Cultural epidemiology of neurasthenia spectrum disorders in four general hospital outpatient clinics of urban Pune, India

Paralikar, Vasudeo; Agashe, Mohan; Sarmukaddam, Sanjeev; Deshpande, Shantanu; Goyal, Vejaya; Weiss, Mitchell G.

doi:10.1177/1363461511404623

Cited by 19 publications

(5 citation statements)

References 32 publications

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“…In an Indian study, significantly more women with features of neurasthenia spectrum disorder had identified marital problem as the most important perceived cause for their suffering, while none of the men did so [28]. Similar results from this study can be explained as patients are from the similar cultural background (Table 3).…”

Section: Discussionsupporting

confidence: 75%

Stresses and Disability in Depression across Gender

Deshpande

Kalmegh

Patil

et al. 2014

Depression Research and Treatment

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Depression, though generally episodic, results in lasting disability, distress, and burden. Rising prevalence of depression and suicide in the context of epidemiological transition demands more attention to social dimensions like gender related stresses, dysfunction, and their role in outcome of depression. Cross-sectional and follow-up assessment of men and women with depression at a psychiatric tertiary centre was undertaken to compare their illness characteristics including suicidal ideation, stresses, and functioning on GAF, SOFAS, and GARF scales (N = 107). We reassessed the patients on HDRS-17 after 6 weeks of treatment. Paired t-test and chi-square test of significance were used to compare the two groups, both before and after treatment. Interpersonal and marital stresses were reported more commonly by women (P < 0.001) and financial stresses by men (P < 0.001) though relational functioning was equally impaired in both. Women had suffered stresses for significantly longer duration (P = 0.0038). Men had more impairment in social and occupational functioning compared to females (P = 0.0062). History of suicide attempts was significantly associated with more severe depression and lower levels of functioning in case of females with untreated depression. Significant cross-gender differences in stresses, their duration, and types of dysfunction mandate focusing on these aspects over and above the criterion-based diagnosis.

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Section: Discussionsupporting

confidence: 75%

Stresses and Disability in Depression across Gender

Deshpande

Kalmegh

Patil

et al. 2014

Depression Research and Treatment

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“…Furthermore, there are the Short Explanatory Model Interview (Lloyd et al, 1998), the Mental Distress Explanatory Model Questionnaire (Eisenbruch, 1990), and the Barts Explanatory Model Inventory (Bhui, Ru¨dell, & Priebe 2006). For applications of these research tools in India see Banerjee & Banerjee, 1995, p. 219; see also Campion & Bhugra, 1997;Banerjee & Roy, 1998;Nieuwsma, Pepper, Maack, & Birginheir, 2011;Paralikar et al, 2011. Religious explanations might refer to Karma; bad or prior deeds or parent's deeds; the will of God(s); fate; deities and demons; the evil eye; astrological factors; spiritual deficits; sorcery; or other supernatural factors (see Nieuwsma et al, 2011, p. 549).…”

Section: Resultsmentioning

confidence: 97%

“What do I know?” Scholastic fallacies and pragmatic religiosity in mental health-seeking behaviour in India

Quack

2013

Mental Health, Religion & Culture

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This paper draws on ethnographic fieldwork on psychiatrists and their patients (their care-givers and their communities) in North India. It addresses the questions as to when and why people approach psychiatrists and religious healers by arguing that approaches assessing ''explanatory models'' and other knowledge structures relevant to the people's health-seeking behaviour should place more emphasis on the people's strong desire to get well, in any way possible. Secondly, the difference between beliefs rooted in the patients' life-worlds and explanations suggested to them by experts has to be acknowledged. These insights motivate a shift away from the concept ''religion'' towards the differentiation between pragmatic and scholastic religiosities. This argument relates back to the Greek meaning of ''pragma'' understood by Hans-Georg Gadamer as ''that within which we are entangled in the praxis of living''.

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“…[ 11 ] Diverse and rapidly changing cultural features of Indian urban patients and clinicians pose a challenge as well as an opportunity to test the CFI. Cultural epidemiological studies[ 12 ] using EMIC interviews had influenced the development of the CFI.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of the cultural formulation interview in Pune, India

Paralikar

Sarmukaddam

Patil

et al. 2015

Indian J Psychiatry

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Context:Development of the cultural formulation interview (CFI) in DSM-5 required validation for cross-cultural and global use.Aims:To assess the overall value (OV) of CFI in the domains of feasibility, acceptability, and utility from the vantage points of clinician-interviewers, patients and accompanying relatives.Settings and Design:We conducted cross-sectional semi-structured debriefing interviews in a psychiatric outpatient clinic of a general hospital.Materials and Methods:We debriefed 36 patients, 12 relatives and eight interviewing clinicians following the audio-recorded CFI. We transformed their Likert scale responses into ordinal values – positive for agreement and negative for disagreement (range +2 to −2).Statistical Analysis:We compared mean ratings of patients, relatives and clinician-interviewers using nonparametric tests. Clinician-wise grouping of patients enabled assessment of clinician effects, inasmuch as patients were randomly interviewed by eight clinicians. We assessed the influence of the presence of relatives, clinical diagnosis and interview characteristics by comparing means. Patient and clinician background characteristics were also compared.Results:Patients, relatives and clinicians rated the CFI positively with few differences among them. Patients with serious mental disorders gave lower ratings. Rating of OV was lower for patients and clinicians when relatives were present. Clinician effects were minimal. Clinicians experienced with culturally diverse patients rated the CFI more positively. Narratives clarified the rationale for ratings.Conclusions:Though developed for the American DSM-5, the CFI was valued by clinicians, patients and relatives in out-patient psychiatric assessment in urban Pune, India. Though relatives may add information and other value, their presence in the interview may impose additional demands on clinicians. Our findings contribute to cross-cultural evaluation of the CFI.

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Cultural epidemiology of neurasthenia spectrum disorders in four general hospital outpatient clinics of urban Pune, India

Cited by 19 publications

References 32 publications

Stresses and Disability in Depression across Gender

Stresses and Disability in Depression across Gender

“What do I know?” Scholastic fallacies and pragmatic religiosity in mental health-seeking behaviour in India

Clinical value of the cultural formulation interview in Pune, India

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