Conditions that do not reach the threshold for mental disorder in Spanish psychiatric outpatients: prevalence, treatment and management.
BACKGROUND
In recent years there has been controversy around the treatment demands of people who, without meeting diagnostic criteria for a mental disorder, have certain symptoms and are referred to mental health professionals.


OBJECTIVE
To determine the prevalence of individuals assessed by mental health service, referred from primary care, who do not meet the diagnosis criteria of mental disorders according to ICD-10. To analyze the medical treatment given to these individuals, measured by the indication for discharge or follow-up and by the pharmacological intervention decided in the first interview, as well as the associated variables.


METHODS



METHODS
descriptive study.


METHODS
urban area.


METHODS
all patients referred to the Salamanca mental health service during a year, without any exclusion (n = 1,187).


METHODS
sociodemographics; clinical and health service utilization gathered through clinical interview, GHQ-28, SCL-90-R and an expectations scale.


RESULTS
Of the 1,004 patients who attended interview, 24.4% (CI 95%: 21.6-27.0) did not present any diagnosable mental disorder (Z codes); they constitute the body of this study. 50.8% of these were referred from primary care with a psychotropic drug treatment already prescribed. Any drug intervention (addition, suspension or modification) was performed in 37.2% of the cases by the mental health service. Regardless of the treatment indicated, 52% were discharged after the first interview.


CONCLUSIONS
The prevalence of patients who failed to reach diagnostic criteria for a mental disorder in this health service is similar to other studies, in spite of the filter provided by primary care. Many individuals without a diagnosable mental disorder received treatment both in primary care and in the mental health service.
Ortiz-Lobo
Alberto
A
Psychiatrist, Centro de Salud Mental de Salamanca, Madrid, Spain. aortizlobo@yahoo.es
García-Moratalla
Beatriz
B
Lozano-Serrano
Carolina
C
De La Mata-Ruiz
Iván
I
Rodríguez-Salvanés
Francisco
F
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology