Family history of mental illness and frequent mental distress in community clinic patients

OBJECTIVE: The objective of this study was to investigate the importance of family history of mental illness as a risk factor for self-reported frequent mental distress among patients who use community-based clinics. DESIGN: A cross-sectional survey was distributed to a convenience sample in three community clinics serving largely low-income patients. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables. RESULTSL: In this sample of primary care patients, 27.1% had frequent mental distress. Having a family history of mental illness or substance abuse was found to be associated with frequent mental distress in this population [adjusted odds ratio (OR) = 2.24, P = 0.000]. Also associated with increased odds of frequent mental distress were avoiding medical care owing to cost (OR = 1.86, P = 0.003) and obesity (OR = 1.73, P = 0.006). CONCLUSIONS: Having a family history of mental illness or substance abuse is independently associated with increased odds of frequent mental distress among primary care patients seen in community clinics. Three strategies are suggested for using this information to prevent frequent mental distress: health education via mass communication to the general population of primary care patients being followed in a clinic, health education to at-risk patients, and targeted screening of clinic patients who have the risk factor.