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Severe Mental Illness in Community Mental Health Care in Spain

Prevalence and Related Factors

Martín-Pérez, Carlos, PhD*†; Herrero-Martin, Juan Jesús, MD; Pérez-López, Gonzalo, MD; Pedrosa-García, Rafael, RN; Ibañez-Casas, Inmaculada, PhD§; Torres-González, Francisco, PhD; Moreno-Küstner, Berta, PhD¶#

The Journal of Nervous and Mental Disease: February 2019 - Volume 207 - Issue 2 - p 106–111
doi: 10.1097/NMD.0000000000000929
Original Articles

The aims of this study were to determine the prevalence of severe mental illness (SMI) in patients in contact with mental health services and to determine the factors associated with SMI. A total of 260 patients who met diagnostic criteria for SMI were assessed using the Global Assessment of Functioning (GAF) scale and Health of the Nation Outcome Scales. The overall prevalence of SMI was 6.08 per thousand. According to the three different cutoff points with GAF, the prevalence of SMI ranged from 5.38 per thousand under the weak criterion (GAF < 70) to 1.01 per thousand under the strict criterion (GAF < 50). In the regression model, the dependent variable (presence of SMI) was defined using a GAF < 60, and the variables independently associated with the dependent variable were years of disease duration since diagnose, mental health service use, alcohol or other substance abuse, and depressive anxiety and other psychological symptoms.

*Andalusian Health Service, North East Granada Sanitary District, Clinical Management Unit at Marquesado, Granada;

“Mental Health, Services and Primary Care” Research Group (SAMSERAP), Malaga;

Guadix Community Mental Health Unit, Avenida Mariana Pineda;

§CIBERSAM University of Granada, Biomedical Research Centre;

Maristán Network, Faculty of Medicine, University of Granada, Granada;

Department of Personality, Assessment and Psychological Treatment, Faculty of Psychologist, University of Malaga; and

#Maristán Network, Andalusian Group of Psychosocial Research (GAP), Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.

Send reprint requests to Berta Moreno-Küstner, PhD, Faculty of Psychology, University of Málaga, Campus Teatinos, 29071, Málaga, Spain. E-mail:

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