Muhammad Ajmal Zahid
Kuwait University, Kuwait
Title: Prevalence of psychiatric morbidity in the primary health clinic attendees in Kuwait
Biography
Biography: Muhammad Ajmal Zahid
Abstract
Statement of the problem: A considerable number of patients attending the primary health clinics suffer from co-morbid psychiatric disorders.
Objectives: To estimate the prevalence of the comorbidity between common mental disorders (anxiety/depression/somatization) and common chronic physical illnesses among primary health care attendees, and explore the relationship of comorbidity with type of illness and socio-demographic characteristics.
Method: The Physical Health Questionnaires (PHQ-SADs) were administered to a randomized sample of 1046 primary clinic attendees in all the five governorates of the country over a 5-month period. Physical diagnoses were ascertained by the attending physicians based on ICD-10 criteria.
Results: Out of 1046 respondents, 442 (42.25%) had at least one mental disorder, while 670 (64.1%) had a physical illness diagnosis, viz: diabetes mellitus (37.01%), hypertension (34.18%), heart diseases (7.2%) and non-chronic physical illnesses (9.4%). Physical comorbidity was significantly associated with older age, divorce, illiteracy, and poorer living conditions. 34.4% (360/1046) had physical-mental comorbidity while 53.7% (670) had physical-mental comorbidity; and of 376 without physical illness, 82 (21.8%) had at least one mental disorder (OR=4.1, P<0.001). The commonest comorbid mental disorders were somatization and the simultaneous presence of all 3 mental disorders. There was an increase in the prevalence of mental disorders with increase in the number of physical illnesses, and increase in psychopathology scores with number of physical comorbidity. Subjects with heart diseases and asthma consistently had higher psychopathology scores.
Conclusion: The findings call for the primary care physicians to be sensitive to the psychosocial context of patients who present primarily with physical conditions; more so for patients with multiple medical illnesses and social disadvantage.