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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
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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 

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