Morbidity patterns of psychiatric disorders among patients attending psychiatry OPD in a tertiary care hospital of upper Assam: a retrospective study

INTRODUCTION

The World Health Organization (WHO) defines mental health as a “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can make a contribution to his or her community”.¹ Mental and behavioral disorders are thought to be clinically significant issues that are linked to a person's emotional suffering and/or reduced functioning and are characterized by changes in behavior, mood, thinking, or feeling.²

Psychiatric disorders are the second most common cause of years lived with disability (YLDs) globally and account for a substantial portion of the global burden of disease, approximately 10%. Anxiety disorders, depression, organic illnesses, substance use disorders, and purposeful self-harm are among the most common mental health conditions worldwide.³ The weighted lifetime and current prevalence of any mental morbidity in the state of Assam were 8.01% and 5.85%, respectively.⁴

The widespread occurrence of mental health issues significantly affects individuals, families, and communities. However, the lack of epidemiological data and understanding about the prevalence of mental health problems and the resources available to tackle them creates a major obstacle to implementing policies and initiatives effectively.

Jorhat Medical College and Hospital is the sole medical college in the Jorhat District. This tertiary care facility caters to both urban and rural residents in the region, as well as its surrounding districts. Determining the morbidity pattern of mental illnesses among patients who visited this tertiary care hospital's psychiatry outpatient department (OPD) was the aim of this study, as published data on the current topic in the study area is not available.

METHODS

Study design and study setting

This was a retrospective record-based cross-sectional study conducted at Psychiatry OPD of Jorhat Medical College and Hospital, Jorhat, Assam.

Data collection procedure

Data were collected from the OPD register of the Psychiatry department from 1^st April 2023 to 31^st March 2024.

Inclusion criteria

All the newly registered patients attending Psychiatry OPD of JMCH between 1^st April, 2023 to 31^st March, 2024

Exclusion criteria

Any case record with incomplete information on demographic and diagnosis.

Diagnostic criteria/ classification

ICD-10 classification was used to classify the psychiatric morbidities.⁵

Data analysis

Data analysis was done by computing frequencies and percentages using IBM SPSS Version 21.0

Ethical consideration

The requirement for Institutional Ethics Committee approval was waived by the Institutional Ethics Committee (H), Jorhat Medical College and Hospital, as the study involved the review of already existing/stored retrospective data.

RESULTS

A total of 4350 patients were included in the study. The mean age of attending patients was (35.79±16.93) years. The majority belonged to the age group of 15-30 years, followed by 31-45 years. The majority were males (64.2%), practiced the Hindu religion (94.7%), and most of the patients were from urban areas (60.98%) as per Table 1.

Figure 1 and Table 2 show that the majority of the patients (26%) were diagnosed with substance use disorder, followed by neurotic and stress-related disorders. Alcohol use disorder was the most common (20%) among substance use disorders. As per Table 3, 22.6% cases were referred from other departments to the psychiatry OPD for consultations, out of which the majority were from the medicine department. Among the referred patients 65% of them did not have any form of comorbidities, while those having comorbid conditions majority of them reported of diabetes, followed by hypertension and respiratory illnesses.

DISCUSSION

The present study was undertaken to assess the morbidity profiles of the patients with mental health problems visiting the psychiatric OPD of JMCH, in addition to their referral patterns. The study provides an insightful overview of the psychiatric case patterns, revealing key trends and socio-demographic characteristics. The majority of patients belonged to 15-30 years of age group, reflecting a critical period for the onset of many psychiatric disorders. This highlights the importance of focused medical therapies for this productive age group and takes into account several factors that contribute to mental health problems. The higher male prevalence (64.2%) could be suggestive of gender-specific factors influencing mental health or help-seeking behaviour, similar to a study done by Bora et al.⁶ A major chunk of the patients attending were from the urban areas, which is also highlighted by the study conducted by Rajiv Gupta, which reports that there is a significant gap in psychiatric care utilization in urban-rural areas.⁷

The findings of the current study show that mental and behavioural disorders due to psychoactive substance use (26%) and neurotic, stress-related disorders (25.3%) are the most prevalent categories among the patients attending the Psychiatry OPD of JMCH, which is consistent with global and national trends reported in previous studies.⁸ A study conducted by Deka et al in the Psychiatry department of JMCH reported a prevalence of 12.68% for alcohol dependence syndrome.⁹ The finding is in contrast to the current findings, where the prevalence of alcohol use disorder was higher. This discrepancy may be due to increased awareness with a different time frame and increased health-seeking behaviour among the patients due to the establishment of an addiction treatment facility at JMCH. Substance use disorders were the most common diagnoses, highlighting a significant public health issue in the region. Anxiety disorders and other stress-related disorders form a significant portion of the neurotic category, consistent with studies by Prasad et al.¹⁰ This highlighted the high burden of anxiety and stress disorders in India and points to the need for stress management and mental resilience programs at institutions as well as at the community level. Schizophrenia was the most common diagnosis among psychotic disorders, consistent with global epidemiological data.¹¹

A significant percentage of patients (22.6%) were referred from other departments, with the highest number of referrals coming from the medicine department (15.4%). This aligns with the findings by Keertish et al, the data show that patients with other physical illnesses presenting to different departments also have underlying mental health conditions, highlighting the strong connection between physical and psychological health and the need for integrated care models in tertiary care settings.¹² The high number of self-referred patients (77.4%) indicates increasing awareness and recognition of mental health issues among the general population.

The limitation of the current study was that it was a retrospective and single-institution study, which introduces potential biases and limits the generalizability of the findings. The reliance on hospital records constrained the ability to gather comprehensive information on socio-economic status, medical comorbidities, and treatment outcomes. Future research should aim to incorporate a broader population base and prospective data collection to enhance the depth and applicability of findings. Exclusion of incomplete records may have led to the omission of relevant cases.

CONCLUSION

The study highlights the urgent need for targeted mental health interventions, especially regarding substance use disorders among younger adults. The data indicate that while self-reporting is common, there is also significant interdepartmental referral, showing that psychiatric symptoms often overlap with other medical conditions. The findings stress the need for stronger integration of mental health services within the general healthcare delivery system. From a policy perspective, the results support strengthening consultation-liaison psychiatry, capacity building of healthcare providers, and prioritization of substance use prevention in existing public health programs. Such evidence can guide policymakers in resource allocation and planning of comprehensive mental health services.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of Jorhat Medical College and Hospital, Jorhat, Assam (No. EC/NEW/INST/2024/AS/0552)

REFERENCES

1. 1. Pan American Health Organization. Mental Health, 2024 Available at: https://www.paho.org/en/topics/mental-health. Accessed 25 March 2025.
2. 2. Shrestha MR, Pradhan S, Sharma S. Morbidity pattern of psychiatric disorders in patient seeking treatment in psychiatric OPD of private tertiary care hospital. Postgraduate Medi J NAMS. 2011;11:28.
3. 3. Kena T, Bagra I, Doke G, Yubey M, Kothapalli J. Patterns of psychiatric illness in a tertiary care centre of Arunachal Pradesh: an observational study. Maedica (Bucur). 2022;17(3):628-35.
4. 4. Gogoi V, Abhishek P, Sengupta S, Banerjee I, Sarma S, Sobhana H, et al. District-level differences in the distribution of mental and substance use disorders in Assam. Indian J Psych. 2023;65(12):1282-8.
5. 5. World Health Organization-ICD-10 Version:2019. International Statistical Classification of Diseases and Related Health Problems 10th Revision. Available at: https://icd.who.int/browse10/2019/en. Accessed 01 December 2025.
6. 6. Bora K, Gogoi P, Gogoi A, Chauhan N. Sociodemographic characteristics and clinical profile of inpatients in the psychiatry unit of a tertiary care hospital in Assam: a retrospective study. Acad Bull Ment Health. 2024;2(1):36-41.
7. 7. Gupta R. Rural–Urban Divide in Mental Health Care in India: Bridging the Gaps. Ind J Social Psych. 2024;40(1):7.
8. 8. Bhanujirao P, Salari S, Behzad P, Salari T. A narrative review of global perspective on illicit drug utilization and substance use disorders. Arch Med Heal Sci. 2022;10(2):266.
9. 9. Deka K, Baruah MP, Bora D. Occurrence of alcohol dependence, pattern of alcohol use, and psychiatric comorbidity in a tertiary care centre in Upper Assam, India. JEBMH. 2021;8(21):1674-8.
10. 10. Prasad S, Rohit BK, Das A, Choubey V. Psychiatric morbidity: a retrospective study from a tertiary care center. Cureus. 2023;15(3):e36687.
11. 11. World Health Organization. Schizophrenia, 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/schizophrenia. Accessed 01 December 2025.
12. 12. Keertish N, Sathyanarayana MT, Kumar BGH, Singh N, Udagave K. Pattern of psychiatric referrals in a tertiary care teaching hospital in Southern India. J Clin Diagn Res. 2013;7(8):1689-91.