COMMON MENTAL-DISORDERS, EXPLANATORY MODELS AND CONSULTATION BEHAVIORAMONG INDIAN WOMEN LIVING IN THE UK

Women of Indian origin are said to have a lower rate of recognized com mon mental disorders and a higher frequency of consultation in primary care than white British. The aim of this study was to evaluate factor s, including explanatory models (patient perspectives) of illness, ass ociated with common mental disorders and with frequency of consultatio n among women of Indian origin in primary care. The investigation was conducted in a general practice in West London with a large Indian pop ulation. Consecutive woman attenders of Indian descent were screened w ith the General Health Questionnaire-12 to identify probable cases of psychiatric morbidity. 100 patients were interviewed with the Revised Clinical Interview Schedule (CIS-R), a specific tool for the diagnosis of common mental disorders, and the Short Explanatory Model Interview , which elicits the individual's conceptualization of his or her illne ss. Those patients who satisfied CIS-R criteria were classified as 'ca ses', the others as 'controls'. Common mental disorders were documente d in 30% of patients. The general practitioner's diagnosis of common m ental disorders had a sensitivity of 17% and a specificity of 91%. Ind ividuals with common mental disorders had a higher frequency of consul tation (P=0.017), were less likely to see depression as an indication for medical intervention and were more likely to withhold some of thei r concerns from the general practitioner. Incorrect diagnosis by the G P was most likely to occur when patients did not disclose all their co mplaints. These associations were all statistically significant after adjustment for possible confounders by multiple linear and logistic re gression. Women of Indian origin in this sample had rates of common me ntal disorders similar to those in other UK populations. Differing con ceptualizations of common mental disorders may contribute to their und errecognition in women of Indian origin.