Psychiatric problems in general outpatient clinics: prevalence and reasons for help seeking

ABSTRACT

The aims of the present study are to examine the prevalence of psychiatric problems and the reasons for seeking care in urban health centers in district 17 of Tehran [capital of Iran], and to study the sensitivity and predictive value of the presence of psychiatric symptoms as chief complaint and self-report of a psychiatric history for correct recognition of a psychiatric problem. The present research was a cross-sectional and descriptive study. Two urban health centers located in district 17 in Tehran were randomly selected from a total of 7 health centers. Patients referring to outpatient clinics of the centers were consecutively asked to fill in General Health Questionnaire-28 and a pathways-to-care questionnaire. In total, 126 subjects [54% female] were included. Forty-two patients [33.3%] had psychiatric problem based on GHQ. Only 11 [8.7%] had psychiatric symptoms as chief complaints [reasons for referral] and 60 [47.6%] considered themselves having a psychiatric illnesses. Of all GHQ cases, 27 [64.2%] had never consulted for a psychiatric illness. The sensitivity of self-report of psychiatric complaint or illness was less than 70% with positive predictive values of less than 55%. In line with previous research, psychiatric disorders were commonly observed in outpatient clinics in Tehran. However, most of those with a problem had not sought care. In addition, sole reliance on patients' self-report of psychiatric complaint or illness might not lead to proper recognition of patients in primary care