Unaiza Niaz, Sehar Hassan, Haider Husain, Sofia S Siddiqui.
A cross-sectional study of the frequency of psychiatric morbidity in affluent urban population of Karachi.
Pak J Med Sci Jan ;20(4):337-44.

Objective: To estimate the frequency and incidence of psychiatric morbidity in "elite, affluent" urban population of Karachi Pakistan. Sample: The new outpatients at The Psychiatric Clinic and Stress Research Center situated at Zamzama Boulevard over a period of three years (2001-2003). Methods: Information about the demographic characteristics, socio-economic status and clinical diagnoses of patients was obtained from case history files maintained at the clinic, retrospectively. Secondly a list of specific stressors in the upper social class female patients lives (their own set of unique stressors, to keep up with their social class materialistically, competition, boredom, no meaningful application of their achievements having higher, education and professions, hectic banal social demands – coffee parties, jet set life styles, alcohol and drug abuse was documented. Results: Most common psychiatric disorders were Depressive Illness (49.4%) Schizophrenia (16.2%), Schizoaffective Disorder (5.8%) Panic Disorder (5.2%), OCD (4.7%), Disorders of Childhood and Adolescence (2.8%), Epilepsy (1.6%), Substance Abuse Disorder (1.5%) and Conversion Disorder (1.4%). The ratio of female patients to male patients was 2:1.The female patients in this sample of population had distinctly higher percentages in psychotic disorders (14.3% Vs 9.4%), mood disorders (37.5% Vs 18.6%) & conversion disorders (0.8% vs 0.6%), compared to the male patients, thereby indicating better living conditions, financial advantages & even post graduate professional education in upper affluent social class does not reduce their stress, "every body has their axe to grind in life " these women said!!!! Conclusion: The results of this study distinctly showed that depressive illness and other psychiatric disorders are not only the "diseases of poverty" but are twice as common among apparently adjusted upper class females. The Upper middle class is an affluent population of Karachi, a cosmopolitan city of Pakistan. This clearly indicates that causes of depression or other psychiatric morbidity may vary but the psychiatric morbidity in women is markedly more than men in every class of the society worldwide and the perception that depression is more common in females of lower socioeconomic class is not true in Pakistan.

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