Mental health status: a cross sectional study on rural economically productive population of field practice area of a tertiary medical care institute in Ujjain, Madhya Pradesh

Vibha Arjaria, Badri Narayan Mishra, Dharampal Singh Chouhan


Background: The World Health Organization (WHO) Global Burden of Disease Study has estimated that psychiatric disorders emerging all around the globe and are increasing at a high pace. They have an impact on both the economic aspects and quality-of-life of the people. Present study was conducted to broaden our knowledge regarding mental health status in terms of prevalence of mental health disorders in the rural population, constituting 64% of the total population in India. Present study aims to estimate the prevalence of mental health disorders in the selected area and study the association of each disorder with various socioeconomic variables of individuals. Objectives of the study were to assess and associate the prevalence of study population for major mental health disorders under the headings –overall probability of any mental health disorder, internalizing disorders and externalizing disorders as broad categories.

Methods: A cross-sectional study was conducted among 430 participants residing in six selected villages of rural field practice area of native college in Ujjain district. Statistical methods which applied are: percentage and proportion, mean and standard deviation and chi-square analysis for assessing the association.

Results: Present study showed 44.2% participants scored in the category of high probability of having diagnosis of any mental health disorder. On testing each subgroup disorder probability of getting diagnosed with internalizing disorder emerged with prevalence of almost 50% while probability of externalizing disorder was found in 30.4% population.

Conclusions: The present study revealed that nearly half of study participants had the probability of suffering from some kind of mental health disorder and association found with gender, family type, and occupation of the individual.


Internalizing disorders, Externalizing disorders, Mental health

Full Text:



World Health Organization. The world health report 2001 - Mental Health: New Understanding, New Hope. World Health Organization 2001, Geneva.

Kessler RC. Psychiatric epidemiology: selected recent advances and future directions. Bull World Health Organ. 2000;78(4):464-74.

Tiwari S. Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India. Indian J Med Res. 2013;138(4):504-14.

Math SB, Srinivasaraju R. Indian Psychiatric epidemiological studies: Learning from the past. Indian J Psychiatry. 2010;52:95-103.

Pothen M, Kuruvilla A, Philip K, Joseph A, Jacob KS. Common Mental Disorders Among Primary Care Attendees in Vellore, South India: Nature, Prevalence and Risk Factors, Int J Soc Psychiatry. 2003;49:119-25.

Patel V, Pereira J, Coutinho L, Fernandes R, Fernandes J, Mann A. Poverty, psychological disorder and disability in primary care attenders in Goa, India. Br J Psychiatry. 1998;172:5337.

Chatterjee S, Chowdhary N, Pednekar S, Cohen A, Andrew G, Andrew G, et al. Integrating evidencebased treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa, India. World psychiatry. 2008;7(1):39-46.

Nambi SK, Prasad J, Singh D, Abraham V, Kuruvilla A. Jacob KS. Explanatory models and common mental disorders among patients with unexplained somatic symptoms attending a primary care facility in Tamil Nadu. Natl Med J India. 2002;15:331-5.

Kisely SR, Goldberg DP. Physical and psychiatric co-morbidity in general practice. Br J Psychiatry 1996;169:236-42.

Bask, M. Externalising and internalising problem behaviour among Swedish adolescent boys and girls. International Journal of Social Welfare 2015;24(2):182–92.

Dennis M, Chan Y, Funk R. Development and Validation of the GAIN Short Screener (GSS) for Internalizing, Externalizing and Substance Use Disorders and Crime/Violence Problems Among Adolescents and Adults. Am J Addict. 2006;15(1):80-91.

"Indian States Census 2011". Census Organization of India. 2011. Accessed on 1 January 2014.

Labor bureau of India.Report on Fourth Annual Employment & Unemployment Survey 2013-14. Chandigarh: Government of India Ministry of Labor & Employment Labor Bureau; 2015.

Premrajan KC, Danabalan M, Chandrasekhar R, Srinivasa DK. Prevalence of psychiatric morbidity in an urban community of Pondicherry. Indian J Psychiatry. 1993;35:99–102.

Sharma R. Revision of Prasad’s social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013;2:157.

Park K. Preventive and Social Medicine. Jabalpur, India: Pub: M/S Banarsidas Bhanot; 2007.

Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K, Singh LK, et al. National Mental Health Survey of India, 2015-16: Summary. Bengaluru, NIMHANS Publication No. 128, 2016.

Badrakalimuthu VR, Sathyavathy VR. India Mental health practice in private primary care in rural India: a survey of practitioners, World Psychiatry. 2009;8:2.

Moylan CA, Herrenkohl TI, Sousa C, Tajima EA, Herrenkohl RC, Russo MJ. The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. J Family Violence. 2010;25(1):53–6.

Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A, Richardson C. The standardization of Achenbach’s Youth Self-Report in Greece in a national sample of high school students. European Child Adolesc Psychiatry. 2001;10(1):47–53.

Kessler R, Chiu W, Demler O, Walters E. Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617.

Sethi BB, Gupta SC, Mahendru RK, Kumari P. Mental health and urban life: A study of 850 families. British J Psychiatry. 1974;124:243-6.

Angst J, Sellaro R, Ries MK. Multimorbidity of psychiatric disorders as an indicator of clinical severity. European Arch Psychiatry Clin Neurosci. 2002;252:147–54.

Kandel DB, Johnson JG, Bird HR, Weissman MM, Goodman SH, Lahey BB, et al. Psychiatric comorbidity among adolescents with substance use disorders: Findings from the MECA study. J Am Acad Child Adolesc Psychiatry. 1999;38:693–9.

Kessler RC, Nelson CB, Mc Gonagle KA, et al. The epidemiology of co-occurring addictive and mental disorders: Implications for prevention and service utilization. Am J Orthopsychiatry. 1996;66:17-31.

Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617–27.

Krueger RF, Markon KE. Reinterpreting Comorbidity: A Model-Based Approach to Understanding and Classifying Psychopathology. Annu Rev of Clin Psychol. 2006;2:111–3.

Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) study. JAMA. 1990;264:2511–8.

Brooner RK, King VL, Kidorf M, Schmidt CW Jr, Bigelow GE. Psychiatric and substance use comorbidity among treatment-seeking opioid abusers. Arch Gen Psychiatry. 1997;54:71–80

Cornelius JR, Maisto SA, Martin CS, Bukstein OG, Salloum IM, Daley DC, et al. Major depression associated with earlier alcohol relapse in treated teens with AUD. Addict Behav. 2004;29:1035–8.

McLellan AT, Luborsky L, Woody GE, O'Brien CP, Druley KA. Prediction response to alcohol and drug abuse treatments. Arch Gen Psychiatry. 1983;40:620–8.

Mueser KT, Drake RE, Miles KM. The course and treatment of substance use disorder in persons with severe mental illness. In: Onken LS, Blaine JD, Genser S, Horton AM, eds. Treatment of Drug-Dependent Individuals with Comorbid Mental Disorders. National Institute on Drug Abuse; 1997.

Hien DA, Nunes E, Levin FR, Fraser D. Posttraumatic stress disorder and short-term outcome in early methadone treatment. J Subst Abuse Treat. 2000;19:31–7.

Project MATCH Research Group. Project MATCH secondary a priori hypotheses. Addiction. 1997;92:1671–1698

Rounsaville BJ, Kosten TR, Weissman MM, Kleber HD. Prognostic significance of psychiatric disorders in treated opiate addicts. Arch Gen Psychiatry. 1986;43:739–45.

Shane P, Jasiukaitis P, Green RS. Treatment outcomes among adolescents with substance abuse problems: The relationship between comorbidities and post-treatment substance involvement. Eval Prog Plann. 2003;26:393–402.

Bijl RV1, de Graaf R, Hiripi E, Kessler RC, Kohn R, Offord DR, et al. The Prevalence of Treated and Untreated Mental Disorders in Five Countries. Health Afs. 2003;22:122–33.

Mechanic D, Bilder S, McAlpine DD. Employing persons with serious mental illness. Health Affairs. 2002;21(5):242–53.

Reddy BV. Mental Health issues and challenges in India: A Review. Int J Sci Res Pub. 2013;3(2).