Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology

Kohrt, Brandon A.; Rasmussen, Andrew; Kaiser, Bonnie N.; Haroz, Emily E.; Maharjan, Sujen Man; Mutamba, Byamah B; Jong, Joop T. V. M. de; Hinton, Devon E.

doi:10.1093/ije/dyt227

Cited by 246 publications

(219 citation statements)

References 118 publications

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“…Quality assessments were independently performed by using the Systematic Appraisal of Quality in Observational Research (SAQOR) tool, that comprises six domains (each containing two to five questions): sample, control/comparison group, exposure/outcome measurements, follow-up, confounders, and reporting of data 7 . The SAQOR has been adapted for use in cross-cultural psychiatric epidemiology studies 8 . In the current study, two domains were omitted (control/comparison group and follow-up), as they were not applicable to any of the papers identified.…”

Section: Analysesmentioning

confidence: 99%

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

et al. 2018

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Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high-income countries. Nearly two-thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta-analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07-1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low-income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo-material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality.

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Section: Analysesmentioning

confidence: 99%

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

et al. 2018

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“…However, this finding contrasts international studies showing substantially lower rates of common mental disorders in Eastern Asia as compared to English-speaking counties of the West [20,21]. These studies have mainly used Western culturally developed instruments such as the Composite International Diagnostic Instrument (CIDI), and it has been recommended that culture-specific expressions of mental distress should be included when studying mental disorders across ethnic diverse groups [18].…”

Section: Discussionmentioning

confidence: 91%

“…Other transcultural epidemiologic studies, such as a WHO study [20] reporting considerable variation of mental disorders across countries, have typically used Western culturally developed psychiatric diagnostic criteria exclusively [21]. …”

Section: Introductionmentioning

confidence: 99%

Do Norwegian Sami and non-indigenous individuals understand questions about mental health similarly? A SAMINOR 2 study

Sørlie

Hansen

Friborg

2018

International Journal of Circumpolar Health

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The Western culturally developed Hopkins Symptom Checklist (HSCL-10) is a self-report measure of mental distress widely used for both clinical and epidemiological purposes – also in the multiethnic epidemiological SAMINOR studies in Northern Norway, but without any proper cross-cultural validation. Our objective was to test invariance of the HSCL-10 measurements among Sami and the non-indigenous majority population in Northern Norway (participants in the SAMINOR 2 study) and whether the previously used HSCL-10 cut-off level (1.85) fits the Sami subgroups in the study. Participants belonged to Sami core, Sami affiliation, Sami background or majority Norwegian groups. The confirmatory factor analysis framework adapted for testing of measurement invariance showed no significant measurement invariance between the groups indicating that the HSCL-10 response scale predominantly was used in the same way and that significantly different meanings were not ascribed to the same set of questions. The cut-off criteria of 1.85 as indicative of psychological distress based on Norwegian data equal a score of 1.89, 1.94 and 1.91 in the Sami core, Sami affiliation and Sami background groups, respectively. Thus, the same cut-off criterion 1.85 may be safely used in all groups. However, one should still be looking for culture-specific expressions of mental stress.

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“…Some argue that sociocultural differences in symptomatology and culture are not suffi ciently taken into consideration by global mental health initiatives such as the mhGAP programme (Bass et al, 2007;White & Sashidharan, 2014), despite the fact that there are important variations in how mental distress presents and is experienced (Fernando, 2012;Kohrt et al, 2014;Patel, 1995;Ventevogel et al, 2013).…”

Section: Medicalization: a Potential Drawback Of Mhgapmentioning

confidence: 99%

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

Ventevogel

2014

International Review of Psychiatry

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Since 2008 the World Health Organization (WHO), through its mental health Gap Action Programme, has attempted to revitalize efforts to integrate mental health into non-specialized (e.g. primary) healthcare. While this has led to renewed interest in this potential method of mental health service delivery, it has also prompted criticism. Some concerns raised are that it would contribute to the medicalization of social and psychological problems, and narrowly focus on primary care without sufficient attention given to strengthening other levels of the healthcare system, notably community-based care and care on district levels. This paper discusses seven elements that may be critical to preventing inadvertently contributing to increasing a narrow biomedical approach to mental healthcare when integrating mental health into non-specialized healthcare: (1) using task shifting approaches within a system of stepped care, (2) ensuring primary mental healthcare also includes brief psychotherapeutic interventions, (3) promote community-based recovery-oriented interventions for people with disabling chronic mental disorders, (4) conceptualizing training as a continuous process of strengthening clinical competencies through supervision, (5) engaging communities as partners in psychosocial interventions, (6) embedding shifts to primary mental healthcare within wider health policy reforms, and (7) promoting inter-sectoral approaches to address social determinants of mental health.

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Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology

Cited by 246 publications

References 118 publications

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

Do Norwegian Sami and non-indigenous individuals understand questions about mental health similarly? A SAMINOR 2 study

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

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