Impact of ethnicity, unemployment and economy on mental disorders : A study from Western Nepal

Abstract

Background: The causes of mental health problems and ethnic variation are poorlyunderstood. The main objective of the study was to find out about psychiatricdiseases which frequently occur in Western Nepal for which hospitalization isrequired. The specific objective was to research about theeconomic condition ofthe psychiatric patients and the prevalence of common psychiatric disorderwitnessed among hospitalized patients who belong to diverse ethnic and culturalgroups in Western Nepal. 

Materials and Methods: It was a cross sectional studywhich was conducted in between 1st October 2009 and 31th March 2010 between at Manipalteaching hospital, Pokhara, Nepal. Odds ratios and adjusted odds ratio andtheir 95% confidence intervals (95% CI) were calculated. p < 0.05 wasconsidered as statistically significant. 

Results: Out of 240 cases the commonestcases of psychiatric disorders include Schizophrenia, Schizotypal and DelusionDisorders 36.3%, Mood Disorders 27.9%, Neurotic, stress-related and somatoformdisorders 15.8%. Study based on ethnicity revealed that the majority ofpatients were Dalit [n= 72] followed by Brahmin [n = 66], Chettri [n = 46],Newar [n = 19], Gurung [n = 17], others [n = 13] and Magar and Pun [n = 7].Most of the patients were <40yrs [n=191] unemployed [n=199], monthly familyincome <10000 NPR/month [n= 187], students [n = 102] housewives [n = 74,], job holders [n= 17]. Study showed that Mental and Behavioural disorder due toPsychoactive Substance abuse, Schizophrenia, Schizotypal and Delusion DisordersMood (Affective) Disorders, Neurotic, stress-related and somatoform disorderswere prevalent among unemployed patients [OR 8.170(CI 1.062, 62.853)], [OR3.033(CI 1.334, 6.897)], [OR 0.413(CI 0.199, 0.856)[OR 0.228(CI 0.089,0.583)]as compared to employed patients(p=0.001). 

Conclusion: Schizophrenia was the commonestpsychiatric disorder among the low socio-economic class of like Dalits. The study showed that culture based differences concerning mental health is furthermediated by poverty, unemployment and dearth of family income which leads tohigh prevalence of psychiatric illness among Nepalese population. Based on thefinding of the study, interventions should target these factors to minimise theload of various psychiatric illness among poor Dalit Nepalese population.

DOI: http://dx.doi.org/10.3126/nje.v4i1.10132

Nepal Journal of Epidemiology 2014;4 (1): 306-315

Keywords:Culture, Ethnicity,Nepal, Psychiatry