Poverty, psychological disorder and disability in primary care attenders in Goa, India

BACKGROUND: This study examined the association of common mental disorders in primary health clinic attenders with indicators of poverty and disability in Goa, India. METHOD: Adult attenders (n = 303) in two primary health clinics were recruited. RESULTS: There were 141 (46.5%) cases of common mental disorder. The following were associated with common mental disorder: female gender; inability to buy food due to lack of money; and being in debt. Cases scored significantly higher on all measures of disability. Primary health clinic staff recognised a third of the morbidity but used multiple oral drugs, injectable vitamins and benzodiazepines to treat common mental disorders. CONCLUSIONS: Poverty is closely associated with common mental disorder which in turn is associated with deprivation and despair. Primary mental health care priorities in low-income countries need to shift from psychotic disorders which often need specialist care to common mental disorders. Health policy and development agencies need to acknowledge the intimate association of female gender and poverty with these disorders.