Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-04T21:40:25.221Z Has data issue: false hasContentIssue false

Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries

Published online by Cambridge University Press:  09 July 2009

T. W. Harding*
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
V. De Arango
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
J. Baltazar
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
C. E. Climent
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
H. H. A. Ibrahim
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
L. Ladrido-Ignacio
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
N. N. Wig
Affiliation:
Investigators in a WHO Collaborative Study on Strategies for Extending Mental Health Care
*
1Address for correspondence: Dr T. W. Harding, Medical Officer, World Health Organization, 1211 Geneva 27, Switzerland. Principal investigator for the study.

Synopsis

1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13·9 %. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1980

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Climent, C. E. & Plutchick, R. (1980). Confiabilidad, validez y sensibilidad de los itemes de una escala de auto-reportaje de sintomas de enfermedad mental. Revista Colombiana de Psiquiatria (in the press).Google Scholar
Dilling, H., Weyerer, S. & Enders, I. (1978). Patienten mit psychischen Störungen in der Allgemeinpraxis und ihre psychiatrische Überweisungsbedürftigkeit. Monographien aus dem Gesamtgebiete der Psychiatrie (Berlin) 17, 135160.CrossRefGoogle Scholar
Foulds, G. A. & Hope, K. (1968). Manual of the Symptom Sign Inventory (SSI) University of London Press: London.Google Scholar
Giel, R. & Harding, T. W. (1976). Psychiatric priorities in developing countries. British Journal of Psychiatry 128, 513522.CrossRefGoogle ScholarPubMed
Giel, R. & Van Luijk, V. N. (1969). Psychiatric morbidity in a small Ethiopian town. British Journal of Psychiatry 115, 149162.CrossRefGoogle Scholar
Giel, R. & Le Nobel, C. P. J. (1971). Neurotic instability in a Dutch village. Acta psychiatrica scandinavica 47, 462472.CrossRefGoogle Scholar
Giel, R. & Workneh, F. (1980). Coping with outpatients who cannot cope – management of persistent complainers in an African country. Transactions of the Royal Society of Tropical Medicine and Hygiene (in the press).CrossRefGoogle Scholar
Giel, R., de Arango, M. V., Climent, C. E., Harding, T. W., Ibrahim, H. H. A., Ladrido-Ignacio, L., Srinivasa Murthy, R., Salazar, M. C. I., Wig, N. N. & Younis, Y. O. A. (in preparation). Childhood mental disorders in primary health care.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire Oxford University Press: London.Google Scholar
Goldberg, D. P. (1974). Psychiatric disorders (a series on ‘screening for disease’). Lancet ii, 12451247.CrossRefGoogle Scholar
Goldberg, D. P. & Blackwell, B. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal ii 439443.CrossRefGoogle Scholar
Harding, T. W. (1973). The detection of psychiatric illness by questionnaire in Jamaica. West Indian Medical Journal 22, 190191.Google Scholar
Harding, T. W. (1976). Validating a method of psychiatric case identification in Jamaica. Bulletin of the World Health Organization 54, 225231.Google ScholarPubMed
Harding, T. W. (1978). Psychiatry in rural agrarian societies. Psychiatric Annals 8, 7484.CrossRefGoogle Scholar
Harding, T. W., Climent, C. E., Collignon, R., Diop, B. S. M., Giel, R., Guèye, M., Ibrahim, H. H. A., Ladrido-Ignacio, L. & Wig, N. N. (1979). Santé mentale et soins de santé primaires: premiers résultats d'une étude concertée de L'OMS. Psychopathologie africaine 15 (1), 528.Google Scholar
Holmes, J. A. & Speight, A. N. P. (1975). The problem of non-organic illness in Tanzanian urban medical practice. East African Medical Journal 52, 225236.Google ScholarPubMed
Kessel, W. I. N. (1960). Psychiatric morbidity in a London general practice. British Journal of Preventive and Social Medicine 14, 1622.Google Scholar
Kessel, W. I. N. (1962). Conducting a psychiatric survey in general practice. In The Burden on the Community (ed. Hill, J. D. N.), pp. 1330. Nuffield Provincial Hospitals Trust: London.Google Scholar
Kessel, N. & Shepherd, M. (1962). Neurosis in hospital and general practice. Journal of Mental Science 108, 159165.CrossRefGoogle ScholarPubMed
Mbanefo, S. E. (1971). The general practitioner and psychiatry. In Psychiatry and Mental Health Care in General Practice (ed. Boroffka, A.), pp. 4549. University of Ibadan: Ibadan.Google Scholar
McEvoy, P. J. & McEvoy, H. F. (1976). Management of psychiatric problems in a Kenyan mission hospital. British Medical Journal i, 14541456.CrossRefGoogle Scholar
Mezey, A. G. & Syed, I. A. (1975). Psychiatric illness and attitudes to psychiatry. Social Psychiatry 10, 133138.CrossRefGoogle Scholar
Ndetei, D. M. & Muhangi, J. (1979). The prevalence and clinical presentation of psychiatric illness in a rural setting in Kenya. British Journal of Psychiatry 135, 269272.CrossRefGoogle Scholar
Pemberton, J. (1949). Illness in general practice. British Medical Journal i, 306308.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice Oxford University Press: London.Google Scholar
Verma, S. K. & Wig, N. N. (1977). Standardisation of a neuroticism questionnaire in Hindi. Indian Journal of Psychiatry 19, 6772.Google Scholar
Wig, N. N., Suleiman, M. A., Routledge, R., Srinivasa Murthy, R., Ladrido-Ignacio, L., Ibrahim, H. H. A. & Harding, T. W. (1980). Community reactions to mental disorders: a key informant study in three developing countries. Acta psychiatrica scandinavica 61, 111126CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms Cambridge University Press: Cambridge.Google Scholar
World Health Organization (1975). Organization of Mental Health Services in Developing Countries. Sixteenth Report of the WHO Expert Committee on Mental Health Technical Report Series No. 564. WHO: Geneva.Google Scholar
World Health Organization Regional Office for Africa (1979). Mental Health: Report of the WHO Regional Expert Panel on Mental Health AFRO Technical Report Series No. 7. Brazzaville.Google Scholar
World Health Organization (in preparation). Provisional title: Community Mental Health in Developing Countries.Google Scholar