Pathway to psychiatric care in Karachi

ABSTRACT

This research was done to study the care and referral pathway taken by patients before they present to a psychiatrist at a university teaching hospital in Karachi, Pakistan. The key study variables were the obstacles and delays at each level of care i.e. community, primary care physician and psychiatrist. A consultant psychiatrist conducted an initial interview for diagnostic assessment. Patients' diagnosis was based on ICD-10 clinical care version. During the study period a total of 94 initial patients were seen and assessed in the psychiatry screening of Aga Khan University Hospital [AKUH]. Of them, there were 52 [55.3%] males and 42 [44.0%] females. Among the whole sample, 15% patients were in adolescent age group [<20 years age], while 38% were in the age range of 21-to-30 years, 17% in the age range 31-to-40 years, 15% between 41-to-50, while 6.5% were above the age of 60 years. Majority [64.5%] was single while 29 [10 females, 19 males] patients were married. Only 3% were divorced or widowed. Majority of patients were housewives [30%], followed by students [20%, 12 males, 6 females] and professionals [16%; 7 females, 8 males]. Five patients were unemployed at the time of referral while 5 had retired from their respective occupation The most common diagnosis in both genders was depression [females n=26, 52%; males n=21, 37%], while schizophrenia, bipolar disorder and obsessive-compulsive disorder was diagnosed with similar frequency in both genders