Mental, physical and functional status in primary care attenders

Objective: The purpose of the present study was to analyze the association, in primary care attenders, between psychiatric disorders, medical comorbid ity, and impairment in mental and physical function status. Methods: The st udy had a two-stage design. The GHQ-12 was used to screen 1647 patients, an d 323 of them were then interviewed using the CIDI-PHC to obtain ICD-10 dia gnoses. Severity of mental illness was assessed using the Hamilton scales f or anxiety and depression. The DUSOI was used to evaluate the severity of p hysical illness. The MOS SF-36 was used to assess health related quality of life. Results: The estimated prevalence of ICD-10 psychiatric disorders an d subthreshold disorders was 12.4 percent and 18 percent respectively. The most common psychiatric disorders were generalized anxiety, major depressio n, and neurasthenia. The severity of physical illness did not vary across d iagnostic status categories. Significant impairment, both in physical and m ental functioning was seen in patients suffering from ICD-10 full-fledged a nd subthreshold disorders. Severity of impairment increased from subthresho ld cases to full-fledged cases, and among the latter according to the sever ity of depressive and anxious symptoms, assessed using Hamilton scales. The most frequent psychiatric disorders were associated with significant worse ning in health related quality of life, with relevant differences between p sychiatric diagnoses regarding the domains affected. Impairment associated with mental disorders was greater than that associated with physical illnes s. Conclusions: The results of the present study confirm that ICD-10 psychi atric disorders are common in general practice and are associated with rele vant impairment in physical and mental functional status. Psychiatric morbi dity is not related to severity of physical illness rated by general practi tioner.