Patel V, Pereira J, Coutinho L, Fernandes R, Fernandes J, Mann A
Institute of Psychiatry and Human Behaviour, Goa, India.
Br J Psychiatry. 1998 Jun;172:533-6. doi: 10.1192/bjp.172.6.533.
This study examined the association of common mental disorders in primary health clinic attenders with indicators of poverty and disability in Goa, India.
Adult attenders (n = 303) in two primary health clinics were recruited.
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.
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.
本研究调查了印度果阿邦初级卫生保健诊所就诊者中常见精神障碍与贫困及残疾指标之间的关联。
招募了两家初级卫生保健诊所的成年就诊者（n = 303）。
有141例（46.5%）常见精神障碍病例。以下因素与常见精神障碍相关：女性；因缺钱无法购买食物；以及负债。病例在所有残疾指标上的得分显著更高。初级卫生保健诊所的工作人员识别出了三分之一的发病率，但使用多种口服药物、注射用维生素和苯二氮䓬类药物来治疗常见精神障碍。
贫困与常见精神障碍密切相关，而常见精神障碍又与贫困和绝望相关。低收入国家的初级精神卫生保健重点需要从通常需要专科护理的精神障碍转向常见精神障碍。卫生政策和发展机构需要认识到女性性别和贫困与这些障碍之间的密切关联。
