Date received: 07/27/2020 / Date reviewed: 09/29/2020 / Date accepted: 11/15/2020

Introduction

Mental or psychological disorders are becoming more and more a serious problem. According to the Pan American Health Organization (PAHO, 2005), by 1993, mental illness was responsible for 8.1% of the global burden of disease, a percentage that even exceeded tuberculosis, cancer, or heart disease, and this was done in reference to the cost and suffering caused by all diseases together. A very approximate figure of 8% corresponds to Latin America and the Caribbean. The prevention, care and rehabilitation of people affected by mental disorders are becoming a health problem in Latin America, as stated by Kohn et al. (2005) that by 1990 psychiatric care reached 8.8%, by 2002 that amount had more than doubled (22.2%), this indicates that the demand for mental health care is increasing. The World Health Organization, already for the year (2013) stated that only depression represents 4.1% of the global burden of disease. This indicates that, adding the other disorders such as anxiety, psychosis, alcoholism, etc., the percentage would be much higher.

On the other hand, the issue becomes even more complicated if it is considered that many people suffer from mental disorders and yet they do not consider it that way, since they do not know the symptoms of the disorder, or in any case they resist receiving professional psychological help (Díaz - Cruz, Bethencourt and Peñate, 2004). I agree with the reflection of Nizama-Valladolid (2015) who argues that we live in a society with extreme individualism, family anomie, corruption and social violence, which end up affecting the population, thus generating the risk of acquiring alterations in mental health or even worsen the disorders they already have. Nizama-Valladolid continues with his reflection and affirms that the origin of mental disorders can be multifactorial, that is, it ranges from alterations in the genome to social dysfunctions, interacting with each other. Likewise, this situation is badly influenced by the media that promote hedonism, debauchery, and compulsive connectivity.

Mental disorders

The World Health Organization (WHO, 2006) affirms that defining a mental disorder is difficult since there is no single diagnosis or clinical picture, but rather a group of disorders with some traits in common. However, we find Taipe, Lajo and Huamani (2012) who affirm that mental disorders are diseases that cause great disability and decrease the quality of life, in addition to reducing the ability to produce economic resources in people who suffer from it. They also ensure that many of these people who suffer from this disease live in low and middle-income countries, therefore they do not receive the necessary attention from the health services. On the other hand, Ortiz de Zarate, Alonso, Ubis and Ruiz de Azúa (2010) state that mental illness is generally characterized by a long course with recurrences and sometimes progressive deterioration. These relapses are the ones that usually cause increasingly long and deteriorating hospital admissions. The same progressive deterioration contributes to the sociocultural dislocation of the person, social isolation and as a consequence it becomes an added risk factor for the appearance of new crises. The Ministry of Health and Social Policy (2009) refers that mental disorders mean a long time, at the same time that they generate disability and social dysfunction and that they must be cared for by psychiatric and social care resources. To complement the idea, we found Jiménez (2000) who made a bibliographic review on the subject, and mentions that mental disorders can be differentiated by groups, thus having organic mental disorders, sleep disorders, eating disorders, sexual dysfunctions , neurotic disorders and secondary to stressful situations, non-organic psychotic mental disorders, psychotropic substance use disorder (alcohol use) and affective disorders. In the present study, we focus on the last three groups of mental disorders mentioned, whose symptoms are considered in the SRQ instrument used in the present investigation.

Puertas, Ríos and Del Valle (2006) found in a sample of 878 people in Colombia that a 27.2% suffered from a common mental disorder, 11.3% acknowledged having had suicidal thoughts in the last 30 days and 13.6% acknowledged having some problem with alcohol, it was also found that women had higher rates in the presence of pathology compared to men with 31% and 20%, respectively.

Following this same line, for a few decades, various investigations had already been carried out in Lima and its districts, for example Minobe, et al. (1990) in Lima found that 9.7% suffered from major depression, 3.4% dysthymia, 0.6% schizophrenia, 18.6% alcohol dependence and / or abuse, and 32.1% had a history at some point in their life in relation to any mental illness. On the other hand, according to Pérez (2008) the mental health situation in Peru, according to the statistics, were the following: in Metropolitan Lima the prevalence in depression is 18.2%, in the Sierra 16.2%, and in the Jungle 21.4%. We also find Saravia (2010) director of the Gestalt Institute of Lima, who states that eight out of ten cases of suicides could be avoided if they were detected in time. It is evident that the current health system is not yet prepared to face the demand for care regarding the mental area that is increasing every day. In this sense, Flores (2011) states that one in four people suffers from a mental disorder at some stage of their life and approximately 450 million human beings around the world suffer from mental or neurological disorders, although very few receive adequate treatment. This also applies to the national context, so the epidemiological studies of the Honorio Delgado - Hideyo Noguchi Specialized Mental Health Institute (2009) confirm these findings in Peru, finding that up to 37% of the general population is likely to suffer a mental disorder sometime in your life. Such is the case of the depression that has been significantly affecting the country, triggering 75% of the suicides that have occurred in recent years.

Vicente, Rioseco, Saldivia, Kohn and Torres (2005) carried out a research work in Chile to determine the prevalence and risk factors of mental illnesses based on a representative sample of its national population, for this they used the CIDI instrument (diagnostic interview international composite). The results were very similar to the results of other investigations carried out in Latin America, finding that 36% of the population has a psychiatric disorder, that is, one in three individuals suffers from a disorder. Rajmil, Gispert, Roset, Muñoz and Segura (1998) investigated the prevalence of mental disorders in the population of Catalonia, in people over 14 years of age, for which they applied the General Health Questionnaire (GHQ-12) test. The results were that 17.42% presented a probable mental disorder, being 18.66% in women and 15.77% in men. The prevalence was higher in women compared to men, in all age groups.

In Peru, research has been carried out for years in various parts of the country, finding similar results, which indicates that it is evident that a large part of the population has suffered some type of mental disorder at some point in their life.

The National Institute of Mental Health Honorio Delgado - Hideyo Noguchi (2002) studied the prevalence of clinical disorders in the general population of Metropolitan Lima, using the following instruments: Mental Health Questionnaire, Quality of Life Index, EMBU (own memory about parenting, translated from English), Mini Mental State Examination, Family Violence Questionnaire, MINI: International Neuropsychiatry Interview Spanish Version ICD - 10, Questionnaire on Determinants of Access to Health Services in Peru and Inventory of Disorders of Eating Behavior. Women were found to suffer from more psychiatric disorders than men. In addition, more than a third of the population (37.3%) have suffered a psychiatric disorder at some time in their life, about a quarter have suffered them in the last 6 months 26.5%, and 23.5% presented it at the time of the survey. As a group, anxiety disorders are the most prevalent. On the other hand, Chero, Figueroa and Luciano (2004) carried out a research work with victims of various emergencies and disasters in Lima, as part of protocolized interventions of the public sector. The goal was to provide a space for emotional expression in a quick and timely manner. For this, a sample of 45 people who were victims of emergencies was used, and the SRQ questionnaire was applied, the results found a 64% affected population with some mental disorder, such as anxiety and depression.

Tapia (1994) affirms that prevalence could be understood etymologically as the quality of something that prevails or express the degree of something that is frequent. On the other hand, Moreno, López and Corcho (2000) affirm that prevalence is a proportion that indicates the frequency of an event. In general, it is defined as the proportion of the population that suffers from the disease under study at a given time.

The Ministry of Health and Social Policy (2009) defines people who suffer from mental disorders as “a group of heterogeneous people, who suffer from serious psychiatric disorders with long-term mental disorders, which entail a variable degree of disability and dysfunction social, and that they have to be cared for through various socio-sanitary resources of the psychiatric and social care network”.

Definition of terms

Alberdi, Taboada, Castro and Vásquez (2006) affirm that depression is a syndrome or grouping of symptoms, susceptible of assessment and ordering, in rational and operative diagnostic criteria. Pathological sadness, decay, irritability, subjective feeling of discomfort, impotence in the face of life's demands.

According to the AUGE magazine of the Chilean Ministry of Health (2013), depression is a mood and mood disorder, which manifests itself through a series of symptoms, including sudden mood swings, irritability, lack of enthusiasm and a feeling of anguish.

Anxiety can be defined as an anticipation of future harm or misfortune, accompanied by a feeling of dysphoria or unpleasant sensation, or somatic symptoms of tension, as stated by the (Ministry of Health and Consumer Affairs, 2008). Likewise, it refers that it manifests itself as an alert signal that warns of an imminent danger and allows the person to adopt the necessary measures to face a threat.

For Díaz (2013), schizophrenia is a serious mental illness that affects some brain functions such as thinking, perception, emotions and behavior, and in terms of its symptoms it is included within psychotic disorders, those in which the patients lose control of reality, therefore when this disorder occurs in the form of outbreaks it is called schizophrenia, and approximately 1% of the world population suffers from this disease regardless of sex, race and social class.

According to MINSAL (2009), epilepsy or seizure disorder is defined as an alteration that affects the Central Nervous System, specifically the cerebral cortex and that manifests clinically as discontinuous events called “epileptic seizures”. It is a chronic neurological condition, of high frequency, of episodic manifestation and of diverse etiology. It is estimated that it affects 50 million people in the world. For the Ministry of Health in Chile MINSAL (2009) the prevalence data are from 17 to 10.8 per thousand inhabitants and the incidence of 114 per 100,000 inhabitants per year. In relation to the cumulative incidence, which is the individual risk of developing epilepsy in a given time, in Chile, as well as in the rest of Latin America, this information is unknown.

According to Guardia, Jiménez, Pascual, Flores and Contel (2007), alcoholism is a multifactorial disease that is probably due to an alteration in the functioning of certain brain circuits that intervene in the self-control of the behavior of drinking alcoholic beverages. If the course of this disease is not stopped, its medical, psychiatric and addictive consequences will appear progressively, which will lead the patient to successive relapses and this disease to become chronic.

On the other hand, Guzmán et al (2007) estimate that approximately 50% of the adult population worldwide consumes alcohol, since the data from the last National Addiction Survey (ENA) of Mexico (2011), reported that 55.6% of the population over 18 years of age have consumed alcohol in the last 12 months, likewise, there are dramatic increases in the rate of alcohol consumption in adolescents; in 1998 27% of male adolescents consumed it and by 2002 35%. Regarding women, the figures were 18% to 25% respectively. Another fact that draws attention is that among male adolescents the consumption increased from 5 to more drinks per drinking occasion, from 6.3% in 1998 to 7.8% in 2002. And a notable increase of 2% of adolescents who reported having manifested, in recent years, at least three of the dependency symptoms of the Diagnostic and Statistical Manual of Mental Disorders.

Method

Design

The present research work is a descriptive study, and has a non-experimental, cross-sectional design.

Participants

The sample consisted of 220 outpatients from the “José Agurto Tello” Hospital outpatients. Non-probabilistic convenience sampling was used, which is characterized by being a sampling technique where the elements are chosen at the discretion of the researcher. Being excluded people under 18 years of age and over 65 years of age, people with disabilities to manifest symptoms were also excluded, and people who attended other hospital services were not considered. Regarding the characteristics of the participants, Table 1 shows the particularities, finding that the female gender is the most representative group with a percentage of 69.3%. Regarding age, those who are between 25 and 34 years old present a high percentage (26.1%) followed by 18 and 24 years (20.2%). Likewise, it can be seen that in the population there are more singles (37.6%) as well as married (32.1%) as opposed to widowers (2.3%). On the other hand, there are more patients with completed high school studies (48.1%) in contrast to illiterates (3.7%). Finally, of the sample studied, housewives represent 39.9% followed by independent workers (25.7%).

Instrument

For the present study, the Self-Reporting Questionnaire of Psychiatric Symptoms for adults (SRQ) was used, validated by the Pan American Health Organization and applied by the Ministry of Health (2005). The Self-Reporting Questionnaire-SRQ has been designed by the World Health Organization as part of a collaborative study on strategies to extend mental health services (WHO Collaborative Study to Extend Mental Health Services, Harding T. et al. 1980; Climent, C. and Col, 1981). The questionnaire has several parts: the first 18 questions refer to disorders of mild or moderate intensity, such as depressives, anxiety and others. Eleven or more positive responses in this group determine that the interviewee has a high probability of suffering from mental illness, and therefore is considered a case. Questions 19-22 are indicative of a psychotic disorder; a single positive answer among these four also determines a case. A positive answer to question 23 indicates a high probability of suffering from a seizure disorder. Questions 24 to 28 indicate problems related to alcohol; a positive response to only one of them determines that the patient is at high risk of alcoholism. Any one of these possibilities, or a combination of the three, indicates that it is indeed a “case”.

Process

The administration of the SRQ questionnaire was carried out in person and individually. For two and a half months, every morning, the instrument was applied through the corridors of the medical offices of the “José Agurto Tello” hospital. At the beginning, each person was told what the questionnaire consisted of. The vast majority of outpatients agreed, except in some exceptions where they showed their refusal to answer the questionnaire. The time taken by each person to respond to the survey was approximately 15 minutes. I was close to each participant to make sure they understood each item well and could give a real answer to their symptoms. Once the information was collected with the instrument, the data were processed in SPSS for Windows version 22.0, and previously it had the support of the Microsoft Excel 2010 program.

Results

As a first result, it was found that the most prevalent disorder of the investigated sample is anxiety with 30.7%, followed by depressive disorder that is equivalent to 23.9%. This indicates that the most common and prevalent disorders in outpatients are anxiety and depression, respectively.

As a second result, it can be observed that women (37.1%) have a greater inclination to present anxiety than men (16.7%). In relation to depression, 28.5% of women presume this disease and 83.3% of men indicate absence of depressive symptoms. The 22.5% of women are prone to psychosis, while men (7.6%). Likewise, the female sex had greater experience in seizure disorder (6%) compared to the males (3%); in contrast to alcoholism, where men (22.7%) present higher indicators than women (4.6%)

As a third result, it is extracted that people with an age range between 35 and 44 years are those who present higher percentages in the dimension: anxiety (36.8%), the group 55 years and over were those who present greater depressive symptoms (32.4%). However, it was the group of 35 and 44 years who presented the greatest symptoms for psychosis (23.7%). On the other hand, the age group that presented greater symptoms of seizure disorder was the group 25 and 34 years (8.8%), this same group has higher rates of alcohol consumption, compared to the other groups.

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