclusion: This study revealed that socio-demographic correlates like age group of 50 years and above, unemployed or housewives, living alone, and a history of psychiatric illness in the family were independently associated with psychiatric disorders in adult population.

Introduction

Today, the adult population does suffer from a number of physical and mental morbidities along with psychosocial problems. An estimated 500 million people worldwide are believed to suffer from neurotic, stress-related, and somatoform disorders. A further 200 million suffer from mood disorders, such as chronic and manic depression. [sup][1] Nearly 400 million suffer from mental or neurological disorders or from psychosocial problems such as those related to alcohol and drug abuse. It is estimated that five out of the ten most disabling disorders are psychiatric in nature. Unipolar major depression, alcohol abuse, bipolar affective disorder (manic depression), schizophrenia and obsessive-compulsive disorder (OCD) are among the 10 leading causes of disability worldwide in 1990. [sup][2]

Though psychiatric problems impose a heavy burden of morbidity and disability on the society, management of mental ill health remains at the bottom of medical packing order. Only the most severe cases, such as schizophrenia or manic depression, receive what minimal care there is, even in developed countries. Coping with mental health problems have become more difficult because we do not have information regarding people not getting the help they need; help that is available; help that can be obtained at no great cost. [sup][2]

Kessler et al., [sup][3] employed a revised version of composite international diagnostic interview (CIDI) with a national probability sample of 8,098 aged between 15-54 years' non-institutionalized civilian population in the US. Forty-eight percentages of respondents reported at least one lifetime disorder, and 29.5% reported at least one DSM III R (Diagnostic and Statistical Manual of Mental Disorders, Third Edition) disorder over a 12-month period.

Since 1960, epidemiological studies of psychiatric morbidity in different samples of the Indian population have been conducted. The prevalence rate of mental disorders differed from time to time in different studies under different settings. The Bhore Committee (Govt. of India, 1946) extrapolated from rates in UK and USA and concluded that mental patients requiring hospitalization in India be taken as 2 per 1,000. Again in 1966, the Mental Health Advisory Committee of the Govt. of India suggested a probable prevalence of mental illness of 20 per 1,000 population in general, 18 per 1,000 for semi-rural and 14 per 1000 for rural areas. [sup][4],[5]

A meta-analysis of 13 epidemiological studies consisting of 33,572 people, belonging to 6,550 Indian families was attempted by Reddy and Chandrashekar. [sup][6] The estimated prevalence rate is 58. …

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