Outcomes of common mental disorders in a rural community in South India

Krishnamachari Srinivasan, Anton Neville Isaacs, Tinku Thomas, Geetha Jayaram

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Common mental disorders that refer to anxiety and depression syndromes are important cause of psychiatric
    morbidity in primary health center. Studies evaluating outcomes of common mental disorders (CMD) from India are few.
    Objectives: The aim of the present study was to examine the outcomes of the broad category of CMD and specifically major
    depression in individuals resident in a rural community following naturalistic treatment with antidepressants. Methods:
    Individuals with a diagnosis of CMD using a 2 stage diagnostic process were invited to seek treatment from a Primary health
    center. Outcome was assessed in 144 patients diagnosed with major depression using a structured interview schedule
    (SCID) at 6 months. Outcome was measured using 17-item Hamilton Depression Rating Scale (HAMD) and WHO QOL (Brev)
    version. Individuals with a score of = 7 on HAMD were deemed to have incomplete remission. Results: 114 (79%) individuals
    with CMD continued to be symptomatic at 6 months. Co-morbid psychiatric conditions especially anxiety was associated with
    poor outcome. Individuals with higher score on HAMD had poorer quality of life as measured by WHO QOL. Treatment with
    antidepressant medication did not significantly influence the outcome. Conclusion: A significant majority of individuals
    diagnosed with major depression resident in a rural community had a poor outcome. However, many patients either did not
    seek treatment or prematurely discontinued treatment. Implications for public health approach to the treatment of CMD are
    highlighted.
    Original languageEnglish
    Pages (from-to)110-115
    Number of pages6
    JournalIndian Journal of Social Psychiatry
    Publication statusPublished - 2006

    Keywords

    • Common mental disorders
    • Major depression
    • Primary Care
    • Antidepressants
    • Outcome

    Cite this