The prevalence of psychiatric disorders among the chronically-ill medical patients in selected tertiary hospitals in the Philippines

OBJECTIVE: This study was conducted to document the prevalence of psychiatric morbidity among chronically ill medical patients in selected hospitals in the Philippines. METHODS: This is a cross-sectional study of the chronically medically ill patients seen in selected Primary are Evaluation of Mental Disorders (PRIME-MD), 774 patients were screened for mental disorders. The prevalence of each of the psychiatric disorders were calculated using the formula for estimation of a proportion for stratified random sampling. The differences in the sample size from each of the study sites were taken into consideration in the estimation of the sitespecific prevalence of mental disorders. The 95 percent confidence intervals of the prevalence rates were computed. RESULTS: Almost half of the patients (47.8 percent) were diagnosed with at least one of the psychiatric disorders elicited from the PRIME-MD. Thirty two percent had depressive disorder, followed by anxiety disorder, somatoform disorders, alcohol-related disorder and eating disorder. According to hospital site, the overall prevalence rate of psychiatric disorder was noted to be highest at the Davao Medical Center. CONCLUSION: The overall prevalence of psychiatric disorder noted in this study was higher than that described in foreign literature, the most common of which was depression.

Comparison between primary care evaluation of mental disorders patient questionnaire and the self-reporting questionnaire as screening tools for psychiatric disorders at the UP-PGH Pain Clinic

OBJECTIVE: To compare the validities of two instruments- the Primary Care Evaluation of Mental Disorders Patient Questionnaire (PRIME-MD PQ) and the Self-Reporting Questionnaire (SRQ)- in terms of discriminating between patients with and without psychiatric disorders seen at the UP-PGH Pain Clinic. DESIGN: Cross-sectional, criterion standard SETTING: Pain Clinic at the Department of Outpatient Services SUBJECTS: A total of 102 adult patients assessed by three pain fellow physicians MAIN OUTCOME MEASURES: Positive or negative results for mental disorders using PRIME-MD PQ and SRQ as screening procedure plotted against psychiatric interview whether positive or negative using a two-by-two contingency table RESULTS: There was good agreement between PRIME-MD PQ and psychiatric interview (k=0.67) whereas poor correlation between SRQ and psychiatric interview (k=0.51). However, with the removal of one item eliciting grandiosity from the "psychotic" items, agreement with the SRQ rose to k=0.76 when all items on psychosis are eliminated (shorter version of SRQ), agreement was almost excellent (k=0.79). CONCLUSION: The modified version of SRQ is slightly superior to the PRIME-MD PQ in discriminating between patients with and without psychiatric disorders at the Pain Clinic.