Regional features of the incidence of mental disorders in the population (on the example of the Irkutsk region): a retrospective study

Abstract

Background. Mental and behavioural disorders pose a pressing challenge in healthcare as pertaining to socially significant diseases. The significance is conditioned by high morbidity rates, including temporary and permanent disability, high fi nancial burden of medical care andregular social subsidy to target groups. According to the World Health Organisation, mental burden currently aggravates to entail serious social, human-rights and economic impact around the globe.Objectives. A study of regional dynamics of mental and behavioural morbidity in the Irkutsk Region over a seven-year period.Methods. A retrospective descriptive study used statistics data on primary and overall morbidity of definitely diagnosed mental and behavioural disorders (other than substance use disorders; F00–F09, F20–F99). The analysis of mental and behavioural illness incidence was based on statistical reports over the period of 2013–2019. The inclusion criterion was definite diagnosis of a mental and behavioural disorder (other than substance use disorder; F00–F09, F20–F99) in children, adolescents and adults. The main study indicators were the regional mental morbidity rate and prevalence, mental and behavioural morbidity rates among “dispensary care” and “medical counselling” outpatients, and primary morbidity rates by mental and behavioural nosology groups.Results. The article reports the regional traits of mental morbidity dynamics exhibiting a growing trend in Irkutsk Region. The morbidity traits of primary diagnoses have been analysed in dispensary care and medical counselling outpatients. Growing psychoneurologic visits are observed along with the institutional redirection of fi rst diagnoses towards decreasing the numbers of dispensary care vs. medical counselling outpatients. Thus, the structure of fi rst mental diagnoses changed towards prevailed medical counselling. Primary morbidity rate in male population is higher almost 1.5-fold in the study period. Primary morbidity elevated in both men and women. A primary morbidity analysis in different age cohorts reveals its growth in ages 0–14, 40–59 and >60 years.Conclusion. Our analyses reveal a lowering primary morbidity rate of mental disorders in outpatients taken for dispensary care, given the overall higher incidence. This may occur due to an institutional and instructional change in medical care provided to this patient category, including ineffective diagnosis, poor aid access and visit rate, statistical reporting design and possible changes in the criteria of taking for dispensary care. This fact requires improvements in the legal regulation of outpatient management of mental and behavioural illness at psychoneurologic institutions and the development of clear criteria of registering for dispensary care.