Abstract
ABSTRACT Objective This study aimed to characterize the patients assisted at the general outpatient clinic of the Psychiatry Institute of Universidade Federal do Rio de Janeiro (IPUB-UFRJ) and to assess these patients’ clinical stability. Methods This cross-sectional study collected information using a structured questionnaire filled in by the patient’s physician. The questionnaire, specifically developed for this purpose, included sociodemographic data; the dwelling area; psychiatric diagnosis according to ICD-10; clinical stability assessment by means of five psychiatric instability criteria and the physician’s global clinical impression over the six previous months. Clinical stability was defined as a negative answer to all five pre-defined instability criteria. Results Overall, 1,447 questionnaires were filled in. The sample was composed of 824 (57%) women; with an average age of 49 years; 1,104 (76.3%) patients lived in the city of Rio de Janeiro and 343 (23.7%) lived outside the city; 983 (67.9%) patients had a severe mental disorder (SMD) diagnosis and 946 (65.3%) patients were considered stable. Statistically, the clinical stability by dwelling area did not differ. The most frequent clinical instability criterion was “exacerbation or emergence of acute manifestations of the disease”. Conclusion The major part of the patients displayed a SMD and was considered clinically stable.
Highlights
The idea of an outpatient clinic specialized in psychiatry in Brazil emerged with the implementation of the Mental Hygiene Welfare Policy in the 1920s, and it aimed to prevent mental disorders in the population
All the Planning Areas of the city of Rio de Janeiro were considered in the distribution of the dwelling area, as well as other cities in and out of the State of Rio de Janeiro
We found that severe mental disorder (SMD), which belongs to categories F20-F29 – Schizophrenia, schizotypal, and delusional disorders, and F30-F39 – Mood [affective] disorders, corresponded to 435 (30.0%) and 548 (37.9%) patients respectively, totaling 67.9% of the sample
Summary
The idea of an outpatient clinic specialized in psychiatry in Brazil emerged with the implementation of the Mental Hygiene Welfare Policy in the 1920s, and it aimed to prevent mental disorders in the population. The policy, which had a hygienist and normalizing nature, was in force until the 1980s, when the Consulting Board of the Governmental Health Insurance Administration developed the Reorientation Plan for Psychiatric Care. This plan invested strongly in public assistance, reforming psychiatric hospitals and expanding the extramural network of outpatient clinics[1]. The National Mental Health Policy started to have, among its objectives, the full exercise of citizenship, and the control of symptoms This policy recommends the substitution of the traditional model (medical- and hospital-centered) and the articulation of the care network, aiming at the individual’s integrality. Primary Care became the preferred entrance door to the Healthcare System, which includes Mental Health[3]
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