The prevalence of mental disorders in rural office practice.
OBJECTIVE
To determine the prevalence of mental disorders in rural primary care office practice.


METHODS
Patient interview; chart review.


METHODS
Two rural primary care office practices.


METHODS
Three hundred-fifty scheduled or walk-in patients age 18 years or older.


METHODS
Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36), the Primary Care Evaluation of Mental Disorders (PRIME-MD), physical health using Greenfield's index of coexistent disease (ICED), and health care utilization using the number of office visits and total office and laboratory charges six months before until six months after the interview.


RESULTS
Of these patients 34% met criteria for one or more of the 18 mental disorders evaluated by the PRIME-MD; 19% met criteria for specific disorders according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). Mood disorders were most common (21.7%), followed by anxiety disorders (12.3%), somatoform disorders (11.1%), probable alcohol abuse or dependence (6.0%), and eating disorders (2.0%). By logistic regression, there was an association of age, sex, race (black), and education with lower prevalence of various mental disorder categories. Even after adjustment for demographic variables and physical health (ICED score), those with PRIME-MD diagnoses had significantly lower function as measured by the eight MOS SF-36 scales and higher utilization of office services (p < .001).


CONCLUSIONS
The prevalence of mental disorders in rural primary care office practice is as high as in urban office practice.
Philbrick
J T
JT
Department of Medicine, Univ. of Virginia School of Medicine, Charlottesville, USA.
Connelly
J E
JE
Wofford
A B
AB
D000328:Adult; D000368:Aged; D005194:Family Practice; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010824:Physicians' Offices; D015995:Prevalence; D012423:Rural Health