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The 12-item General Health Questionnaire (GHQ-12) and the revised Clinical Interview Schedule (CIS-R) were used to estimate the prevalence of psychiatric morbidity among 78 consecutive admissions to a general medical ward in a Brazilian university hospital (43 males and 35 females; mean age = 43.2 years). The CIS-R was administered by three 5th-year medical students after a brief training. A prevalence rate of 36% was found for psychiatric disorders. The most frequent symptoms were sleep disorders (48.7%), worry (35.9%), depression (28.2%) and anxiety (26.9%). The sensitivity and specificity of the GHQ-12 were 71% and 76%, respectively. The CIS-R was simple to administer and acceptable both to patients and interviewers. Misunderstanding was most likely to occur with the poorly educated (20% were illiterate) in questions involving time calculation. Alternative options might be used to specify the length of time in future studies. The findings support the feasibility of the CIS-R and the use of 'lay' interviewers to produce epidemiological information on psychiatric disorders in developing countries at lower costs. [ABSTRACT FROM AUTHOR]

Background: There is little information available on the changes in mental health services in South American countries following the social and political upheavals of recent decades.Methods: A postal survey was conducted of all South American countries (health ministries, national psychiatric associations and key informants) to assess the development of mental health programs and the organization of alternative psychiatric care centers such as the psychiatric units in general hospitals (PUGH).Results: Most of the mental health programs were implemented during the 1980s and 1990s, and aimed at incorporating psychiatric care into primary health care, as well as relocating provision from large hospitals to decentralized services. Most of the countries surveyed have less than 0.5 psychiatric beds per 1000 inhabitants. This change reflects a tendency to reduce the total number of psychiatric beds and increase the number of PUGH. Over the last 10 years this increase was significant in some countries (50-75%), but was not reflected in the availability of adequate human and material resources.Conclusions: A transition from a system based on large mental hospitals to alternative service provision is on the way in South American countries. Intensive efforts have to be made to collect and disseminate information, as well as to monitor the development and outcome of the mental health programs in these countries. [ABSTRACT FROM AUTHOR]