Health encompasses complete physical, mental, and social well-being. Psychiatric disorders represent a major public health concern and contribute substantially to the global burden of disease. Four psychiatric disorders are among the ten leading health conditions contributing to Disability-Adjusted Life Years (DALYs).[1] Despite their considerable impact, mental health problems are often overlooked, underestimated, or inadequately addressed by patients, families, and society.[2] Epidemiological evidence from the past decade has demonstrated that mental disorders are highly prevalent worldwide and are associated with significant functional impairment.[3] It has been estimated that approximately one in four individuals worldwide experiences a mental health problem each year, with nearly 450 million people affected by mental disorders globally.[4] Psychiatric diagnoses may be organized hierarchically based on the relative prominence and clinical significance of presenting symptoms.[5] Foulds and Bedford (1975) proposed a hierarchical model of functional psychiatric disorders, describing non-reciprocal and inclusive relationships among four groups of disorders. According to this model, abnormalities of the sensorium, including memory impairment and disorientation, take precedence over other psychiatric conditions. In the absence of such abnormalities, first-rank symptoms characteristic of schizophrenia are considered diagnostically prominent.[6] In India, despite initiatives such as the National Mental Health Programme introduced in 1982 and its district-level implementation through the District Mental Health Programme (DMHP), a substantial proportion of individuals requiring mental health services continue to remain untreated.[7] Mental disorders can affect multiple domains of functioning, including interpersonal relationships, occupational performance, and social participation, thereby contributing substantially to disability and reduced quality of life.[8] Anxiety and depressive disorders are among the most commonly encountered mental disorders globally and account for a considerable proportion of the overall burden of mental illness.[9] Despite the availability of effective interventions, significant gaps remain in the recognition, diagnosis, and treatment of mental disorders, particularly in low- and middle-income countries.[10] In India, the substantial treatment gap is influenced by factors such as inadequate awareness, stigma, limited availability of mental health services, and socioeconomic barriers, emphasizing the need for early identification and appropriate management of psychiatric disorders.[10] Understanding the burden and distribution of psychiatric disorders in healthcare settings is therefore important for planning appropriate mental health services. Hence, the present study was undertaken to assess the prevalence and pattern of psychiatric morbidity among patients attending the Psychiatry Outpatient Department of a tertiary care centre. Aim To assess the prevalence and pattern of psychiatric disorders among patients attending a Tertiary care centre in Bagalkot, and to assess the distribution of psychiatric disorders according to selected sociodemographic characteristics such as age, sex, education, occupation, domicile, and socioeconomic status. To study the association between psychiatric morbidity and selected sociodemographic characteristics of the participants.

The present study is a cross-sectional study done in the outpatient psychiatry department of HSK Hospital, Tertiary Health Care Centre, Bagalkot in the State of Karnataka. Ethical clearance was obtained from the institutional ethics committee. The study was conducted over 3 months (January 2022–March 2022). A total of 600 consecutive subjects’ details were collected. International Classification of Diseases – 10 Classification of Mental and Behavioural Disorders (ICD – 10) was used for the diagnosis of subjects. Statistical analysis Data were entered using MS Excel and analyzed using the SPSS trial version. Quantitative data were analyzed using frequency, percentage, and proportion. The distribution of broad psychiatric diagnoses across demographic variables was assessed using the Pearson chi-square (χ²) test. Associations were considered statistically significant at a p-value <0.05

Table 1 presents the sociodemographic and clinical characteristics of the 600 study participants attending the Psychiatry Outpatient Department. The mean age of the study population was 37.10 ± 14.60 years. Males constituted the majority of participants (334; 55.7%), while females accounted for 266 (44.3%). With regard to age distribution, most participants belonged to the 25–44-year age group (328; 54.7%), followed by those aged 45–60 years (112; 18.7%) and 19–24 years (71; 11.8%). Participants younger than 12 years constituted 0.8% of the study population, while those aged 61–75 years accounted for 8.7%. Regarding place of residence, 355 (59.2%) participants were from rural areas, whereas 245 (40.8%) were from urban areas. Based on case status, 383 (63.8%) participants were follow-up cases, while 217 (36.2%) were newly registered cases. Thus, the study population predominantly comprised middle-aged adults, males, individuals from rural areas, and patients attending the department for follow-up care. Table 1. Sociodemographic and Clinical Characteristics of the Study Participants (N = 600) Variable Subcategory Frequency (n) Percentage (%) Gender Male 334 55.67 Female 266 44.33 Age (Years) <12 5 0.83 12–18 32 5.33 19–24 71 11.83 25–44 328 54.67 45–60 112 18.67 61–75 52 8.67 Residence Rural 355 59.17 Urban 245 40.83 Case Status New cases 217 36.17 Old cases (follow-up) 383 63.83 Table 2. Distribution of Psychiatric Diagnoses Among the Study Participants (N = 600) S.No. Diagnosis Frequency (n) Percentage (%) 1 Organic mental disorders 16 2.73 2 Psychoactive substance use disorders 77 12.89 3 Schizophrenia and delusional disorders 127 21.09 4 Mood disorders 164 27.34 5 Anxiety, stress-related and somatoform disorders 181 30.20 6 Behavioural disturbances 21 3.51 7 Intellectual disability 5 0.78 8 Disorders of psychological development 1 0.20 9 Fitness certificate assessment 1 0.20 10 Diagnostic clarification 7 1.17 Total 600 100.00 Table 2 presents the distribution of psychiatric diagnoses among the 600 study participants. Anxiety, stress-related, and somatoform disorders constituted the most frequently observed diagnostic category, accounting for 181 (30.2%) participants. This was followed by mood disorders in 164 (27.3%) participants and schizophrenia and delusional disorders in 127 (21.2%) participants. Psychoactive substance use disorders were observed in 77 (12.8%) participants, while behavioural disturbances were reported in 21 (3.5%) participants. Organic mental disorders accounted for 16 (2.7%) cases. Intellectual disability was identified in 5 (0.8%) participants, whereas disorders of psychological development, fitness certificate assessment, and diagnostic clarification accounted for 1 (0.2%), 1 (0.2%), and 7 (1.2%) participants, respectively. Overall, anxiety, stress-related, and somatoform disorders represented the largest proportion of psychiatric presentations in the study population. Here is your data formatted into a clean, professional, and publication-ready markdown table. Table 3. Association Between Demographic Variables and Broad Psychiatric Diagnosis (N = 600) Variable Category Projected n (%) p-value Place of residence Rural 355 (59.17%) 0.486 Urban 245 (40.83%) Sex Male 334 (55.67%) <0.001 Female 266 (44.33%) Consultation status New 217 (36.17%) <0.001 Follow-up/Old 383 (63.83%) Of the total participants, 355 (59.17%) were from rural areas. There was no statistically significant association between place of residence and broad psychiatric diagnosis (Pearson’s χ² = 4.45, df = 5, p = 0.486). Regarding sex, 334 (55.67%) were males, and 266 (44.33%) were females. A statistically significant association was observed between sex and broad psychiatric diagnosis (Pearson’s χ² = 70.33, df = 5, p < 0.001), indicating that the distribution of psychiatric diagnoses differed significantly between males and females[Table 3]. With respect to consultation status, 217 (36.17%) were new patients, whereas 383 (63.83%) were follow-up/old patients. A statistically significant association was found between consultation status and broad psychiatric diagnosis (Pearson’s χ² = 29.93, df = 5, p < 0.001). Age group also showed a statistically significant association with broad psychiatric diagnosis (Pearson’s χ² = 105.95, df = 30, p < 0.001), suggesting that the distribution of broad psychiatric diagnoses varied significantly across different age groups. Overall, sex, consultation status, and age group were significantly associated with broad psychiatric diagnosis, whereas place of residence was not significantly associated. Table 4. Psychiatric Diagnosis According to Sex (N = 600) Sex Affective Anxiety & Stress Drug & Alcohol Organic Other Psychosis Total Female 87 90 1 2 12 74 266 Male 77 91 76 14 23 53 334 Total 164 181 77 16 35 127 600 Among females, affective disorders (n = 87) and anxiety and stress-related disorders (n = 90) were the most frequently observed diagnostic categories, followed by psychosis (n = 74). Drug and alcohol-related disorders were least frequent among females (n = 1). Among males, anxiety and stress-related disorders (n = 90) and affective disorders (n = 77) were the most common diagnostic categories[Table 4]. This was followed by drug and alcohol-related disorders (n = 76) and psychosis (n = 53). Organic disorders (n = 14) and other psychiatric disorders (n = 23) were less frequently observed. Overall, across both sexes, anxiety and stress-related disorders were the most frequent diagnosis (n = 181), followed by affective disorders (n = 164), psychosis (n = 127), and drug and alcohol-related disorders (n = 77). The distribution indicates noticeable differences in diagnostic categories between males and females, particularly for drug and alcohol-related disorders, which were substantially more frequent among males, while psychosis was more frequently observed among females.

In the present study, males constituted the majority of the study population, and a greater proportion of participants were from rural areas. Anxiety and stress-related disorders were the most frequently observed psychiatric conditions, followed by affective disorders. With regard to age distribution, the majority of participants belonged to the 25–44-year age group (54.68%), followed by those aged 45–60 years (18.55%). In the present study, males constituted 55.7%, while females accounted for 44.3%. Patients from rural areas represented approximately 59.2% of the study population compared with 40.8% from urban areas. Follow-up patients constituted approximately 63.8%, whereas new patients accounted for 36.2%. The predominance of male patients and individuals from rural areas may reflect the demographic characteristics of the population served by the study centre and the pattern of utilisation of psychiatric outpatient services. Anxiety and stress-related disorders constituted the largest broad diagnostic category, accounting for approximately 30.0% of the projected sample, followed by affective disorders (27.3%) and psychotic disorders (21.2%). Drug- and alcohol-related disorders accounted for approximately 12.8% of patients, while organic disorders and other diagnostic categories constituted smaller proportions. Thus, anxiety/stress-related, affective, and psychotic disorders together represented the major diagnostic burden in the psychiatric outpatient population. This distribution highlights the broad spectrum of psychiatric morbidity encountered in routine outpatient practice, ranging from common emotional disorders to severe and persistent psychiatric illnesses. A statistically significant association was observed between sex and broad psychiatric diagnosis (Pearson's χ² = 70.33, df = 5, p < 0.001). The diagnostic distribution differed between males and females, with drug- and alcohol-related disorders occurring predominantly among males, whereas affective and anxiety/stress-related disorders were represented substantially among both sexes. These findings suggest that sex may be associated with the pattern of psychiatric diagnoses encountered in the outpatient setting. Although rural patients constituted a larger proportion of the overall study population, the distribution of broad diagnostic categories between rural and urban patients was not statistically different. This finding suggests that, within this outpatient population, the broad pattern of psychiatric diagnoses was relatively similar across residential groups. A statistically significant association was observed between age group and broad psychiatric diagnosis (Pearson's χ² = 105.95, df = 30, p < 0.001). This indicates that the distribution of diagnostic categories varied across age groups. The analysis of continuous age using the Kruskal–Wallis test also demonstrated a statistically significant difference in age distributions across the diagnostic groups (H = 24.98, df = 9, p = 0.003). The descriptive findings showed variation in mean age across diagnostic categories, with organic disorders having a relatively higher mean age, whereas disorders of psychological development occurred in much younger patients. The relatively high proportion of anxiety/stress-related and affective disorders in the present study is important from a public health perspective, as these conditions can substantially affect functioning, quality of life, interpersonal relationships, and occupational productivity. The presence of drug- and alcohol-related disorders, particularly among male patients, further emphasizes the need for appropriate screening, early intervention, relapse prevention, and integrated addiction services within psychiatric outpatient care. Overall, the present findings demonstrate a diverse pattern of psychiatric morbidity in the outpatient setting, with anxiety/stress-related disorders, affective disorders, and psychotic disorders comprising the principal diagnostic groups. Significant associations between diagnosis and sex, consultation status, and age group indicate that demographic and clinical characteristics may influence the pattern of psychiatric presentations. The findings support the importance of comprehensive psychiatric assessment, early identification of common mental disorders, continuity of care for chronic psychiatric illnesses, and attention to substance-use disorders within routine outpatient psychiatric services. In a study conducted by Md. Sultan et al., major depressive disorder was the most frequently reported psychiatric morbidity (38.6%), followed by anxiety disorders (25.8%).[11] In contrast, depression was the second most commonly observed psychiatric disorder in the present study. Epidemiological evidence suggests that depressive and anxiety disorders are more prevalent among women and are associated with greater disability in females at the population level,[12] similarly, a statistically significant association was observed between sex and broad psychiatric diagnosis. Anxiety disorders may frequently present with physical or somatic symptoms rather than explicitly reported psychological complaints, which can contribute to their under-recognition in clinical settings.[13,14] Improved recognition, appropriate diagnostic evaluation, and timely management of anxiety disorders, particularly at the primary-care level, may contribute to better patient outcomes and reduce unnecessary utilization of healthcare services. Screening may be particularly useful when integrated with comprehensive clinical assessment, appropriate treatment, psychosocial support, and follow-up. The present study comprehensively assessed the spectrum of psychiatric diagnoses encountered in the outpatient setting, thereby providing an overview of the diagnostic profile of the study population. It also evaluated the association of psychiatric diagnoses with key demographic and clinical variables, including age, sex, place of residence, and consultation status. The systematic assessment of these variables adds to the strength of the study by providing a broader understanding of the patterns of psychiatric morbidity and their demographic correlates in the outpatient population. The study was conducted in a medical college hospital and included patients presenting to a psychiatric outpatient setting that might limit generalizability of the findings. However, the relatively small sample size, use of convenience sampling, and single-centre design limit the generalizability of the findings to the wider population. Further multicentric studies involving larger and more representative samples are warranted to better characterize the prevalence and distribution of psychiatric disorders in the community.

The present study demonstrates that psychiatric disorders constitute a substantial proportion of patients attending a tertiary care psychiatry outpatient department. The study population was predominantly composed of males and individuals from rural areas. Anxiety and stress-related disorders were the most frequently observed psychiatric conditions, followed by affective disorders. These findings highlight the diverse pattern of psychiatric morbidity encountered in tertiary care settings and underscore the importance of systematic assessment and early identification of common psychiatric disorders to facilitate appropriate management and comprehensive mental healthcare. To take the early and necessary steps for better care, accurate and relevant statistics of the pattern of psychiatric disorders are required. We anticipate that the findings of this study will be useful in developing a strategy for improving mental health services in tertiary care facilities.

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