Community Screening for Psychiatric Morbidity in Four Remote Valleys of Hindu Kush and Karakoram Regions of Pakistan.

Abstract

To find out the frequency of psychiatric morbidity in patients reporting to general medical camps in the Hindu Kush and Karakoram ranges of Pakistan. A cross-sectional study. Four different valleys of the region, with the Psychiatry Department, Combined Military Hospital, Gilgit as the base, from August 2015 to December 2016. Consenting adults of either gender, reporting to medical camps for various health related issues were administered Bradford Somatic Inventory 21 (BSI 21) and Self Report Questionnaire (SRQ). Non-parametric statistical techniques including Mann-Whitney test, Kruskall-Wallis test, and Spearman correlation, along with median and inter quartile range, were used to analyse data. Out of a total of 478 (52.1% females) respondents, half [n=234 (48.9%) on BSI and n=243 (50.8%) on SRQ] reported positive psychiatric morbidity. Inter-valley differences were significant (BSI, X2=49.1, p <.001; SRQ, X2=66.5, p <.001). Females reported higher levels of psychiatric morbidity measured by BSI (p <.001) and SRQ (p <.001), as compared to males. Participants' occupation was significantly associated (BSI; X2=23.1, SRQ; X2=35.3, p <.001) while their age was not significantly associated (BSI, r=-.06, p >.05; SRQ, r=-.09, p >.05) with their psychiatric morbidity. Psychiatric morbidity was prevalent in the population studied, which may go unrecognized, overlooked, or mistreated by the locally available medical resources. There is a huge need for mental health services in these areas.