ABSTRACT
OBJECTIVE: To determine the more common symptoms of mental illness among Saudi adult primary health care (PHC) patients, and to apply the factor analysis of the Rahim Anxiety and Depression (RAD) Scale. METHODS: This is a cross-sectional study of a sample of 641 patients that attended the PHC clinics in Al-Kharj city, from July to November 2000. Their ages ranged from 15 to 65 years. The RAD Scale was used as a self-administrating questionnaire to explore the common symptoms of mental illness. A factor analysis was performed by principle component analysis with varimax rotation of RAD Scale, with an eigen value of >1.5 for factor extraction. Only those items loading >0.4 were included. RESULTS: A total of 609 patients with the mean age + SD of 33.7+13.4 responded, and of these men formed 46.6%. The most common mental illness symptoms were getting angry easily (46%), tension (35%), sleeping badly (27%), not enjoying daily activities (15%), and unhappiness (14%). Physical symptoms reported were headaches (43%), joint pains (38%), fatigue (36%), stomach problem (33%), and dizziness (27%). All the 39 items of the RAD Scale were included for factor analysis. Five factors (groups) were generated, which together accounted for 47% of the total variance. These factors were represented as: psychic depressive, psychic and somatic (headache and bodily pains) anxiety symptoms, somatization in the form of gastrointestinal complaints, somatization in the form of cardio-respiratory symptoms, and somatic anxiety symptoms. CONCLUSION: Both physical and psychological symptoms of mental illness are a burden on the PHC patients. Consequently, using the RAD scale is helpful in diagnosis. The factor analysis categorizes the items into different groups to save time and specify the disorder. This will be a simplified method in the PHC settings.
ABSTRACT
OBJECTIVE: To measure changes in the attitude of Primary Health Care (PHC) physicians towards mental illnesses after a short-term training course. In addition, to ascertain if this change would persist 6 months after the training course. METHOD: This is an intervention type study. Out of 296 PHC physicians working in Eastern Saudi Arabia, 191 were randomly selected and divided randomly into two groups. The Study groups were tested for pre and post exposure (immediate and 6months later), to the psychiatric training course. The Control group was not involved in the intervention. The course was run over a 4-day period in June 1999. A 26-item self-administered questionnaire to assess the PHC physicians' attitudes was used. RESULTS: The study group consisted of 45 trainees, 24 (53%) of whom were men. The control group, 121 out of 166 physicians, responded to the questionnaire, with an 83% response rate, men forming 49%. The data analysis indicated a significant improvement in the PHC physicians' attitude after the course (P<0.0001). Six months later, as compared with their immediate post-test, the positive attitudes persisted within the study group (p-value=0.274). Multiple regressions indicated that the duration of undergraduate psychiatric training was the only contributor factor. CONCLUSION: This training course resulted in a positive change in the trainees' attitudes. Besides, it showed that the undergraduate psychiatric training had a favourable effect on the PHC physicians' attitude. Therefore, there should be frequent mental health training programs for PHC physicians. Moreover, physicians who spent longer period in undergraduate psychiatric training should be given the priority to work in PHC settings.
ABSTRACT
OBJECTIVE: The objective of this study was to measure changes in the Primary Health Care (PHC) physicians` knowledge towards mental illnesses after a short-term training course. METHODS: The interventive study consisted of a sample of 31 PHC physicians randomly selected from different PHC centers in Eastern Saudi Arabia. The physicians were exposed to a 4-day intensive training course in mental illnesses in June 1999. They were assessed using multiple choice questions testing before (pre-test) and after (post-test) to assess their knowledge regarding mental illnesses. RESULTS: The analysis of the accumulated data indicated that there was a significant improvement in the PHC physicians` knowledge of mental illnesses after the course (p<0.0001). The effect of recall bias was excluded in the post-test evaluation. In addition, multiple regression analysis indicated that the undergraduate psychiatric training courses had a positive contribution in both pre- and post-tests. CONCLUSION: The authors surmised that a mental training course could improve the knowledge base of PHC physicians. Furthermore, by giving substantial weight to the undergraduate and internship psychiatric training might improve the delivery of mental health services at the PHC level.
ABSTRACT
OBJECTIVE: To determine the prevalence of mental illness morbidity among Saudi adult primary care patients from Al-Kharj, Kingdom of Saudi Arabia. METHODS: This is a cross-sectional epidemiological study of the prevalence of mental illness morbidity in a randomly selected sample of 609 Saudi adult patients, aged from 15 years to 65 years who attended Family and Community Medicine Clinic, Armed Forces Hospital, Al-Kharj, Kingdom of Saudi Arabia, from July 2000 to November 2000. The Rahim Anxiety-Depression Scale was used in the evaluation. RESULTS: In this study, 609 Saudi patients were screened. Their mean age standard deviation was 33.72 13.39. Of these, 46.6% were men and 53.4% were women. The prevalence of the minor mental illness morbidity was 18.2%, (30.5% when the sub-threshold mental illness are included). It was significantly higher in women (22.2%) than men (13.7%) with p-value=0.0073. The prevalence rate was high in the younger age group, (p<0.0001). In patients aged 15 years to 29 years it was 23.2%, and in those aged between 30 years and 44 years it was 17.8%, whereas, in patients aged 45 years to 65 years the prevalence was 7.1%. Also, the rate was high in divorcees (40%) and widows (43.8%). The prevalence rate in patients with diabetes mellitus was 16% (p=0.562), with hypertension, 22.2% (p=0.303), and with bronchial asthma, 28.3% (p=0.008). Multiple logistic regression analysis showed that age, gender and bronchial asthma were associated with mental illness. CONCLUSION: Our study shows that one 3rd of primary health care patients have mental illness. Due to the high prevalence of mental illnesses among primary health care clinic attendants and screening for such problems by using Rahim Anxiety-Depression scale could be time consuming, exploring the psychiatric dimension and effect of diseases should be included during any consultation.
