Ali B S, Rahbar M H, Naeem S, Tareen A L, Gul A, Samad L.
Prevalence of and factors associated with anxiety and depression among women in a lower middle class semi-urban community of Karachi, Pakistan.
J Pak Med Assoc Jan ;52(11):513-7.

OBJECTIVE: To study the prevalence of, and factors associated with anxiety and depression among women. DESIGN: A cross sectional survey. SETTING: A lower middle class semi-urban community of Karachi, Pakistan. PARTICIPANTS: A total of 1218 women between the ages of 18-50 years. METHODOLOGY: Systematically every third household was identified from which a woman was randomly selected. The Aga Khan University Anxiety and Depression Scale and a socio-demographic questionnaire were administered verbally by trained interviewers for assessing the prevalence of, and associated factors for anxiety and depression. RESULTS: A prevalence of 30% was found. Increasing age, lack of education and verbal abuse were the associated factors found to have an independent relationship. CONCLUSION: Providing education and reducing domestic abuse could lead to decrease in the prevalence of anxiety and depression in women.

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Posted by: skhan3 on Oct 2004

I note with interest the relatively high prevalence rates of depression in a major Pakistani city. I am not aware of any other studies of prevalence of psychiatric disorders in Pakistan and this is a novel study in this regard. However, there are a number of methodological issues to consider. Prevalence studies are essentially cross sectional surveys of a population at a point in time (point prevalence) or over a period of time (period prevalence) and determine the proportion of persons in a given population who have ever experienced the disorder up to the date of assessment. Thus, the period to which this prevalence refers, differs between subjects (dependant on their ages) and the value arrived at, is consequently a reflection of the age structure of the population. Identifying the associations of a disease can be achieved by comparing rates in different localities or by comparing associations in those with and without the disorder. The key to conducting a good survey is that the population studied is representative of the population in general and this is achieved by selecting a large random sample and by reducing sampling and response bias. Some of the earlier studies of prevalence of depression failed to use operationalised criteria for case identification and diagnosis, which may have led to variability in prevalence rates. In this particular study the use of arbitrary age cut off points, the use of ??lay interviewers and the small sample size of only 1218 women limit the validity. Furthermore, I shall like to see data regarding the sensitivity, specificity, positive predictive value and negative predictive, validity and relaibility of the questionaires used.
Posted by: steel on Jun 2005

few comments, 1. steel i believe they mentioned the Word "Trained" interviers which can be seen in the abstract as well. 2. I believe after interviewing 1218 women in such a closed society is not a small achievement , this is not a western society. I believe many would have refused to even talk to them , this is not the western world. ijaz
Posted by: ijazali on Jul 2005

i do agree eduaction is an importnat componenet of management in dealing with depression and anxiety.However the role of exercise should be emphasized when dealing with such patients. There are few randomized controlled trial done in sydney to evaluate the effectiveness of exercise and to compare with antidepression drugs in patients with depression and anxiety , which showed very promising result where doing moderate to intense level exercise found to be more effective in patients with depression and anxiety. therefore one can conclude on the basis of concrete evidence that exercise is a key factor in helping these patients in returning to their normal life keeping in mind the health model given by WHO.
Posted by: khafh001 on Jul 2005

I note with interest the relatively high prevalence rates of depression in a major Pakistani city. I am not aware of any other studies of prevalence of psychiatric disorders in Pakistan and this is a novel study in this regard. However, there are a number of methodological issues to consider. Prevalence studies are essentially cross sectional surveys of a population at a point in time (point prevalence) or over a period of time (period prevalence) and determine the proportion of persons in a given population who have ever experienced the disorder up to the date of assessment. Thus, the period to which this prevalence refers, differs between subjects (dependant on their ages) and the value arrived at, is consequently a reflection of the age structure of the population14. Identifying the associations of a disease can be achieved by comparing rates in different localities or by comparing associations in those with and without the disorder. The key to conducting a good survey is that the population studied is representative of the population in general and this is achieved by selecting a large random sample and by reducing sampling and response bias. Some of the earlier studies of prevalence of mania failed to use operationalised criteria for case identification and diagnosis, which may have led to variability in prevalence rates. In this particular study the use of arbitrary age cut off points, the use of ? lay interviewers and the small sample size of only 1218 women limit the validity.
Posted by: steel on Jun 2005

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