Mental disorders among primary health care patients in Nicaragua

Abstract

The objective of this study was to validate the Self Report Questionnaire (SRQ-20) as a screening instrument to identify probable psychiatric cases in the general population in Nicaragua and to study the prevalence and identification of mental disorders in primary health care. In the general population 576 people were screened using SRQ-20. A subsample was further interviewed using the Present State Examination (PSE). In primary health care centers 781 patients were screened according to SRQ-20 and staff indicated whether a mental disorder was identified or not. In the general population study, 9/10 turned out an adequate cut-off for SRQ-20, identifying 23% as probable cases. Using the same cut-off, 47% of the primary health care patients were identified as probable cases. Among male probable cases only 7% were identified as cases by health care staff, and among female probable cases health care staff identified 13% as cases. When the results are compared with previous studies, it becomes evident that the general level of psycho-emotional complaints and accordingly the cut-off for caseness differ in different parts of the world. SRQ must be calibrated for each cultural setting. Among primary health care patients, mental disorders were overrepresented and frequently overlooked by the physicians. Educational programs with training in psychiatry should be implemented for primary health care staff.

Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors

“…In Chile 30 and Nicaragua 31 it is 53% and 47%, respectively, similar to India 32,33,34 that is 50%. Even in European countries, there is a high prevalence of psychiatric morbidity.…”

Processo de produção rural e saúde na serra gaúcha: um estudo descritivo

“…Estes dados contrastam com os resultados da maioria dos estudos que usaram o mesmo teste em populações urbanas e rurais (Penayo et al, 1990;Rumble et al, 1996).…”

Prevalence of Mental Illness in the Community

“…1,2,4 Various surveys have found that 20%, 47-56%, 53.4%, 23-47%, 16.6%, 25-66% and 31.5% were suffering from psychiatric disorders in Uganda, Brazil, Chile, Nicaragua, Sudan, India and Spain respectively. [5][6][7][8][9][10][11][12] In 1978, one community based study reported that 6.5% of people in a village were suffering from psychiatric disorders. 13 Around 20 years later, another study in an urban area reported a prevalence of 28% in adults.…”