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Brief research Communication

 

PSYCHIATRIC SERVICE UTILISATION: THE ‘START 6’ PROGRAMME

Das Shyamanta,1 Talukdar Uddip, 2 Chakravarty Suresh, 3 Ghosh Prosenjit, 4 Hazarika Mythili 5

1Assistant Professor, Department of Psychiatry, Fakhruddin Ali Ahmed Medical College Hospital, Barpeta, Assam, India ,2Registrar, Department of Psychiatry, Fakhruddin Ali Ahmed Medical College Hospital, Barpeta, Assam, India, 3Professor and Head, Department of Psychiatry, Fakhruddin Ali Ahmed Medical College Hospital, Barpeta, Assam, India, 4Assistant Professor, Department of Psychiatry, Silchar Medical College Hospital, Silchar, Assam, India, 5Senior Lecturer of Clinical Psychology, Department of Psychiatry, Gauhati Medical College Hospital, Guwahati, Assam, India

 

Abstract

 

The clinical and demographic profiles of patients utilising psychiatric service at a newly opened medical college hospital were examined. Study design was retrospective, analysed with descriptive statistics. Four hundred and thirteen patients utilised the service for the first time. Mean age of the patients was 33.31 years and men constituted 56.42%. Highest number of patients was with neurotic, stress-related and somatoform disorders (F4) followed by mood (affective) disorders (F3) and schizophrenia, schizotypal and delusional disorders (F2). It gave us information regarding the service utilisation pattern in the initial period of a medical college hospital providing psychiatric service.

Keywords Diagnosis. Age. Sex.

 

Introduction

 

Fakhrudddin Ali Ahmed Medical College Hospital is a newly opened medical college which at the time of preparing the study is running only the hospital services as the college is yet to obtain the Medical Council of India (MCI) permission. It is situated in the district of Barpeta of the state of Assam in India. The medical college hospital caters to the people of the district and also to the adjoining districts of Baksa, Nalbari and Bongaigaon. Before its onset the population was dependent on Gauhati Medical College Hospital in Guwahati for tertiary care which is situated at a distance of 100 kilometers from Barpeta. The district had one government appointed psychiatrist who used to work in the Barpeta Civil Hospital, and there were private practitioners delivering psychiatry services on outdoor basis.

As already mentioned the college hospital is newly opened, hence the population is using the services more as a primary care than tertiary care i.e. more number of patients is coming themselves than being referred. The hospital wing started functioning with effect from 10 February 2011. The Department of Psychiatry was catering its service from the inception. Aim of the present study was to evaluate the pattern of psychiatric service utilisation in the initial six months.

 

Method

 

Under the ‘start6’ programme, record sheets were examined for the period of six months from February 2011 up to July 2011. Demographic and clinical characteristics in the form of age, gender and diagnosis were noted. Descriptive statistics were used to analyse the data. The study was approved by the institutional ethics review board.

Results

The total number of new patients utilising psychiatric service in the initial six months was 413. Mean age was 33.31 years (TABLE). Men constituted 56.42% and women 43.58% (TABLE).

 

TABLE Demographic characteristics

 

Age (in years)

     Mean: 33.31

     95% confidence interval: 31.92—34.69

Sex, number (%)

     Men: 233 (56.42%)

     Women: 180 (43.58%)

 

One hundred and fifty three patients received the diagnosis of neurotic, stress-related and somatoform disorders (F4) followed by 72 patients with mood (affective) disorders (F3) and 61 with schizophrenia, schizotypal and delusional disorders (F2). There were 21 patients with mental retardation (F7), 14 with behavioural syndromes associated with physiological disturbances and physical factors (F5) and 13 with mental and behavioural disorders due to psychoactive substance use (F1). Seven patients were diagnosed with behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F9), six each with organic, including symptomatic, mental disorders (F0) and disorders of adult personality and behaviour (F6) and one with disorders of psychological development (F8) (FIGURE).

 

 

FIGURE Diagnosis

F0: Organic, including symptomatic, mental disorders

F1: Mental and behavioural disorders due to psychoactive substance use

F2: Schizophrenia, schizotypal and delusional disorders

F3: Mood (affective) disorders

F4: Neurotic, stress-related and somatoform disorders

F5: Behavioural syndromes associated with physiological disturbances and physical factors

F6: Disorders of adult personality and behaviour

F7: Mental retardation

F8: Disorders of psychological development

F9: Behavioural and emotional disorders with onset usually occurring in childhood and adolescence  

 

Discussion

Our study had shed light on the pattern of psychiatric service utilisation at the start of a medical college hospital. According to the World Health Organization (WHO),1 prevalence of psychiatric disorders in India was 58/1000. Point prevalence of severe mental illness was 10-20/1000 population and incidence 35/100,000 population. Point prevalence of neuroses and psychosomatic disorders was 2-3%. Point prevalence of mental retardation was 0.5-1.0% of all children and point prevalence of psychiatric disorders in children 1-2% of all children. Psychiatric OPD attendance in (1990 data) Govt. hospitals was 3.63 million/year and private practice 2.63 million/year. Total OPD attendance was 6.29 million/year (~1% of population). Additionally, 15-20% of all help-seekers in the general health services do so for emotional and psychosocial problems.

Few characteristics examined were limitations of the study.

 

References

1. World Health Organization. Project Atlas: Resources for Mental Health [Internet]. Geneva: World Health Organization; 2005 [cited 2013 May 13]. Available from: http://www.who.int/mental_health/evidence/atlas/en