Co-existing mental and medical conditions among family medicine outpatients in a tertiary hospital in southern Nigeria

Abstract

Background: A considerable number of patients seen in the Primary Care Clinics have co-morbid mental disorders with medical conditions that are largely not recognized by the primary care physician. This inability to recognize these mental disorders lead to non diagnosis and non treatment with eventual amplification of physical symptoms, low productivity at work and functional disability at home.
Aims: To screen the patients attending the general outpatient clinic for anxiety and depression co-occurring with medical conditions.
Methods: Two hundred and forty five patients aged 20 years and above attending the General Outpatient Clinic of the University of Uyo Teaching Hospital were randomly assessed for anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). The level of caseness for anxiety and depression were determined using a HADS score of 8 and above. Their medical conditions were diagnosed and associations were determined with mental disorders (anxiety and depression).
Results: A total of 36.7% of patients scored above cut off point of 8 on the anxiety subscale while 24.5% of the subjects scored above cut off point of 8 on the depression subscale. 24.1%, (n=59) scored 8-10 on the anxiety subscale of HADS which is interpreted to be mild anxiety, 11.0%, (n=27) scored 11-14 on the anxiety subscale of HADS which is interpreted to be moderate anxiety and 1.6%, (n=4) scored 15-21 on the anxiety subscale of HADS which is interpreted to be severe anxiety. Similarly, 15.9%, (n=39) scored 8-10 on the depression subscale of HADS which is interpreted to be mild depression, 7.8%, (n=19) scored 11-14 on the depression subscale of HADS which is interpreted to be moderate depression and 0.8%, (n=2) scored 15-21 on the depression subscale of HADS which is interpreted to be severe depression.  Hypertension was present in 22.04%, (n=54) respondents with anxiety p = 0.016 and depression p=0.025. HIV/AIDS was present in 4.08%, (n=10) respondents with depression p = 0.006.
Conclusion: The result of the study shows that patients attending general outpatients' clinic suffer from mental disorders like anxiety and depression which may co- exist with hypertension and HIV/AIDS. Therefore, a careful assessment of patients attending these clinics will detect these disorders and treatment will improve the physical condition of the patients.