[Mental health services to poor patients with affective disorders in Mexico City].
OBJECTIVE
To describe the pathways of formal and informal services utilization in urban low income population presenting depressive, dysthymic and bipolar disorders.


METHODS
Information was gathered in face to face interviews using a standardized questionnaire that included sections from the Composite International Diagnostic Interview and one section on service utilization. Interviewees (n=1,486) were selected through stratified socioeconomic variables and a random multistep sample of households of Mexico City.


RESULTS
A significant proportion of individuals with affective disorders attended at the same time to formal and informal services. It was observed that the majority of individuals established the first contact with a general practitioner (81% of the men with depressive disorders, 100% with dysthymia and 36% with bipolar disorders; 44.4% of the women with depression, 23% with dysthymia and 100% with bipolar disorders). Also, 45% of men with depression, 40% with dysthymia and 65% of the women with bipolar disorders sought help through resources provided by alternative medicines.


CONCLUSIONS
The combination of various medical systems has at least two roles: 1) increases the set of care options and thereby maximize healthcare resources available; 2) allows to approaching different aspects of the same illness that a single medical system is unable to meet its complexity.
Berenzon
Shoshana
S
Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México. berenz@imp.edu.mx
Juárez
Francisco
F
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011203:Poverty; D015995:Prevalence; D012737:Sex Factors