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Poverty, psychological disorder and disability in primary care attenders in Goa, India

Published online by Cambridge University Press:  03 January 2018

Vikram Patel*
Affiliation:
Institute of Psychiatry and Human Behaviour, Goa, India
Jerson Pereira
Affiliation:
Institute of Psychiatry and Human Behaviour, Goa, India
Livia Countinho
Affiliation:
Institute of Psychiatry and Human Behaviour, Goa, India
Romaldina Fernandes
Affiliation:
Institute of Psychiatry and Human Behaviour, Goa, India
John Fernandes
Affiliation:
Institute of Psychiatry and Human Behaviour, Goa, India
Antony Mann
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, London
*
Dr Vikram Patel, Sangath Centre for Child Development and Family Guidance, 71 Defence Colony, Alto-Porvorim, Goa 403521, India. E-mail: vpatel@bom2.vsnl.net.in

Abstract

Background

This study examined the association of common mental disorders in primary health clinic attenders with indicators of poverty and disability in Goa, India.

Method

Adult attenders (n=303) in two primary health clinics were recruited.

Results

There were 141 (46.5%) cases of common mental disorder. The following were associated with common mental disorder: female gender; inability to buy food due to lack of money; and being in debt. Cases scored significantly higher on all measures of disability. Primary health clinic staff recognised a third of the morbidity but used multiple oral drugs, injectable vitamins and benzodiazepines to treat common mental disorders.

Conclusions

Poverty is closely associated with common mental disorder which in turn is associated with deprivation and despair. Primary mental health care priorities in low-income countries need to shift from psychotic disorders which often need specialist care to common mental disorders. Health policy and development agencies need to acknowledge the intimate association of female gender and poverty with these disorders.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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