Prevalence of psychiatric morbidity in the primary health clinic attendees in Kuwait

- Up to a third of the primary clinic attendees suffer from psychiatric disorders.
- Many patients prefer to seek psychiatric help at primary care level.
- Somatization, depression and anxiety, were the commonest disorders in our patients.
- Local nationals with mental illness were more likely to attend primary clinics.
- Integration at primary care level can ensure cost-effective psychiatric care delivery.

BackgroundA substantial proportion of primary clinic attendees suffer from psychiatric disorders and many of them are neither recognized nor adequately treated by primary clinic physicians.ObjectivesTo determine the point prevalence of, and identify risk factors for, depression, anxiety, and somatisation disorder in the primary health clinics in the country.MethodThe 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. The descriptive data were computed with chi-square tests while the association of demographic characteristics with psychiatric disorders was determined with the logistic regression test.Results42.7% of the our patients suffered from psychiatric disorders including depressive (22.9%), anxiety (17.7%), and somatization (33.4%) disorder. Comorbidity between the three disorders was found in 20.4% of the sample; 11% had two and 10.4% had all three disorders. The Kuwaiti nationals, female gender, older age group subjects and those with lower level of education were more likely to suffer from psychiatric disorder.LimitationsThe inter-rater reliability may have affected the results as large number of physicians were responsible for administering the questionnaires. Moreover, the study did not include eating and substance-abuse disorders and the findings were limited to detection of somatization, depression, and anxiety disorders.ConclusionsIn order to ensure timely provision of appropriate treatment, the primary care physicians need adequate information on different forms of presentation, and basic front line treatment, of the common mental disorders at the primary care level.