Severe Mental Illness in Community Mental Health Care in Spain: Prevalence and Related Factors.

Abstract

The term severe mental illness (SMI) has been used in psychiatry to refer to long-term mental health conditions that involve severe behavioural problems, disability, and social dysfunction. To date, definitive and consensual criteria for SMI are lacking, although these criteria are essential to determine the prevalence of SMI.The aim of this study was to determine the prevalence of severe mental illness (SMI) in patients in contact with mental health services and to determine the factors associated with SMI. A total of 260 patients who met diagnostic criteria for SMI were assessed using GAF and HoNOS scales. The overall prevalence of SMI was 6.08 per thousand. According to the three different cutoff points with GAF, the prevalence of SMI ranged from 5.38 per thousand under the weak criterion (GAF < 70) to 1.01 per thousand under the strict criterion (GAF < 50). In the regression model, the dependent variable (presence of SMI) was defined using a GAF < 60, and the variables independently associated with the dependent variable were years of disease duration since diagnoses, mental health service use, alcohol or other substance abuse, and depressive anxiety and other psychological symptoms.