A cross-sectional study of psychiatric morbidity in a tertiary care teaching hospital

Abstract

Background: Mental health disorders constitute a major public health concern worldwide. The World Health Organization estimates that one in four individuals will experience a mental health disorder at some point in their lives. Psychiatric morbidity often coexists with physical illnesses, especially in tertiary care hospitals, where patients present with complex and chronic medical conditions. Chronic medical illnesses contribute substantially to global morbidity and mortality, and are frequently complicated by psychiatric comorbidities. The coexistence of physical and psychological disorders negatively affects treatment adherence, disease outcomes, quality of life, and overall prognosis. Despite this, psychiatric morbidity often remains underdiagnosed in patients attending tertiary-care hospitals, particularly in resource-limited settings.

Aim: To assess the prevalence and pattern of psychiatric morbidity among patients attending a tertiary care teaching hospital.

Material and Methods: This observational, cross-sectional study was conducted among 76 patients with established diagnoses of chronic medical illnesses, recruited from the outpatient and inpatient departments of medicine and allied specialties. Sociodemographic details and clinical parameters were recorded using a semi-structured proforma. Psychiatric morbidity was assessed using the General Health Questionnaire-28 (GHQ-28) for psychological distress, the Hospital Anxiety and Depression Scale (HADS) for screening depression and anxiety, and the Mini-International Neuropsychiatric Interview (MINI) for diagnostic confirmation. Statistical analysis was performed using SPSS version 25.0. Descriptive statistics were used for baseline characteristics. Chi-square tests and logistic regression analyses were applied to determine associations and independent predictors, with p < 0.05 considered statistically significant. Results: Psychiatric morbidity was identified in 65.79% of patients. The most common diagnoses were depression (26.32%) and anxiety disorders (18.42%), followed by adjustment disorder (13.16%) and somatoform disorders (7.89%). Female patients had significantly higher psychiatric morbidity (76.47%) compared to males (57.14%, p = 0.041). Psychiatric morbidity was most prevalent among those with chronic kidney disease (80.00%) and diabetes mellitus (72.73%), both showing statistically significant associations (p = 0.041 and p = 0.032, respectively). Multivariable logistic regression analysis revealed that female gender (OR 2.10, p = 0.038), low socioeconomic status (OR 2.72, p = 0.024), diabetes mellitus (OR 2.48, p = 0.031), and chronic kidney disease (OR 3.12, p = 0.021) were independent predictors of psychiatric morbidity.

Conclusion: Psychiatric morbidity is highly prevalent among patients with chronic medical illnesses, particularly in women and those with diabetes or chronic kidney disease. These findings highlight the urgent need for routine psychiatric screening and integrated psychosocial interventions in tertiary-care hospital settings to improve holistic patient care.