Development and validation of a questionnaire for anxiety and depression in Pakistan

Cruickshank

Journal of Affective Disorders

et al. 2012

BackgroundDepressive disorders are common and disabling among perinatal women. The rates are high in ethnic minority groups. The causes are not known in British Pakistani women. The aim of this study was to estimate the rates, correlates and maintaining factors of perinatal depression in a Pakistani sample in UK. The design used was a cross-sectional two phase population based survey with a prospective cohort study.MethodsAll women in 3rd trimester attending antenatal clinic were screened with the Edinburgh postnatal depression scale (EPDS). Women scoring 12 or more on EPDS and a random sample of low scorers were interviewed using the Schedules for Assessment in Neuropsychiatry (SCAN) and the Life Events and Difficulties schedule (LEDS). Social support was assessed with the Multidimensional Scale for Perceived Social Support (MSPSS). They were reassessed 6 months after the delivery using the same measures.ResultsThe weighted prevalence of depression was 16.8%. Depressed mothers had more marked non health difficulties (housing, financial and marital). They had less social support and were socially isolated. Marked social isolation and marked non-health related difficulties were independent predictors of depression. Analyses of all the possible risk factors, comparing 26 persistent depressed with 27 depression resolved group showed significant differences in the MSPSS subscales between the two groups.LimitationsThe study lacked inter-rater reliability testing between the individuals carrying out diagnostic interviews. The study sample did not accurately represent the general population and information about the origins of depression in this group of mothers was limited.ConclusionDepression in British Pakistani mothers is associated with social isolation, poor social support and severe and persistent social difficulties. The findings will have implications in planning suitable services for this group.

Section: Discussionmentioning

confidence: 80%

Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: A cohort study

Cruickshank

Journal of Affective Disorders

et al. 2012

“…It is important that practitioners be aware of the somatization of mental health symptoms by the South Asian elderly (Hussein et al 1997;Kruse 1992;Rait and Burns 1997;Skultans 1991). Using culturally validated screening instruments should also be encouraged for they might help in detecting depression in South Asian older adults (Cole et al 2000;Gallo et al 1998;Mui et al 2002;Mumford et al 2005). Secondly, training health providers in culturally related health beliefs and values, as well as general terms in a given language, could further help in building confidence and trust.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Depression in Aging South Asian Canadians

Lai

Surood

2007

J Cross Cult Gerontol

This study examined the prevalence and factors of depression among aging South Asians in Canada. Telephone surveys were conducted with a random sample of aging South Asians aged 55 and above. Hierarchical regression analysis was used to determine the factors of depression, which was measured by an adapted 15-item Geriatric Depression Scale. Over one in five (21.4%) participants reported at least a mild level of depression. A stronger agreement with South Asian cultural values was significantly related to a higher probability of being depressed. Physical health variables were the most significant factors after controlling for socio-demographic and culture-related factors. The findings have demonstrated the linkages between the relationships among socio-cultural factors and depression in older South Asians. Mental health interventions should consider the cultural uniqueness of this target population and the service delivery system should ensure that services are known and accessible to the increasingly culturally diverse aging population.

“…The instrument was designed based on focus group and key informant interviews identifying local expressions of distress and 22 items were retained after a selection process based on their recurrence in the focus group and semi-directive interviews. A higher score distinguishes distress-disorders from common responses to acute stress experience (Hyder, Bloom, Leach, Syed, & Peters, 2007;Mumford et al, 2005;Saeed, Gater, Hussain, & Mubbashar, 2000;Ventevogel et al, 2007). The instrument has much good overlap with the Afghan Symptom Checklist (Miller et al, 2006), a measure of general psychological distress developed later with similar culturally appropriate terminology: eight items about psychological distress are almost identical to the latter.…”

Section: Assessment Of Mental Distress-disordersmentioning

confidence: 99%

Vulnerability and mental health in Afghanistan: Looking beyond war exposure

Trani

Bakhshi

2013

Transcult Psychiatry

This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45-14.5) and 14.14 (3.38-59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27-8.81) and 8.57 (3.03-24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.