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ORIGINAL ARTICLE
Year : 2017  |  Volume : 44  |  Issue : 2  |  Page : 83-85

A 1-year disease profile of psychiatric patients visiting the outpatient department of a tertiary care hospital


1 Department of Medicine, Chattagram Maa-Shishu O General Hospital, Chittagong, Bangladesh
2 Department of Psychiatry, Chattagram Maa-Shishu O General Hospital, Chittagong, Bangladesh

Date of Web Publication11-Oct-2017

Correspondence Address:
Rajat Sanker Roy Biswas
Department of Medicine, Chattagram Maa-Shishu O General Hospital, Chittagong
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_37_16

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  Abstract 

Introduction: Mental disorders constitute a higher burden on low- and middle-income countries like Bangladesh. Mental disease is poorly recorded, and data are not easily available in countries like Bangladesh. Hence, the aim of the present study was to observe the pattern of mental diseases found in a tertiary care center during 1-year survey. Methods: One-year patient data were explored from January 2015 to December 2015 and were extracted manually manually from the register book. All diagnosis were collected, and data were analyzed using Microsoft Excel. Results: Among the 1474 patients, most were in the age group of 11–20 years (388 [26.3%]) and 21–30 years (437 [29.6%]), next age group was 31–40 years (243 [16.5%]). One-hundred and twenty (8.1%) and 33 (2.2%) patients were found in two extremes of age <10 years and >61 years, respectively. Males were 736 (49.9%) and females were 738 (50.1%). Male:female ratio was 1:1. Schizophrenia (360, 24.4%) was the most common psychiatric disease found which was next to major depressive disorder (187, 12.7%). Bipolar mania was found in 175 (11.9%) cases, and bipolar depression was found in 19 (1.3%) cases. Some other diseases such as generalized anxiety disorder was found in 57 (3.9%), obsessive-compulsive disorder in 35 (2.4%), phobic anxiety in 12 (0.8%), and panic disorder in 76 (5.2%) cases. Conclusion: In Bangladesh, burdens of mental disorders are high but largely unrecognized and underresearched area. To improve the mental health services in Bangladesh, further well-designed epidemiological and clinical research is required.

Keywords: Disease profile, outpatient department, psychiatric patients


How to cite this article:
Roy Biswas RS, Uddin MG, Mostafa M. A 1-year disease profile of psychiatric patients visiting the outpatient department of a tertiary care hospital. J Sci Soc 2017;44:83-5

How to cite this URL:
Roy Biswas RS, Uddin MG, Mostafa M. A 1-year disease profile of psychiatric patients visiting the outpatient department of a tertiary care hospital. J Sci Soc [serial online] 2017 [cited 2020 Sep 18];44:83-5. Available from: http://www.jscisociety.com/text.asp?2017/44/2/83/216500


  Introduction Top


Mental disorders constitute a major public health problem and contribute to 13% of the global burden of disease measured as disability-adjusted life years.[1] Low- and middle-income countries have a higher burden of mental disorders than economically developed countries.[2],[3] Bangladesh is a developing country and health-care delivery system is taking a shape gradually, and it provides basic health need for the community with a very negligible token monetary.

In a prevalence study of psychiatric disorder among the French population reported, 46% of the study population was reported to have had experienced at least one mental disorder in their lifetime.[4] Lifetime prevalence of major depression was 26.5% and that for anxiety disorder was 30%.[4] The prevalence of significant depressive symptoms in a community dwelling elderly individuals ranged from 11% to 44%, with an average of about 20%.[5]

In Bangladesh, there was hardly any study revealing the prevalence and pattern of psychiatric disease among the community. Hence, this study was aimed to analyze the disease spectrum and patterns of psychiatric diseases among the patients visiting an outpatient department (OPD) of a tertiary care hospital, Chittagong, Bangladesh.


  Methods Top


Design of the study was retrospective observational. Data were collected from a register book of the OPD of psychiatry. Name, age, sex, provisional diagnosis of the disease, and mode of treatments were noted. All necessary data were extracted and noted. A total of 1474 patients were found visiting the OPD of our hospital in the year 2015. The monthly patient profile was compiled, and data were presented in tables with the use of Microsoft Excel.


  Results Top


Among the 1474 patients, most were in the age group 11–20 years (388 [26.3%]) and 21–30 years (437 [29.6%]), next age group was 31–40 years (243 [16.5%]). One hundred and twenty (8.1%) and 33 (2.2%) patients were found in two extremes of age <10 years and >61 years, respectively [Table 1]. Males were 736 (49.9%) and females were 738 (50.1%). Male:female ratio was 1:1 [Table 2]. Schizophrenia (360, 24.4%) was the most common psychiatric disease found which was next to major depressive disorder (187, 12.7%). Bipolar mania was found in 175 (11.9%) cases, and bipolar depression was found in 19 (1.3%) cases. Some other diseases were found such as generalized anxiety disorder (GAD) in 57 (3.9%), obsessive-compulsive disorder in 35 (2.4%), phobic anxiety in 12 (0.8%), and panic disorder in 76 (5.2%) cases. Other psychiatric diseases such as conversion disorder were found in 29 (2.0%), somatoform disorder in 24 (1.6%), attention deficit hyperactivity disorder (ADHD) in 44 (3.0%), dissociative disorder in 9 (0.6%), bipolar hypomania in 2 (0.1%), psychotic depression in 14 (0.9%), tension-type headache in 10 (0.7%), extrapyramidal syndrome in 7 (0.5%), brief psychotic disorder in 44 (3.0%), posttraumatic disorder in 33 (2.2%), delusional disorder in 66 (4.5%), deliberate self-harm in 9 (0.6%), mental retardation in 21 (1.4%), nocturnal enuresis in 11 (0.7%), postpartum psychosis in 23 (1.6%), acute traumatic stress disorder (ATSD) in 10 (0.7%), dementia in 29 (2.0%), conduct disorder in 5 (0.4%), sexual disorder in 8 (0.5%), sleep disorder in 1 (0.1%), and substance abuse disorder in 1 (0.1%) case. Epilepsy was found in 153 (10.4%) cases [Table 3].
Table 1: Age group distribution

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Table 2: Gender distribution

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Table 3: Clinical diagnosis

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  Discussion Top


The present study was conducted among the patients who visited the psychiatry OPD of a tertiary care hospital, Chittagong, Bangladesh.

A total of 1474 patients visited during the 1-year study period. Among all patients, most were in younger age groups, where 388 (26.3%) patients were at 11–20 years, 437 (29.6%) patients were at 21–30 years and 243 (16.5%) patients were at age group 31–40 years. In the study, 736 (49.9%) were males and 738 (50.1%) were females. Male:female ratio was 1:1. The earliest preliminary study conducted in urban setting back in 1975 reported that 31% of outpatients had pure psychogenic conditions.[6] Later, a general practice urban setting revealed that 29% of the patients were suffering the same.[7] A community-based rural study reported 3.6% psychiatric disorders and 2.9% both psychiatric and physical disorders with depression and anxiety being the most common condition.[8] Later, an urban community-based study reported psychiatric disorders among 28% of the participants as diagnosed by a psychiatrist.[9] Another study reported an overall prevalence of mental disorders among 12.2% respondents, but more females than males were affected (13.9% vs. 10.2%).[10]

Schizophrenia was the most common psychiatric disease found which was 360 (24.4%) next to which was major depressive disorder 187 (12.7%). Bipolar mania was found in 175 (11.9%) cases, and bipolar depression was found in 19 (1.3%) cases. A rural community-based study showed an overall prevalence of psychiatric disorders as 16.5%; notably, half of the sufferers had depressive disorders (8%), and one-third had anxiety disorders (5%).[11] On the other hand, another study on females in a rural setting reported that 16.4% had mental disorders with depression being the single most common disorder (8.9%).[12] The first national survey on mental health [13] conducted between 2003 and 2005 documented that 16.1% of the adult population had mental disorders and the prevalence was higher in women than men. Overall, the literature evidence suggests that the prevalence of mental disorders ranges from 6.5% to 31% among adults, depending on the community or clinic setting, and women seemed to be more vulnerable.

Some other diseases were found such as GAD, obsessive-compulsive disorder, phobic anxiety, panic disorder conversion disorder, somatoform disorder, ADHD, dissociative disorder, bipolar hypomania, psychotic depression, tension-type headache, extrapyramidal syndrome, brief psychotic disorder, posttraumatic disorder, delusional disorder, deliberate self-harm, mental retardation, nocturnal enuresis, postpartum psychosis, ATSD, dementia, conduct disorder, sexual disorder, sleep disorder, and substance abuse disorder in different frequencies. Epilepsy was found in 153 (10.4%) cases. In an institution-based study of elderly psychiatry outpatients over a period of 3 years, mood disorder was reported to be the most common illness (48.07%), followed by anxiety spectrum disorder (15.47%) and organic mental disorders (14.36%).[14] Medical comorbidity was a significant finding of this study as additional physical illness diagnosis was found to be present in more than half (56.35%) of these patients.[14] In a retrospective study of elderly patients attending a psychiatric clinic, the psychotic disorder was reported in 33.6% and affective psychosis in 31.6% of geriatric patients.[15] Prasad et al. found that 43% of their elderly patient population had nonorganic psychoses while 22% of had organic psychosis.[16] In a psychiatry outpatient-based study, mood disorder was reported to be the most common clinical diagnosis (44%), followed by psychotic disorder (33.3%) and dementia (9.5%).[17]

This study showed that there are huge diversity of mental disorders in Bangladesh. To improve the mental health services we need well-designed epidemiological and clinical research. Public education and awareness programs on mental diseases may be undertaken to reduce misconceptions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Mathers C, Fat DM, Boerma JT. The Global Burden of Disease: 2004 Update. Geneva: WHO Press; 2008.  Back to cited text no. 1
    
2.
Bass JK, Bornemann TH, Burkey M, Chehil S, Chen L, Copeland JR, et al. AUnited Nations General Assembly Special Session for mental, neurological, and substance use disorders: The time has come. PLoS Med 2012;9:e1001159.  Back to cited text no. 2
[PUBMED]    
3.
Hock RS, Or F, Kolappa K, Burkey MD, Surkan PJ, Eaton WW. A new resolution for global mental health. Lancet 2012;379:1367-8.  Back to cited text no. 3
[PUBMED]    
4.
Ritchie K, Artero S, Beluche I, Ancelin ML, Mann A, Dupuy AM, et al. Prevalence of DSM-IV psychiatric disorder in the French elderly population. Br J Psychiatry 2004;184:147-52.  Back to cited text no. 4
[PUBMED]    
5.
Blazer D. Depression in Late Life. 2nd ed. St. Louis: Mosby Yearbook; 1993.  Back to cited text no. 5
    
6.
Chowdhury AK, Salim M, Sakeb N. Some aspects of psychiatric morbidity in the out-patient population of a general hospital. Bangladesh Med Res Counc Bull 1975;1:51-9.  Back to cited text no. 6
[PUBMED]    
7.
Alam MN. Psychiatric morbidity in general practice. Bangladesh Med Res Counc Bull 1978;4:38-42.  Back to cited text no. 7
[PUBMED]    
8.
Chowdhury AK, Alam MN, Ali SM. Dasherkandi project studies. Demography, morbidity and mortality in a rural community of Bangladesh. Bangladesh Med Res Counc Bull 1981;7:22-39.  Back to cited text no. 8
    
9.
Islam MM, Ali M, Ferroni P, Underwood P, Alam MF. Prevalence of psychiatric disorders in an urban community in Bangladesh. Gen Hosp Psychiatry 2003;25:353-7.  Back to cited text no. 9
    
10.
Karim E, Alam MF, Rahman AH, Hussain AA, Uddin MJ, Firoz AH. Prevalence of mental illness in the community. TAJ 2006;19:18-23.  Back to cited text no. 10
    
11.
Hosain GM, Chatterjee N, Ara N, Islam T. Prevalence, pattern and determinants of mental disorders in rural Bangladesh. Public Health 2007;121:18-24.  Back to cited text no. 11
    
12.
Ara N, Hossain GM, Islam MT. Women mental health in rural part of Bangladesh. Bang J Psychiatry 2001;15:5-10.  Back to cited text no. 12
    
13.
National Institute of Mental Health and Hospital (Bangladesh), In: Karim ME, Zaman MM, editors. WHO, Bangladesh: Prevalence, Medical Care, Awareness and Attitude Towards Mental Illness in Bangladesh; 2007. p. 1-27.  Back to cited text no. 13
    
14.
Singh GP, Chavan BS, Arun P, Lobraj, Sidana A. Geriatric out-patients with psychiatric illnesses in a teaching hospital setting – A retrospective study. Indian J Psychiatry 2004;46:140-3.  Back to cited text no. 14
[PUBMED]  [Full text]  
15.
Bhogale GS, Sudarshan CY. Geriatric patients attending a general hospital psychiatry clinic. Indian J Psychiatry 1993;35:203-5.  Back to cited text no. 15
[PUBMED]  [Full text]  
16.
Prasad KM, Sreenivas KN, Ashok MV, Bagchi D. Psychogeriatric patients – A sociodemographic and clinical profile. Indian J Psychiatry 1996;38:178-81.  Back to cited text no. 16
[PUBMED]  [Full text]  
17.
Tiple P, Sharma SN, Srivastava AS. Psychiatric morbidity in geriatric people. Indian J Psychiatry 2006;48:88-94.  Back to cited text no. 17
[PUBMED]  [Full text]  



 
 
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