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.
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DOI：
10.1080/03014460902839194
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发表时间：
2009-05
影响因子：
1.7
通讯作者：
Worthman CM
中科院分区：
文献类型：
--
作者：
Kohrt BA;Speckman RA;Kunz RD;Baldwin JL;Upadhaya N;Acharya NR;Sharma VD;Nepal MK;Worthman CM
人们对种族和种姓心理健康差异的原因知之甚少。找出尼泊尔基于种姓的精神健康差异的根源。一项混合方法对307名成年人(达利特人/尼泊尔人，n=75；高种姓婆罗门和切特里，n=232)进行人种学和流行病学研究，用尼泊尔版本的贝克抑郁(BDI)和焦虑(BAI)量表进行评估。三分之一(33.7%)的参与者被归类为抑郁症：达利特人/尼泊尔人50.0%，高种姓28.4%。四分之一(27.7%)的参与者被归类为焦虑：达利特人/尼泊尔人占50.7%，高种姓占20.3%。人种学研究确定了四个潜在的中介因素：有压力的生活事件、几乎没有牲畜、没有家庭收入和缺乏社会支持。种姓对抑郁评分的直接效应为1.08(95%CI-1.10~3.27)，对焦虑评分的直接效应为4.76(95%CI 2.33~7.19)。四个变量对焦虑均有显著的间接(中介)效应，除社会支持外，其余变量对抑郁均有显著的间接效应。在尼泊尔农村，基于种姓的心理健康差异在统计上是由贫困、缺乏社会支持和紧张的生活事件造成的。干预措施应针对这些领域，以减轻达利特人/尼泊尔人妇女和男子造成的过度心理健康负担。
The causes of ethnic and caste-based disparities in mental health are poorly understood. To identify mediators underlying caste-based disparities in mental health in Nepal. 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. 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. 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.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1023/a:1026595011371
发表时间：
2000-12-01
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
MacKinnon, D P;Krull, J L;Lockwood, C M
通讯作者：
Lockwood, C M
DOI：
10.1017/cbo9780511499739.007
发表时间：
2006-01-01
期刊：
PEER RELATIONSHIPS IN CULTURAL CONTEXT
影响因子：
--
作者：
Cole, Pamela M.;Walker, Alisha R.;Lama-Tamang, Mukta Sing
通讯作者：
Lama-Tamang, Mukta Sing
影响因子：
2.8
作者：
Hadley, Craig;Patil, Crystal L.
通讯作者：
Patil, Crystal L.
影响因子：
0.6
作者：
Kohrt, BA;Kunz, RD;Nepal, MK
通讯作者：
Nepal, MK