Stress and Psychiatric Disorder in the Hindu Kush

1996 ◽  
Vol 168 (3) ◽  
pp. 299-307 ◽  
Author(s):  
David B. Mumford ◽  
Mohammed Nazir ◽  
Faiz-Ul-Mulk Jilani ◽  
Imam Yar Baig

BackgroundIt is widely believed that people in remote areas of the world suffer less emotional distress and fewer psychiatric disorders. Previous studies offer contradictory evidence.MethodFirst stage screening of two mountain villages in Chitral used the Bradford Somatic Inventory (BSI). Psychiatric interviews were conducted with stratified samples using the ICD–10 Diagnostic Criteria for Research.ResultsThe BSI was an effective screening test, with sensitivity of 80% and specificity of 77%. At a conservative estimate, 46% of women and 15% of men suffered from anxiety and depressive disorders. Literate subjects had lower levels of emotional distress than the illiterate. Higher socio-economic status was associated with less emotional distress. Members of joint and nuclear families were similar.ConclusionsThe study offers no support for the belief that people who live in Chitral lead stress-free lives or have low rates of psychiatric morbidity. Women may suffer more anxiety and depressive disorders than in Western societies.

1997 ◽  
Vol 170 (5) ◽  
pp. 473-478 ◽  
Author(s):  
David B. Mumford ◽  
Khalid Saeed ◽  
Imtiaz Ahmad ◽  
Shazia Latif ◽  
Malik H. Mubbashar

BackgroundThe prevalence of psychiatric disorders in rural Punjab is unknown. Previous studies in rural areas elsewhere in the Indian subcontinent have yielded widely differing estimates.MethodFirst-stage screening of a village near Gujar Khan used the Bradford Somatic Inventory and Self Reporting Questionnaire. Psychiatric interviews were conducted with stratified samples using the ICD-10 Diagnostic Criteria for Research.ResultsIt is estimated that 66% of women and 25% of men suffered from anxiety and depressive disorders. Levels of emotional distress increased with age in both genders. Women living in unitary households reported more distress than those living in extended or joint families. With younger men and women, lower levels of education were associated with greater risk of psychiatric disorders. Social disadvantage was associated with more emotional distress.ConclusionsThis study in rural Punjab confirms the findings of a previous study in Chitral, northern Pakistan, of high levels of emotional distress and psychiatric morbidity among women in rural areas of Pakistan.


2000 ◽  
Vol 177 (6) ◽  
pp. 557-562 ◽  
Author(s):  
David B. Mumford ◽  
Fareed A. Minhas ◽  
Imtiaz Akhtar ◽  
Saeed Akhter ◽  
Malik H. Mubbashar

BackgroundRecent studies in rural areas of Pakistan have yielded high prevalence rates of common mental disorders, especially among women.AimsTo investigate emotional distress and common mental disorders in a poor urban district using the same survey method.MethodFirst-stage screening of a slum district of Rawalpindi used the Bradford Somatic Inventory. Psychiatric interviews were conducted with stratified samples using the ICD–10 research diagnostic criteria.ResultsOn a conservative estimate, 25% of women and 10% of men suffered from anxiety and depressive disorders. Levels of emotional distress increased with age in both men and women. Women living in joint households reported more distress than those living in unitary families. Higher levels of education were associated with lower risk of common mental disorders, especially in younger women. Emotional distress was negatively correlated with socio-economic variables among women.ConclusionsThis study found levels of emotional distress and psychiatric morbidity in a poor district of Rawalpindi to be less than half those in a nearby rural village in the Punjab, although rates in women were still double those in men. Possible explanations are that more healthy people migrate to the cities or that urban living is more conducive to good mental health in Pakistan.


2003 ◽  
Vol 33 (4) ◽  
pp. 715-722 ◽  
Author(s):  
S. TARGOSZ ◽  
P. BEBBINGTON ◽  
G. LEWIS ◽  
T. BRUGHA ◽  
R. JENKINS ◽  
...  

Background. In this paper, data from the British National Survey of Psychiatric Morbidity are used to assess depressive disorders and markers of social disadvantage in women bringing up children on their own.Method. The household component of the British National Surveys of Psychiatric Morbidity was based on a stratified random sample of >10000 subjects. This paper reports on 5281 women interviewed in person. Psychiatric symptoms and ICD-10 diagnoses were established by lay interviewers using the CIS-R. Results are presented in terms of depressive episode and mixed anxiety/depressive disorder. Housing tenure and access to a car were used as proxy measures of material status. The life event rate in the 6 months before interview was used to indicate overall exposure to stress, and subjects were asked in detail about perceived social support. Information was collected about various other sociodemographic attributes. Lone mothers were compared with supported mothers and with women not involved in care of children under 16.Results. Lone mothers had prevalence rates of depressive episode of 7%, about three times higher than any other group. The milder condition, mixed anxiety/depression, was also increased in frequency. These increased rates of depressive conditions were no longer apparent after controlling for measures of social disadvantage, stress and isolation.Conclusions. Lone mothers are increasing in numbers as marital stability declines. Their high rates of material disadvantage and of depressive disorder may have considerable implications for psychiatric and social policy.


Children ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Amy E. Peden ◽  
Richard C. Franklin

Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality rated six times (RR = 5.84; 95% CI: 3.76–9.12) that of major city residents. Accidental poisoning and intentional self-harm fatalities were more likely in high IRSAD areas, while road traffic fatalities were more likely in low and mid socio-economic areas (X2 = 69.1; p < 0.001). People residing in regional and remote areas and from low socio-economic backgrounds already face significant health and lifestyle challenges associated with disadvantage. It is time to invest in injury prevention interventions for these populations, as well as upstream policy strategies to minimize any further preventable loss of life.


1998 ◽  
Vol 28 (1) ◽  
pp. 9-19 ◽  
Author(s):  
P. E. BEBBINGTON ◽  
G. DUNN ◽  
R. JENKINS ◽  
G. LEWIS ◽  
T. BRUGHA ◽  
...  

Background. Women are consistently reported to have a greater prevalence of depressive disorders than men. The reason for this is unclear, and is as likely to be social as biological. There is some evidence that the excess of depression is greater during women's reproductive lives. Data from the National Survey of Psychiatric Morbidity were used to test the hypothesis that the excess disappeared in the post-menopausal years and that obvious social explanations for this were inadequate.Method. Subjects (N=9792) from a random sample of the British population provided data for the analysis. Psychiatric assessment was carried out by lay interviewers using the CIS-R. Subjects with ICD-10 depressive episode or mixed anxiety/depression were compared with the remainder. Social variables that were likely to contribute to a post-menopausal decline in depressive disorders were controlled in logistic regression analyses.Results. There was a clear reversal of the sex difference in prevalence of depression in those over age 55. This could not be explained in terms of differential effects of marital status, child care, or employment status.Conclusions. This large and representative survey adds considerably to the increasingly held view that the sex difference in prevalence of depression is less apparent in later middle age. This may be linked to the menopause, and our attempts to explain it in terms of obvious conditions among social variables were not successful. More specific studies are required to clarify the finding.


Author(s):  
Prem Singh ◽  
Harsh Rathi ◽  
Anjali Mishra

Background: Psychiatric morbidity occurs more frequently in patients with substance abuse than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving care of substance abusing population but such data are relatively meager from developing countries.Methods: This study was conducted in the Out-patient facility of the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute of Medical Science & Research, Srinagar (Uttarakhand), starting from 23 September 2015. One hundred consecutive treatment seeking subjects fulfilling international classification of diseases and related health problems, 10th Revision (ICD-10), criteria for mental and behavioral disorders due to psychoactive substance use were included in the study. All the participants were required to sign an informed consent approved by the institutional ethical committee before being enrolled in the study. All the subjects included in the study were administered a semi-structured Proforma to elicit the clinical and socio-demographic variables.  Results: One hundred patients consisting of 95 men (95%) and 05 women (05%) were included. The average age of the sample was 39.68 years (SD=11.97). As for the socio-demographic variables other than age, 87% of the patients were married, 62% patients were living in nuclear families and 66% belonged to the rural areas. 79% patients were educated up to high school and above and only 06% were illiterate. 36 % of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was significant higher in unmarried people with less education (primary or less) and those living in nuclear families.  Conclusions: Psychiatric comorbidity was found in 36% of the study subjects.


2019 ◽  
Author(s):  
Lunic Base Khoza ◽  
Wilfred Njabulo Nunu ◽  
Nthomeni Ndou ◽  
Jane Makgopa ◽  
Nditsheni Ramakuela ◽  
...  

Abstract Background Studies in South Africa showed that cataract was the second leading cause of blindness and the leading single cause of severe visual impairment. People living in the rural and remote areas of the world are usually of lower socio-economic status and therefore lack the opportunity to utilize eye care services adequately which could result to lack of knowledge regarding cataract surgery. The primary aim of the current study was to increase a better understanding of eye health inequalities in Limpopo province with specific reference to cataract surgery and care. The study sought to answer a central question “What are the barriers related to the uptake of cataract surgery and care in Limpopo. Methods This study used qualitative and descriptive designs through exploring barriers related to the uptake of cataract surgery and care from professional nurses’ perspective. The target population comprised of 20 ophthalmic supportive staff. A non-probability, purposive sampling was applied to select three hospitals in which cataract surgeries are performed. All the 20 ophthalmic supportive staff purposively comprised the sample of the study. Data were collected through Focus Group Discussions. The Tesch’s principles as a guide for classifying data into themes and sub-themes applied. Ethical consideration and trustworthiness for data quality were explained. Results The study found that patient ignorance, low education and illiteracy, lack of awareness programmes, shortage of ophthalmologist and supportive ophthalmic health professionals, inadequate cataract facilities and resources lead to poor quality services in the hospitals were the major barriers in the uptake of cataract surgery and care. Conclusion People living in the rural and remote areas of the world are usually of lower socio-economic status and therefore lack the opportunity to utilize eye care services adequately. There is need to expand the awareness programmes and health education regarding prevention of the risks of blindness among the elderly in particular.


Patan Pragya ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. 196-208
Author(s):  
Badri Narayan Sah

Nepal is one of the least developed but high remittances recipient countries in the world. Nepal received remittance from US$ 8.1 billion in 2016 and it is ranked 23rd among the remittance receiving countries in the world. Remittance income is one of the major sources of capital formation in the context of Nepal. It is directly related with the labour migration in a country which in return enhances foreign employment. Remittances have become a major contributing factor to increasing household income as well as country’s GDP. About 30 percent of Nepal’s GDP comes in the form of remittance money which is sent home by Nepalese working abroad and it helps to reduce country’s poverty rate. Poverty reduction took place in Nepal from 42 percent (1995/96) to 25.2 percent (2010/11). Nepal’s remittance recipients reached 31.5 percent GDP in 2015. The total amount of remittance in the country is 259 billion and among which 20 percent is internal sources, 11 percent from India and 69 percent from Gulf countries. Remittance received by the households is mainly used for daily consumption (79 percent) and remaining other purposes. Moreover, Nepal’s economic status mostly depends on remittance received which is therefore migration driven economy.


Author(s):  
Wulan Citra Sari Wulan Citra Sari

  ABSTRACT Diarrhea is cause the number one of a death in the world. The united Nation Children’s Found (UNICEF) thinks about every 30 second there one a child die because diarrhea. Diarrhea disease still be a problem for society healthy in Indonesia well reviewed of morbidity and mortality ant the mark of deaths and “Kejadian Luar Biasa (KLB)” that caused. Accrodin to WHO the mark of diarrhea illness 2010 is 411 patients per 1.000 population. The digit of death diarrhea is 14% from the digit of death over all. The purpose of this research to know a connection between education and mother economic status with toodler (children under 5 years old) diarrhea case at Puskesmas Sekip Palembang in February 2014. Desaign of this research to survey analitic by do coloser Cross Sectional in Accidental Sampling tehnic which one the variable who get research, include education and mothers economic status. The sampel in this research in 33 mothers who come by bring their toodler to MTBS Puskesmas Sekip Palembang at February 2014. Each variabel who get research, then get analysis by use analysis Chi-Square by decisios X² table (3,481). The result of this research show that the respondent by diarrhea as many is 15 respondent (45,5%) and didn’t diarrhea 18 respondent (54,5%). This of high education 13 repondent (39,4%) and less education is many as 20 respondent (60,6%), the respondent based to the high economic status as many as 13 respondent (39,4%). From statistic test Chi-Square show that, there a connection between education  with diarrhea case in X² count = 4,313, and there a connection between mothers economic status with case diarrhea at X² count= 4,917. From the results of this study are expected to further improve health education, especially regarding the incidence of diarrhea in infants to mothers who have young children understand more about the incidence of diarrhea.     ABSTRAK Diare adalah penyebab nomor satu kematian di dunia. The United Nations Children’s Fund (UNICEF) memperkirakan bahwa setiap 30 detik ada anak meninggal karena diare. Penyakit diare masih merupakan masalah kesehatan masyarakat di Indonesia baik ditinjau dari angka kesakitan dan angka kematian serta kejadian luar biasa (KLB) yang ditimbulkan. MenurutWHO angka kesakitan diare pada tahun 2010 yaitu 411 penderita per 1000 penduduk. Angka kematian diare 14% dari angka kematian balita secara keseluruhan. Tujuan penelitian ini untuk mengetahui hubungan antara pendidikan dan status ekonomi ibu dengan kejadian diare pada balita di Puskesmas SekipPalembang pada bulan Februari Tahun 2014. Desain penelitian ini adalah survey analitik dengan pendekatan Cross Sectional dalam teknik Accidental Sampling dimana variableyang diteliti meliputi pendidikan dan status ekonomi ibu. Sampel pada penelitian ini adalah 33ibu yang datang membawa anak balitanya berobat ke MTBS puskesmas Sekip Palembang pada bulan FebruariTahun 2014. Masing-masing variabel yang diteliti kemudian dianalisa dengan menggunakan analisis Chi-Square dengan ketetapan X² Tabel (3,481). Hasil penelitian ini menunjukan bahwa responden dengan diare sebanyak 15 responden (45,5%) dan tidak diare 18 responden (54,5%), responden berdasarkan pendidikan tinggisebanyak 13responden (39,4%) dan pendidikan rendah sebanyak 20 responden (60,6%), responden berdasarkan status ekonomi tinggi sebanyak 20 responden (60,6%) dan yang status ekonomi rendah sebanyak 13 responden (39,4%). Dari uji statistik Chi-Square menunjukkan ada hubungan antara pendidikan dengan kejadian diare pada X²hitung= 4,313, dan ada hubungan antara status ekonomi ibu dengan kejadian diare pada X²hitung= 4,917. Dari hasil penelitian ini diharapkan agar lebih meningkatkan penyuluhan kesehatan khususnya tentang kejadian diare pada balita agar ibu yang mempunyai balita lebih memahami tentang kejadian diare.  


Author(s):  
Mattia Marchi ◽  
Federica Maria Magarini ◽  
Giorgio Mattei ◽  
Luca Pingani ◽  
Maria Moscara ◽  
...  

Consultation–liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000–2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.


Sign in / Sign up

Export Citation Format

Share Document