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<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></affiliation><affiliation><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A3">Rollins School of Public Health, Emory University, Atlanta, USA</nlm:aff></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><nlm:aff id="A4">Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, USA</nlm:aff></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><nlm:aff id="A5">Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Department of Anthropology, University of Illinois, Champaign-Urbana, USA</nlm:aff></affiliation></author><author><name sortKey="Upadhaya, Nawaraj" sort="Upadhaya, Nawaraj" uniqKey="Upadhaya N" first="Nawaraj" last="Upadhaya">Nawaraj Upadhaya</name><affiliation><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff></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><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff></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></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></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></affiliation><affiliation><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A3">Rollins School of Public Health, Emory University, Atlanta, USA</nlm:aff></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><nlm:aff id="A4">Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, USA</nlm:aff></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><nlm:aff id="A5">Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Department of Anthropology, University of Illinois, Champaign-Urbana, USA</nlm:aff></affiliation></author><author><name sortKey="Upadhaya, Nawaraj" sort="Upadhaya, Nawaraj" uniqKey="Upadhaya N" first="Nawaraj" last="Upadhaya">Nawaraj Upadhaya</name><affiliation><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A2">Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</nlm:aff></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><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff></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><nlm:aff id="A7">Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</nlm:aff></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></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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0404024</journal-id><journal-id journal-id-type="pubmed-jr-id">584</journal-id><journal-id journal-id-type="nlm-ta">Ann Hum Biol</journal-id><journal-id journal-id-type="iso-abbrev">Ann. Hum. Biol.</journal-id><journal-title-group><journal-title>Annals of human biology</journal-title></journal-title-group><issn pub-type="ppub">0301-4460</issn><issn pub-type="epub">1464-5033</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19381985</article-id><article-id pub-id-type="pmc">3907946</article-id><article-id pub-id-type="doi">10.1080/03014460902839194</article-id><article-id pub-id-type="manuscript">NIHMS524188</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Culture in Psychiatric Epidemiology: Using Ethnography and Multiple Mediator Models to Assess the Relationship of Caste with Depression and Anxiety in Nepal</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kohrt</surname><given-names>Brandon A.</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><email>brandonkohrt@gmail.com</email></contrib><contrib contrib-type="author"><name><surname>Speckman</surname><given-names>Rebecca A.</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kunz</surname><given-names>Richard D.</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Baldwin</surname><given-names>Jennifer L.</given-names></name><xref ref-type="aff" rid="A5">5</xref><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Upadhaya</surname><given-names>Nawaraj</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Acharya</surname><given-names>Nanda Raj</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Sharma</surname><given-names>Vidya Dev</given-names></name><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Nepal</surname><given-names>Mahendra K.</given-names></name><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Worthman</surname><given-names>Carol M.</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Anthropology, Emory University, Atlanta, USA, 30322, 404-895-1643</aff><aff id="A2"><label>2</label>Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal</aff><aff id="A3"><label>3</label>Rollins School of Public Health, Emory University, Atlanta, USA</aff><aff id="A4"><label>4</label>Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, USA</aff><aff id="A5"><label>5</label>Medical Scholars Program, College of Medicine, University of Illinois, Champaign-Urbana, USA</aff><aff id="A6"><label>6</label>Department of Anthropology, University of Illinois, Champaign-Urbana, USA</aff><aff id="A7"><label>7</label>Department of Psychiatry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal</aff><pub-date pub-type="nihms-submitted"><day>13</day><month>12</month><year>2013</year></pub-date><pub-date pub-type="ppub"><season>May-Jun</season><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>31</day><month>1</month><year>2014</year></pub-date><volume>36</volume><issue>3</issue><fpage>261</fpage><lpage>280</lpage><pmc-comment>elocation-id from pubmed: 10.1080/03014460902839194</pmc-comment>
<abstract><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></abstract><kwd-group><kwd>Mental health</kwd><kwd>ethnicity</kwd><kwd>multiple mediator models</kwd><kwd>mixed methods</kwd><kwd>Nepal</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source><award-id>F31 MH075584 || MH</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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