Psychiatric morbidity and perceptions on psychiatric illness among patients presenting to family physicians, in April 2001 at a teaching hospital in Karachi, Pakistan

Objective: To assess psychiatric morbidity and the perceptions about psychiatric illness, among patients presenting to family physicians, at a teaching hospital in Karachi, Pakistan. Methods: A questionnaire based survey was developed to collect demographic data, information on psychiatric morbidity and perceptions on psychiatric illness. It was administered to 400 patients, against a sample size of 347. The study objective was explained, written consent was taken and confidentiality was assured. Results: There were more women then men in the study, with a mean age of 37 years. The majority was married, better educated and socioeconomically placed then the rest of the population. A total of 175 (43.75%) subjects reported psychiatric illness in the family. A psychiatrist or a family physician diagnosed the illness in 110 (62.85%) and 37 (21.14%) of the cases, respectively. A total of 68 (38.85%) subjects reported reluctance in accepting a diagnosis of psychiatric illness. A total of 296 (74%) of the respondents thought that psychiatric illness is stigmatized and therefore treatment is not sought for it. Alternate treatment for psychiatric illness were quoted as seeking treatment from a Hakim (49 subjects, 12.3%), spiritual healers (49 subjects, 12.3%) and family support (10 subjects, 2.5%). A total of 121 (30%) subjects thought that psychiatric illness is caused by supernatural powers and spirits. A total of 109 (27.3%) subjects felt a need to seek psychiatric help, but did not visit a psychiatrist because of reluctance.Conclusion: Considerable psychiatric morbidity exists among our patient population and is stigmatized. We recommend improvement in psychiatric services, as well as patient education programs.