Objective: This article attempts to document the prevalence of psychiatric disorders among elders in a rural village in Nepal. In addition, we investigate the relationship between psychiatric illness and functional disability to assess the impact of disorder on social functioning. Method: A semistructured interview checklist to diagnose six disorders was used (N = 182). In addition, elders older than age 60 were examined to assess the functional impact of mental health conditions by measuring functional disability. Results: Eighteen percent of elders seem to have a diagnosable psychiatric disorder. Furthermore, in general these elders were also less likely to receive assistance with the disabilities they report, compared with those who do not experience a psychiatric disorder. Discussion: Documenting the extent of psychiatric disorder among elders in developing societies sensitizes health planners to the growing reality of aging in their societies and the need for expanded physical and psychiatric health care services.
Get full access to this article
View all access options for this article.
References
1.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd rev. ed.). Washington, DC: Author.
2.
Andrews, G. R. (1987). Aging in the developing countries of Asia and the Pacific: Implications for health care. Annals of the Academy of Medicine, Singapore, 16, 3-10.
3.
Awas, M., Kebede, D., & Alem, A. (1999). Major mental disorders in Butajira, southern Ethiopia. Acta Psychiatrica Scandinavica, 397(Suppl), 56-64.
4.
Bhagwanjee, A., Parekh, A., Paruk, Z., Petersen, I., & Subedar, H. (1998). Prevalence of minor psychiatric disorders in an adult African rural community in South Africa. Psychological Medicine, 18, 1137-1147.
5.
Bista, D. B. (1981). People of Nepal. Kathmandu, Nepal: Ratna Pustak Bhandar.
6.
Gwatkin, D. R., Guillot, M., & Heuveline, P. (1999). The burden of disease among the global poor. Lancet, 354, 586-589.
7.
Helzer, J. E., & Janca, A. (1988). DSM-III-R Criteria Checklist. St. Louis, MO: Washington University School of Medicine, Department of Psychiatry.
8.
Henderson,A. S., & Hasegawa, K. (1992). The epidemiology of dementia and depressionin later life. In M. Bergener, K. Hasegawa, S. I. Finkel, & T. Nishimura (Eds.), Aging and mental disorders: International perspectives (pp. 65-79). New York: Springer.
9.
Janca, A., Robins, L. N., Bucholz, K. K., Early, T. S., & Shayka, J. J. (1992). Comparisonof composite international diagnostic interview and clinical DSM-III-R Criteria Checklist diagnoses. Acta Psychiatrica Scandinavica, 85, 440-443.
10.
Keith, S. J., Regier, D. A., & Rae, D. S. (1991). Schizophrenic disorder. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area Study (pp. 33-52). New York: Free Press.
11.
Kleinman, A. (1986). Social origins of distress and disease: Depression, neurasthenia, and pain in modern China. New Haven, CT: Yale University Press.
12.
Levkoff, S. E., Macarthur, I. W., & Bucknall, J. (1995). Elderly mental health in the developing world. Social Science and Medicine, 41, 983-1003.
13.
Lin, N., Dean, A., & Ensel, W. M. (1986). Social support, life events, and depression. New York: Academic Press.
14.
Mumford, D. B., Saeed, K., Ahmad, I., Latif, S., & Mubbashar, M. H. (1997). Stress and psychiatric disorder in rural Punjab: A community survey. British Journal of Psychiatry, 170, 473-478.
15.
Murray, C. H., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard University Press.
16.
Robins, L. N., Helzer, J. E., Croughan, J., & Ratliff, K. S. (1981). National Institute of Mental Health: Diagnostic Interview Schedule. Archives of General Psychiatry, 38, 381-389.
17.
Ruiz-Doblado, S. (1999). Prevalence of depressive symptoms and mood disorders in primary care: A Spanish rural study. International Journal of Social Psychology, 45, 180-189.
18.
Rumble,S., Swartz, L., Parry, C., & Zwarenstein,M. (1996). Prevalence of psychiatric morbidity in the adult population of a rural South African village. Psychological Medicine, 26, 997-1007.
19.
Smith, J. P. (1994). Measuring health and economic status of older adults in developing countries. The Gerontologist, 34, 491-496.
20.
Subedi, J., Subedi, S., Sidky, H., Singh, R., Blangero, J., & Williams-Blangero, S. (2000). Health and health care in Jiri. Contributions to Nepalese Studies, (The Jirel Issue), 97-104.
21.
Swartz, M., Landerman,R., George, L. K., Blazer, D. G., & Escobar, J. (1991). Somatization disorder. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area Study (pp. 220-257). New York: Free Press.
22.
Tausig, M., Subedi, S., Broughton,C. L., Subedi, J., & Williams-Blangero, S. (2003). Measuring community mental health in developing societies: Evaluation of a checklist format in Nepal. International Journal of Social Psychiatry, 40, 284-301.
23.
U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General—Older adults and mental health. Rockville, MD: Author.
24.
Üstün, T. B. (1999). The global burden of mental disorders. American Public Health Journal, 89, 1315-1318.
25.
Üstün, T. B., & Sartorius, N. (1995). Mental illness in general health care: An international study. West Sussex, UK: John Wiley and Sons.
26.
Weissman, M. M., Bland, R. C., Canino, G. J., Garavelli, C., Greenwald, S., Hwu, H-G., et al. (1996). Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association, 276(4), 293-299.
27.
Weissman, M. M., Bruce, M. L., Leaf, P. J., Florio, L. P., & Holzer, C., III. (1991). Affective disorders. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area Study (pp. 53-80). New York: Free Press.
28.
Wittchen, H-U., Robbins, L. N., Cottler, L. B., Sartorius, N., Burke, J. D., & Reiger, D., Participants in the Multicentre WHO/ADAMHA Field Trials. (1991). Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). British Journal of Psychiatry, 159, 645-653.
29.
World Health Organization. (1989). Composite International Diagnostic Interview. Geneva, Switzerland: Author.
30.
World Health Organization. (1998). Demographic data for health situations assessment and projections-1998 (WHO/HST/HSP/98.4). Geneva, Switzerland: World Health Organization, Division of Health Situation and Trend Assessment.