Patterns of Psychiatric disorders, self-reported psychological wellbeing and distress and their social and clinical correlates, in persons attending an urban mental health clinic, in Bangalore, a metro city of India- A retrospective chart review

INTRODUCTION: In the era of increasing urbanisation and more migration to urban from rural area, there is a significant treatment gap in the urban population for mental health needs. Studies shows that urban people prefers psychiatric clinics, rather than hospitals, mainly because of accessibility and less stigma; and a significant proportion would not have attended a hospital. So, community-based care is a step for more comprehensive care and clinic-based studies are important, particularly in service planning and resource allocation. To the best of our knowledge, there is no study which has specifically looked in to the pattern of psychiatric morbidity in urban mental health clinic India. Hence, we wanted to look at the pattern of psychiatric morbidity and distress in patients attending at urban primary mental health clinic. METHOD: Retrospective chart review was done for patients, attending NIMHANS centre for wellbeing (NCWB), a primary urban mental health clinic, in Bangalore, from April 2018 to March 2019. Files, having complete sociodemographic and clinical information including WHO 5 wellbeing scale and K10 assessments, were reviewed. Socio demographic and clinical details as well as scores of WHO wellbeing index (WHO-5) and the Kessler’s psychological distress scale (K-10) were collected. Psychiatric diagnosis of the patients was recorded as per DSM 5. RESULT AND DISCUSSION: Out of 195 case file reviewed, majority had depressive disorder (n=70, 35.9%) followed by anxiety including OCD (n=36, 18.5%) and trauma related disorders (n=35, 17.9%). Majority has reported significant distress in K10 (82%) and less well-being in WHO-5 (70.3%). Distress was more in female, depression, not married currently, and presence of familial tendency of psychiatric illness. Wellbeing was inverse to distress, and poor in recurrent psychiatric illness. In future, prospective study to see effect of gender, marital relationship, familial tendency and recurrent psychiatric illness on the wellbeing and perceived distress in psychiatric population are needed. Any gender specific distress or wellbeing expression in psychiatric illness can also be looked into.