MusicSarreV3, Main, Exploration, bibRecord, 000478

Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal

Identifieur interne : 000478 ( Main/Exploration ); précédent : 000477; suivant : 000479

Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal

Auteurs : Brandon A. Kohrt [Népal] ; Rebecca A. Speckman [États-Unis] ; Richard D. Kunz [États-Unis] ; Jennifer L. Baldwin [États-Unis] ; Nawaraj Upadhaya [Népal] ; Nanda Raj Acharya [Népal] ; Vidya Dev Sharma [Népal] ; Mahendra K. Nepal [Népal] ; Carol M. Worthman

Source :

Annals of human biology [ 0301-4460 ] ; 2009.

RBID : PMC:3907946

Abstract

Background

The causes of ethnic and caste-based disparities in mental health are poorly understood.

Aim

To identify mediators underlying caste-based disparities in mental health in Nepal.

Subjects and methods

A mixed methods ethnographic and epidemiological study of 307 adults (Dalit/Nepali, n=75; high caste Brahman and Chhetri, n=232) assessed with Nepali versions of Beck Depression (BDI) and Anxiety (BAI) Inventories.

Results

One third (33.7%) of participants were classified as depressed: Dalit/Nepali 50.0%, high caste 28.4%. One quarter (27.7%) of participants were classified as anxious: Dalit/Nepali 50.7%, high caste 20.3%. Ethnographic research identified four potential mediators: stressful life events, owning few livestock, no household income, and lack of social support. The direct effect of caste was 1.08 (95% CI -1.10—3.27) on depression score and 4.76 (95% CI 2.33—7.19) on anxiety score. All four variables had significant indirect (mediation) effects on anxiety, and all but social support had significant indirect effects on depression.

Conclusion

Caste-based disparities in mental health in rural Nepal are statistically mediated by poverty, lack of social support, and stressful life events. Interventions should target these areas to alleviate the excess mental health burden born by Dalit/Nepali women and men.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907946

DOI: 10.1080/03014460902839194
PubMed: 19381985
PubMed Central: 3907946

Affiliations:

Népal, États-Unis

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal</title>
<author><name sortKey="Kohrt, Brandon A" sort="Kohrt, Brandon A" uniqKey="Kohrt B" first="Brandon A." last="Kohrt">Brandon A. Kohrt</name>
<affiliation><nlm:aff id="A1">Department of Anthropology, Emory University, Atlanta, USA, 30322, 404-895-1643</nlm:aff>
<wicri:noCountry code="subfield">404-895-1643</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Speckman, Rebecca A" sort="Speckman, Rebecca A" uniqKey="Speckman R" first="Rebecca A." last="Speckman">Rebecca A. Speckman</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Rollins School of Public Health, Emory University, Atlanta, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Rollins School of Public Health, Emory University, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kunz, Richard D" sort="Kunz, Richard D" uniqKey="Kunz R" first="Richard D." last="Kunz">Richard D. Kunz</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond</wicri:regionArea>
<wicri:noRegion>Richmond</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Baldwin, Jennifer L" sort="Baldwin, Jennifer L" uniqKey="Baldwin J" first="Jennifer L." last="Baldwin">Jennifer L. Baldwin</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana</wicri:regionArea>
<wicri:noRegion>Champaign-Urbana</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A6">Department of Anthropology, University of Illinois, Champaign-Urbana, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Anthropology, University of Illinois, Champaign-Urbana</wicri:regionArea>
<wicri:noRegion>Champaign-Urbana</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Upadhaya, Nawaraj" sort="Upadhaya, Nawaraj" uniqKey="Upadhaya N" first="Nawaraj" last="Upadhaya">Nawaraj Upadhaya</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Acharya, Nanda Raj" sort="Acharya, Nanda Raj" uniqKey="Acharya N" first="Nanda Raj" last="Acharya">Nanda Raj Acharya</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sharma, Vidya Dev" sort="Sharma, Vidya Dev" uniqKey="Sharma V" first="Vidya Dev" last="Sharma">Vidya Dev Sharma</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj</wicri:regionArea>
<wicri:noRegion>Maharajgunj</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nepal, Mahendra K" sort="Nepal, Mahendra K" uniqKey="Nepal M" first="Mahendra K." last="Nepal">Mahendra K. Nepal</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj</wicri:regionArea>
<wicri:noRegion>Maharajgunj</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Worthman, Carol M" sort="Worthman, Carol M" uniqKey="Worthman C" first="Carol M." last="Worthman">Carol M. Worthman</name>
<affiliation><nlm:aff id="A1">Department of Anthropology, Emory University, Atlanta, USA, 30322, 404-895-1643</nlm:aff>
<wicri:noCountry code="subfield">404-895-1643</wicri:noCountry>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">19381985</idno>
<idno type="pmc">3907946</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907946</idno>
<idno type="RBID">PMC:3907946</idno>
<idno type="doi">10.1080/03014460902839194</idno>
<date when="2009">2009</date>
<idno type="wicri:Area/Pmc/Corpus">000119</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000119</idno>
<idno type="wicri:Area/Pmc/Curation">000118</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000118</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000126</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000126</idno>
<idno type="wicri:Area/Ncbi/Merge">000034</idno>
<idno type="wicri:Area/Ncbi/Curation">000034</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">000034</idno>
<idno type="wicri:doubleKey">0301-4460:2009:Kohrt B:culture:in:psychiatric</idno>
<idno type="wicri:Area/Main/Merge">000478</idno>
<idno type="wicri:Area/Main/Curation">000478</idno>
<idno type="wicri:Area/Main/Exploration">000478</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal</title>
<author><name sortKey="Kohrt, Brandon A" sort="Kohrt, Brandon A" uniqKey="Kohrt B" first="Brandon A." last="Kohrt">Brandon A. Kohrt</name>
<affiliation><nlm:aff id="A1">Department of Anthropology, Emory University, Atlanta, USA, 30322, 404-895-1643</nlm:aff>
<wicri:noCountry code="subfield">404-895-1643</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Speckman, Rebecca A" sort="Speckman, Rebecca A" uniqKey="Speckman R" first="Rebecca A." last="Speckman">Rebecca A. Speckman</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Rollins School of Public Health, Emory University, Atlanta, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Rollins School of Public Health, Emory University, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kunz, Richard D" sort="Kunz, Richard D" uniqKey="Kunz R" first="Richard D." last="Kunz">Richard D. Kunz</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond</wicri:regionArea>
<wicri:noRegion>Richmond</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Baldwin, Jennifer L" sort="Baldwin, Jennifer L" uniqKey="Baldwin J" first="Jennifer L." last="Baldwin">Jennifer L. Baldwin</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana</wicri:regionArea>
<wicri:noRegion>Champaign-Urbana</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A6">Department of Anthropology, University of Illinois, Champaign-Urbana, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Anthropology, University of Illinois, Champaign-Urbana</wicri:regionArea>
<wicri:noRegion>Champaign-Urbana</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Upadhaya, Nawaraj" sort="Upadhaya, Nawaraj" uniqKey="Upadhaya N" first="Nawaraj" last="Upadhaya">Nawaraj Upadhaya</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Acharya, Nanda Raj" sort="Acharya, Nanda Raj" uniqKey="Acharya N" first="Nanda Raj" last="Acharya">Nanda Raj Acharya</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu</wicri:regionArea>
<wicri:noRegion>Kathmandu</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sharma, Vidya Dev" sort="Sharma, Vidya Dev" uniqKey="Sharma V" first="Vidya Dev" last="Sharma">Vidya Dev Sharma</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj</wicri:regionArea>
<wicri:noRegion>Maharajgunj</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nepal, Mahendra K" sort="Nepal, Mahendra K" uniqKey="Nepal M" first="Mahendra K." last="Nepal">Mahendra K. Nepal</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff>
<country xml:lang="fr">Népal</country>
<wicri:regionArea>Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj</wicri:regionArea>
<wicri:noRegion>Maharajgunj</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Worthman, Carol M" sort="Worthman, Carol M" uniqKey="Worthman C" first="Carol M." last="Worthman">Carol M. Worthman</name>
<affiliation><nlm:aff id="A1">Department of Anthropology, Emory University, Atlanta, USA, 30322, 404-895-1643</nlm:aff>
<wicri:noCountry code="subfield">404-895-1643</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series><title level="j">Annals of human biology</title>
<idno type="ISSN">0301-4460</idno>
<idno type="eISSN">1464-5033</idno>
<imprint><date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">The causes of ethnic and caste-based disparities in mental health are poorly understood.</p>
</sec>
<sec id="S2"><title>Aim</title>
<p id="P2">To identify mediators underlying caste-based disparities in mental health in Nepal.</p>
</sec>
<sec id="S3"><title>Subjects and methods</title>
<p id="P3">A mixed methods ethnographic and epidemiological study of 307 adults (<italic>Dalit/Nepali</italic>
, n=75; high caste <italic>Brahman</italic>
 and <italic>Chhetri</italic>
, n=232) assessed with Nepali versions of Beck Depression (BDI) and Anxiety (BAI) Inventories.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">One third (33.7%) of participants were classified as depressed: Dalit/Nepali 50.0%, high caste 28.4%. One quarter (27.7%) of participants were classified as anxious: Dalit/Nepali 50.7%, high caste 20.3%. Ethnographic research identified four potential mediators: stressful life events, owning few livestock, no household income, and lack of social support. The direct effect of caste was 1.08 (95% CI -1.10—3.27) on depression score and 4.76 (95% CI 2.33—7.19) on anxiety score. All four variables had significant indirect (mediation) effects on anxiety, and all but social support had significant indirect effects on depression.</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">Caste-based disparities in mental health in rural Nepal are statistically mediated by poverty, lack of social support, and stressful life events. Interventions should target these areas to alleviate the excess mental health burden born by Dalit/Nepali women and men.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>Népal</li>
<li>États-Unis</li>
</country>
</list>
<tree><noCountry><name sortKey="Worthman, Carol M" sort="Worthman, Carol M" uniqKey="Worthman C" first="Carol M." last="Worthman">Carol M. Worthman</name>
</noCountry>
<country name="Népal"><noRegion><name sortKey="Kohrt, Brandon A" sort="Kohrt, Brandon A" uniqKey="Kohrt B" first="Brandon A." last="Kohrt">Brandon A. Kohrt</name>
</noRegion>
<name sortKey="Acharya, Nanda Raj" sort="Acharya, Nanda Raj" uniqKey="Acharya N" first="Nanda Raj" last="Acharya">Nanda Raj Acharya</name>
<name sortKey="Nepal, Mahendra K" sort="Nepal, Mahendra K" uniqKey="Nepal M" first="Mahendra K." last="Nepal">Mahendra K. Nepal</name>
<name sortKey="Sharma, Vidya Dev" sort="Sharma, Vidya Dev" uniqKey="Sharma V" first="Vidya Dev" last="Sharma">Vidya Dev Sharma</name>
<name sortKey="Upadhaya, Nawaraj" sort="Upadhaya, Nawaraj" uniqKey="Upadhaya N" first="Nawaraj" last="Upadhaya">Nawaraj Upadhaya</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Speckman, Rebecca A" sort="Speckman, Rebecca A" uniqKey="Speckman R" first="Rebecca A." last="Speckman">Rebecca A. Speckman</name>
</noRegion>
<name sortKey="Baldwin, Jennifer L" sort="Baldwin, Jennifer L" uniqKey="Baldwin J" first="Jennifer L." last="Baldwin">Jennifer L. Baldwin</name>
<name sortKey="Baldwin, Jennifer L" sort="Baldwin, Jennifer L" uniqKey="Baldwin J" first="Jennifer L." last="Baldwin">Jennifer L. Baldwin</name>
<name sortKey="Kunz, Richard D" sort="Kunz, Richard D" uniqKey="Kunz R" first="Richard D." last="Kunz">Richard D. Kunz</name>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sarre/explor/MusicSarreV3/Data/Main/Exploration

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000478 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000478 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sarre
   |area=    MusicSarreV3
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     PMC:3907946
   |texte=   Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i   -Sk "pubmed:19381985" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd   \
       | NlmPubMed2Wicri -a MusicSarreV3

This area was generated with Dilib version V0.6.33.
Data generation: Sun Jul 15 18:16:09 2018. Site generation: Tue Mar 5 19:21:25 2024

Serveur d'exploration sur la musique en Sarre

Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal

Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal

Source :

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Serveur d'exploration sur la musique en Sarre
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.