Prevalence of abuse in mentally ill patients visiting outpatient setting in a tertiary care hospital in India

Aim: In a developing country such as India, the abuse of patients suffering from psychiatric disorders has been under-reported. The aim of this study was to detect abuse in chronically ill psychiatric patients visiting a psychiatric outpatient setting in a tertiary care hospital in Delhi, India. Material and Methods: A cross-sectional descriptive written survey was carried out on 406 patients. A self-administered questionnaire for patient abuse was developed in Hindi based on the World Health Organization's Domestic Violence Questionnaire that encompassed questions regarding physical, emotional and sexual abuse. Results: Of the 406 patients, 294 (72%) suffered from abuse, with 64% experiencing emotional abuse, 39% physical abuse and 21% sexual abuse. In chronically ill psychiatric patients, a significant association was found between education and abuse, with most abuse occurring among senior secondary pass outs (i.e. 11-12 years of education) and least among junior high school pass outs (6-8 years of education). A majority (74%) of these patients lived in urban areas (p = .020). A significant association was also found between abuse and the psychiatric diagnosis of the patient, with 53% suffering from depression, 66% anxiety disorder, 81% bipolar disorder, 94% psychotic disorder, 86% obsessive compulsive disorder, 44% sexual disorder and 12% other psychiatric disorders. Conclusions: There is a need to create awareness in society in order to prevent abuse. Screening for abuse in routine psychiatric practice is of utmost importance so that timely interventions can be given, thereby preventing its deleterious health consequences.