Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T07:11:00.193Z Has data issue: false hasContentIssue false
  • English
  • Français

Stress and Psychiatric Disorder in the Hindu Kush

A Community Survey of Mountain Villages in Chitral, Pakistan

Published online by Cambridge University Press:  02 January 2018

David B. Mumford ,
Mohammed Nazir ,
Faiz-Ul-Mulk Jilani  and
Imam Yar Baig
David B. Mumford*
Affiliation:
University of Bristol
Mohammed Nazir
Affiliation:
Aga Khan Health Service, Garam Chashma
Faiz-Ul-Mulk Jilani
Affiliation:
Civil Hospital, Garam Chashma, Chitral
Imam Yar Baig
Affiliation:
Aga Khan Health Service, Chitral, Pakistan
*
Dr D. B. Mumford, Department of Mental Health, University of Bristol, 41 St Michael's Hill, Bristol BS2 8DZ
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

It is widely believed that people in remote areas of the world suffer less emotional distress and fewer psychiatric disorders. Previous studies offer contradictory evidence.

Method

First 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.

Results

The 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.

Conclusions

The 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.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue 3 , March 1996 , pp. 299 - 307
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. London: Tavistock.Google Scholar
Carstairs, G. M. & Kapur, R. L. (1976) The Great Universe of Kota: Stress, Change and Mental Disorder in an Indian Village. London: Hogarth Press.Google Scholar
Desjarlais, R., Eisenberg, L., Good, B., et al (1995) World Mental Health: Problems and Priorities in Low-income Countries. New York: Oxford University Press.CrossRefGoogle Scholar
Dube, K. C. (1970) A study of prevalence and biosocial variables in mental illness in a rural and an urban community in Uttar Pradesh – India. Acta Psychiatrica Scandinavica, 46, 327–359.CrossRefGoogle Scholar
Freud, S. (1930) Civilisation and its Discontents. London: Hogarth Press.Google Scholar
Goldberg, D. P. (1978) Manual of the General Health Questionnaire. Slough: NFER Publishing Company.Google Scholar
Goldberg, D. P. & Huxley, P. (1992) Common Mental Disorders: a Biosocial Model. London: Routledge.Google Scholar
Grima, B. (1992) The Performance of Emotion Among Paxtun Women: “The Misfortunes Which Have Befallen Me”. Texas: University of Texas Press.Google Scholar
Jarvis, E. (1851) Causes of insanity. Boston Medical and Surgical Journal, 45, 289–305.Google Scholar
Leff, J. L. (1986) The epidemiology of mental illness across cultures. In Transcultural Psychiatry (ed Cox, J. L.), pp. 23–36. London: Croom Helm.Google Scholar
Lin, T. (1953) A study of the incidence of mental disorder in Chinese and other cultures. Psychiatry, 16, 313–336.CrossRefGoogle ScholarPubMed
Mumford, D. B. (1989) Somatic sensations and psychological distress among students in Britain and Pakistan. Social Psychiatry and Psychiatric Epidemiology, 24, 321–326.Google Scholar
Mumford, D. B. (1993) Somatisation: a transcultural perspective. International Review of Psychiatry, 5, 231–242.Google Scholar
Mumford, D. B. (1994) Can ‘functional’ somatic symptoms associated with anxiety and with depression be differentiated? International Journal of Methods in Psychiatric Research, 4, 133–141.Google Scholar
Mumford, D. B., Bavington, J. T., Bhatnagar, K. S., et al (1991a) The Bradford Somatic Inventory: A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. British Journal of Psychiatry, 158, 379–386.Google Scholar
Mumford, D. B., Tareen, I. A. K., Bajwa, M. A. Z., et al (1991b) An investigation of ‘functional’ somatic symptoms among patients attending hospital medical clinics in Pakistan: I. Characteristics of ‘non-organic’ patients. Journal of Psychosomatic Research, 35, 245–255.Google Scholar
Mumford, D. B., Tareen, I. A. K., Bhatti, M. R., et al (1991c) An investigation of ‘functional’ somatic symptoms among patients attending hospital medical clinics in Pakistan: II. Using somatic symptoms to identify patients with psychiatric disorders. Journal of Psychosomatic Research, 35, 257–264.CrossRefGoogle ScholarPubMed
Orley, J. H. & Wing, J. K. (1979) Psychiatric disorders in two African villages. Archives of General Psychiatry, 36, 513–520.Google Scholar
Sethi, B. B., Gupta, S. C. & Kumari, P. (1972) A psychiatric survey of 500 rural families. Indian Journal of Psychiatry, 14, 183–196.Google Scholar
World Health Organization (1993) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10): Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.