Trastornos esquizofrénicos en la atención primaria a la salud mental

Abstract

To determine the prevalence and incidence of schizophrenia and other psychoses in a mental health unit (MHU) closely connected to primary health care. Retrospective longitudinal study of the register of all patients with psychiatric illnesses detected in a specific geo-demographic and health care area. Five basic health care areas of Barcelona (103 615 inhabitants). MHU patients who had attended clinics due to mental health disorders during the period from 1982-2000 (N=21 236). Strict health and diagnostic criteria based on the DSM-4 classification were applied. All cases were validated using clinical history review and concensus. Incidence (in the last 3 years) and prevalence of schizophrenia and other psychoses in the whole period of study, both in the general population and in the risk population age group (15-54 years). In total, 838 patients complied with the diagnosis of suffering from schizophrenia (N=476) or other psychoses (N=362). The incidence of schizophrenia was 3.47/10,000 (95% confidence interval [CI], 2.3-4.6) in the general population and 5.09/10,000, 95% CI, 3.2-6.9) in the population at risk, and the prevalence of schizophrenia was 54.9/10,000 (95% CI, 41.8-50.1) in the general population and 80.7/10,000 (95% CI, 73.5-88) in the population at risk. The MHU-primary health care interface can be a good place to detect and study schizophrenic syndromes and other psychoses, as long as they comply with the agreed health and research criteria.