Evidence map›Paper›PMID 24366490›Full record

SynthesisInternational journal of epidemiology2014

Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology.

Brandon A Kohrt, Andrew Rasmussen, Bonnie N Kaiser, Emily E Haroz, Sujen M Maharjan, Byamah B Mutamba, Joop T V M de Jong, Devon E Hinton

Open access · bronzeAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 151 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
151citing papers in PubMed, 12 pooled it
15.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

151 citing papers in PubMed, 12 syntheses or guidelines pooled it, 321 citations in OpenAlex.

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  15. A randomised test of the effect of medicalEpidemiology and psychiatric sciences · 2020
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91 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Brandon A KohrtDuke Global Health Institute, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA, Department of Psychology, Fordham University, New York, USA, Department of Anthropology, Department of Epidemiology, Emory University, Atlanta, GA, USA, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA, Department of Psychology, Tribhuvan University, Kirtipur, Nepal, Butabika National Referral Mental and Teaching Hospital, Kampala, Uganda, AISSR, University of Amsterdam, The Netherlands and Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Andrew Rasmussen
Bonnie N Kaiser
Emily E Haroz
Sujen M Maharjan
Byamah B Mutamba
Joop T V M de Jong
Devon E Hinton
Johns Hopkins University · US

Funding

PSYCHIATRIC EPIDEMIOLOGY TRAINING PROGRAMT32MH014592 · NIMH · JOHNS HOPKINS UNIVERSITY · PI HEATHER E VOLK, Peter P. Zandi · 1985 to 2026
$8.5M
South Asian Hub for Advocacy, Research & Education on Mental Health (SHARE)U19MH095687 · NIMH · LONDON SCH/HYGIENE & TROPICAL MEDICINE · PI FUHR, DANIELA, RAHMAN, ATIF · 2011 to 2015
$2.9M
NIMH NIH HHS T32 MH014592NIMH NIH HHS U19 MH095687NIMH NIH HHS U19 MH095687-01S1
6 · The paper itself

Abstract

backgroundBurgeoning global mental health endeavors have renewed debates about cultural applicability of psychiatric categories. This study's goal is to review strengths and limitations of literature comparing psychiatric categories with cultural concepts of distress (CCD) such as cultural syndromes, culture-bound syndromes, and idioms of distress.

methodsThe Systematic Assessment of Quality in Observational Research (SAQOR) was adapted based on cultural psychiatry principles to develop a Cultural Psychiatry Epidemiology version (SAQOR-CPE), which was used to rate quality of quantitative studies comparing CCD and psychiatric categories. A meta-analysis was performed for each psychiatric category.

resultsForty-five studies met inclusion criteria, with 18 782 unique participants. Primary objectives of the studies included comparing CCD and psychiatric disorders (51%), assessing risk factors for CCD (18%) and instrument validation (16%). Only 27% of studies met SAQOR-CPE criteria for medium quality, with the remainder low or very low quality. Only 29% of studies employed representative samples, 53% used validated outcome measures, 44% included function assessments and 44% controlled for confounding. Meta-analyses for anxiety, depression, PTSD and somatization revealed high heterogeneity (I(2) > 75%). Only general psychological distress had low heterogeneity (I(2) = 8%) with a summary effect odds ratio of 5.39 (95% CI 4.71-6.17). Associations between CCD and psychiatric disorders were influenced by methodological issues, such as validation designs (β = 16.27, 95%CI 12.75-19.79) and use of CCD multi-item checklists (β = 6.10, 95%CI 1.89-10.31). Higher quality studies demonstrated weaker associations of CCD and psychiatric disorders.

conclusionsCultural concepts of distress are not inherently unamenable to epidemiological study. However, poor study quality impedes conceptual advancement and service application. With improved study design and reporting using guidelines such as the SAQOR-CPE, CCD research can enhance detection of mental health problems, reduce cultural biases in diagnostic criteria and increase cultural salience of intervention trial outcomes.

Indexed as

CultureAnxiety DisordersEpidemiologic MethodsGlobal HealthHumansMental DisordersMental HealthCulturedeveloping countriesepidemiologic methodsglobal mental healthmental disordersmeta-analysis

Identifiers

PMID24366490
PMCPMC3997373
OpenAlexW2143077576

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.