BackgroundMental disorders such as depression are common and rank as major contributors to the global burden of disease. Condition recognition and subsequent management of depression is variable and influenced by the attitudes and beliefs of clinicians as well as those of patients. Most studies examining health professionals’ attitudes have been conducted in Western nations; this study explores beliefs and attitudes about depression among doctors working in Lahore, Pakistan.MethodsA cross-sectional survey conducted in 2015 used a questionnaire concerning demographics, education in psychiatry, beliefs about depression causes, and attitudes about depression using the Revised Depression Attitude Questionnaire (R-DAQ). A convenience sample of 700 non-psychiatrist medical practitioners based in six hospitals in Lahore was approached to participate in the survey.ResultsSix hundred and one (86 %) of the doctors approached consented to participate; almost all respondents (99 %) endorsed one of various biopsychosocial causes of depression (38 to 79 % for particular causes), and 37 % (between 13 and 19 % for particular causes) noted that supernatural forces could be responsible. Supernatural causes were more commonly held by female doctors, those working in rural settings, and those with greater psychiatry specialist education. Attitudes to depression were mostly less confident or optimistic and less inclined to a generalist perspective than those of clinicians in the UK or European nations, and deterministic perspectives that depression is a natural part of aging or due to personal failings were particularly common. However, there was substantial confidence in the efficacy of antidepressants and psychological therapy. More confident and therapeutically optimistic views and a more generalist perspective about depression management were associated with a rejection of supernatural explanations of the origin of depression.ConclusionsNon-psychiatrist medical practitioners in Pakistan hold a range of views about the causes of depression, with supernatural explanations held by more than a third. Depression attitudes appear less positive than among UK and European clinicians, with the notions that depression is due to a lack of stamina and will-power and a natural part of growing old being especially commonly held; more positive attitudes appear to be associated with a rejection of supernatural explanatory models of depression.
Background: Metabolic syndrome (MetS) is widely prevalent in the South Asian (SA) population. The syndrome leads to a high risk of premature atherosclerosis and diabetes. Obesity, specifically abdominal obesity, is a central pathological mechanism of disease in this population. Ethnic-specific modified measurements of waist circumference (WC) have been proposed for the diagnosis in various populations, including those of SA phenotype. We studied the prevalence of MetS and subclinical inflammation in young physically fit students in a major urban city of Pakistan. Specifically, we addressed the new lower WC measurement and its relationship with MetS and inflammation. C-reactive protein (CRP) was measured as a marker for subclinical inflammation. Methods: A total of 509 respondents (mean age 19.86 years) filled out self-administered questionnaires for data collection. Measurements were made by trained nurses using standardized equipment and fasting blood samples were drawn for chemical analysis. Data were verified, tabulated, and statistically analyzed. Results: MetS was identified in 6% of this cohort and 16% had subclinical information as measured by CRP. Higher CRP levels were noted with higher WC and independently identified subjects with MetS. CRP levels of ‡2.2 mg/dL predicted presence of MetS. Conclusions: MetS is widely prevalent in young, otherwise physically fit, individuals. High proportion of this young cohort had evidence of subclinical inflammation as measured by CRP. Increasing WC showed significant correlation with higher CRP levels, level of 2.2 mg/dL independently identified MetS in this cohort.
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