Psychiatric morbidity of a rural Indian community. Changes over a 20-year interval.

BACKGROUND: Cross-sectional studies give no indication of the changes that may occur in the mental health status of a community in course of times. Studies should be designed to assess these changes. AIMS: To assess the changes, if any, in the prevalence of mental disorders in a rural community after an interval of 20 years in the context of its changing socio-economic conditions. METHOD: A door-to-door survey of the prevalence of psychiatric morbidity in two villages was conducted by a team of psychiatrists. The survey was repeated after 20 years by the same team and by the same method. Changes in the mental health status of the community were compared. RESULTS: Total morbidity per 1000 fell from 116.8 to 105.2. Morbidity in men fell from 86.9 to 73.5 per 1000 and in women from 146.8 to 138.3 per 1000. Rates of anxiety, hysteria and phobia had fallen dramatically and those of depression and mania had risen significantly. CONCLUSION: The level of psychiatric morbidity showed no statistically significant change. The morbidity pattern (relative proportion of type of morbidity), however, showed some interesting changes. Similar studies should be done on a larger sample.

A study of psychiatric morbidity of the elderly population of a rural community in west bengal.

A door to door field-survey was conducted in two villages by a team of psychiatrists with the aim of assessing the mental morbidity of the population. The present communication is restricted to the mental morbidity of the elderly population aged 60 years and above. The total sample comprised 183 persons (male 85, female 98). Majority of the families (44.2%) belonged to class IV according to Pareek and Trivedi's scale. Sixty one percent of the elderly population was mentally ill. Women had a higher rate of morbidity than men (77.6% and 42.4% repetitively). The overwhelming majority of the affected persons were depressives. Rate of dementia was low.

Is hysteria on the wane? A community survey in West Bengal, India.

A field survey was conducted in two villages--Gambhirgachi and Paharpur--in 1972. The survey was repeated after 10 years in the former village and after 15 years in the latter one. The second survey showed very little change in the rate of total mental morbidity. The rate of prevalence of hysteria declined significantly in both villages. In Gambhirgachi the rate of hysteria dropped from 16.9 to 4.6 per 1000 in 10 years, and in Paharpur it dropped from 32.3 to 2.05 per 1000 in 15 years.

Urbanization and mental morbidity in certain tribal communities in west bengal.

The same team of workers surveyed a rural and an urban sample of the same tribe (Santal) by the same method. It was found that urbanization had little effect on the total mental morbidity. But stress-dependent disorders were commoner in the urban tribe.

An epidemic of "jhin-jhini" - a strange contagious psychogenic disorder in a village in west bengal.

An epidemic psychogenic disorder called "Jhin-Jhini" which broke out in a village in West Bengal, is described. Tlie social anthropological perspective is explored.

Factors associated with the course and outcome of schizophrenia a multicentred follow-up study : result of five year follow-up.

This paper describes the results of a five year follow up study on factors associated with the course and outcome of schizophrenia conducted in 3 centers (Lucknow, Madras and Vellore) under the auspices of the Indian Council of Medical Research. 386 patients who satisfied well defined criteria of diagnosis and inclusion and exclusion criteria were studied. All patients were regularly followed up. 287 patients had complete follow up after 5 years. After 2 years, most of the active symptoms had subsided. At 5 year follow up, about 67% of the patients showed good outcome. Regular drug compliance, short duration of illness, absence of economic difficulties, absence of dangerous behaviour and delusions of presecution at intake; presence of agitation at intake; acute onset, absence of schizoid traits in personality, low level of education, rural background and lower age of onset were significantly related to good outcome. A combination of 8 factors could correctly predict the outcome in 80% of patients. The implications of the above findings are discussed.

The vulnerability of Indian women to suicide a field-study.

58 cases of suicide were recorded in one year in a cluster of villages comprising a police-station area. The incidence was 43.4 per lakh. Women out numbered men. Two-thirds of the victims were aged below 25 years. In women the commonest cause of suicide was quarrel with husband and in men it was quarrel with parents. Poisoning with insecticide was the mode of suicide in an overwhelming majority of cases. The situational, psychological and socio-cultural perspectives have been discussed.

Modified masters johnson technique in the treatment of sexual inadequacy in males.

21 married men were treated for erectile defect and premature ejaculation (both primary & secondary) by modified Masters-Johnson technique. 16(76.2%) recovered. The success rate was higher in secondary cases (83.3%). Best results were obtained in 30-39 yrs age group. The modified technique has been described in detail. Factors favourable and unfavourable for success have been discussed.

The social and psychological correlates of leprosy.

Leprosy, one of the most chronic tropical diseases, acts as a unique psychosocial stressor for the social stigma associated with it. The present study assessed the nature of such stigma and its possible effect on the patient's mental health. Leprosy patients perceive that (a) their illness evokes public fear and hate, (b) it is degrading and humiliating and they should be segregated from family and society and (c) it is incurable and a consequence of sin. Psychiatric morbidity is commoner among the in-patients (64%) than among the out-patients (25%).

A study of psychiatric morbidity in married males with sexual dysfunction.

Thirty married males with sexual dysfunction were first examined by the venereologist in the STD clinic. Then they were assessed with General Health Questionnaire-36 items (Physical illness items removed) (GHQ-36P) and Hamilton Rating Scale for depression (HRS-D). Results were compared with properly matched controls. 53 % of the patients belonged to age group of 25-34 years. Erectile importence was the most common type' of sexual dysfunction. 80% of the patients scored high(≥ 5) in GHQ-36P. Depression of moderate to severe degree were present in more than 75% of the high scorers.

A study of psychiatric morbidity of a rural community at an interval of ten years.

A field survey of psychiatric morbidity was conducted in a village by a door to door survey. The survey was repeated after 10 years by the same team and by the same method. The aim was to compare the rates of mental morbidity of the community at the interval of a decade and to trace out during the second survey all the persons - both ill and well - found in the first survey and to assess their mental health status.Though the total morbidity did not change from 1972 to 1982 there was a definite rise in the rates of morbidity of Hysteria and Anxiety showed a slight fall in 1982. The health population of 1972 traced and assessed in 1982 showed a lower rate of morbidity than the total population of 1982. The rate of recovery of the morbid stock assessed after ten years was about 29 % and as many as 14.8% of the morbid people died during this period. This death rate is much higher than that of healthy population assessed after ten years (h.9%). 47.8% of the cases detected in the first survey were found to be ill during the second survey richer with the same diagnosis or with a new diagnosis.

Psychiatric morbidity in an urbanized tribal (santal) community - a field survey.

Psychiatric morbidity was studied in an urbanized tribal (Santal) community comprising 205 families in the district of Nadia, West Bengal by the method of door to door survey of each family by a team of psychiatrists. Total morbidity was 519 1000. Depression was the commonest type of illness. Neurotic illness, epilepsy and mental retaliation had a very low rate of prevalence. Married individuals were more attached than the unmarried ones. Males had a slightly higher rate of mental morbidity. The population showed a general tendency of greater vulnerability to mental illness with advancing age. Results are discussed in the perspective of relevant studies.

Contagious hysteria in a West Bengal village.

This article reports on the phenomenon of contagious hysteria in a village in West Bengal. The psychosocial and psychodynamic aspects are discussed.

Psychiatric morbidity in an urban slum-dwelling community.

The present study concerns the prevalence of psychiatric morbidity in a slum area in Calcutta and its relation to certain demographic and social variables. The survey was carried out by a team of psychiatrists by a door-to-door enquiry. Significant relationship of mental morbidity were found with age, sex, caste, socioeconomic status and family size.

Mode of spread of epidemic koro in a village in west bengal.

The mode of spread of epidemic Koro in a village in West Bengal has been described and the psychological principles involved in it have been explained.

Epidemic koro in West Bengal, India.

The present study draws attention to the recent sudden outbreak of Koro in epidemic form in the rural areas of West Bengal, India. The details of three such cases are reported.

Prognosis of depression.

Relationship of different symptoms, personal history, some measures of Rorschach, neuroticism, ego strength score with prognosis of depression was studied. Out of 60 items studied in 60 cases, eleven were found to have statistically significant association with improvement. Multiple regression of percentage of improvement on 23 items (12 from personal and family history and 13 measurable items of Rorschach) was determined. To check the ability of this multiple regression to expl. in differences in responsiveness, predicted values were obtained for 24- cases (not included in the previous regression analysis). In most cases considerable differences was found in observed and predicted values. Then a regression coefficient using only 12 items (other than 13 Rorschach items) was determined similarly. Using this regression equation, predicted Values for percentage of improvement was obtained for the same 24 cases. There was insignificant association between observed and predicted Values. Thereafter only five measurable characteristics strongly related with percentage of improvement were taken and multiple regression on these items was determined and checked similarly on the same 24- cases. This also showed insignificant association between observed and predicted Values. Linear regression is unable to explain the difference in prognosis of population very similar to one on which it was developed. Inclusion of more history and social interaction factors might lead to more fruitful results.