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Correlates of psychiatric morbidity and case identification in Ibadan, Nigeria
1Department of Psychiatry, College of Medicine, University of Lagos, Nigeria.
Objective:
To determine the correlates of psychiatric morbidity and the factors that may influence the recognition of psychiatric cases in primary care.
Design:
In the cross-sectional survey, the sample was selected by systematic sampling technique. Each subject was interviewed in sequence by a research nurse, a psychiatrist and a general practitioner (GP).
Setting:
The primary care facility at the University College Hospital, Ibadan.
Subjects:
Eight GPs and 414 (44% males, 56% females) patients were selected.
Intervention:
A socio-demographic questionnaire, the present state examination (PSE), and clinical interview were administered to the subjects. Eysench personality questionnaire (EPQ) was completed by GPs. The research nurses scored each GP on an enthusiasm scale.
Main Outcome Measures:
The diagnosis by psychiatrist and GPs recorded on doctors' information sheet: the PSE scores of subjects, the EPQ scores of GPs and their observed enthusiasm ratings among others were the main measures.
Results:
The psychiatric morbidity rate was 43.4% in the centre. GPs accuracy was 0.7 and Kappa score was 0.44. EPQ Neuroticism and Psychoticism scores correlated negatively with GPs ability to recognise cases, whereas enthusiasm correlated positively. GPs had difficulty in recognising minor psychiatric disorders accounting for 94.4% of morbidity in the primary care. Morbidity was significantly associated with female sex, age 45-54 years, self-employment, low level of education and being currently married. Females and the self-employed were over-represented among GPs' cases.
Conclusion:
More data from similar studies across cultures would provide useful insight into strategies that could bring about early recognition and treatment of minor psychiatric disorders in the primary health care.