September 2006, Volume 56, Issue 9

Student's Corner

Relation of gender education and health seeking behaviour of the general population regarding psychiatric illness

Abstract


he aim of this study is to find out the health seeking behaviour of mentally ill patients in Karachi. This is a cross sectional survey of two hundred adults who were selected from five districts of Karachi on the basis of convenient sampling. A questionnaire was used to inquire about mental illness. SPSS version 11 was used for statistical analysis. Out of the total 200 sampled, 96 were to have some mental illness (53 males and 43 females). No significant difference found in the health seeking behaviour of males and females (p>0.05). Education had a significant effect on the health seeking behaviour (p<0.05). Gender was not found to have significant effect on the health seeking behaviour. However, education had significant association with health seeking behaviour of the persons studied.

Introduction

The term mental illness is generally referred to mental health problems in adults.1 Significant disease load is attributed to mental illnesses globally and talking in terms of DALY (disability adjusted life years) a more reliable indicator, more than two fifth of total disabilities are due to mental illness.2 Out of the top ten leading causes of disabilities throughout the world, five are psychiatric illnesses.3 According to WHO, mental illnesses are responsible for 11.5% of the global burden of diseases, a figure that is projected to increase to 15% by 2020. Worldwide, 340 million people suffer from depressive illnesses with majority living in the developing world.5

In Pakistan according to a rough estimate one million are severely mentally ill and ten millions are mildly ill.4 Besides such a big disease load in Pakistan the approach for health of general population multiplies the problem. A number of studies have shown that many people attribute depression (which is a major psychiatric problem) to evil influences. Many parents belief in Jin, magic and evil eye for the mental illness of their child.5,6

A few studies revealed that majority of people first approach, a shaman for seeking cure from mental illnesses.7,8 Studies have also shown that majority of the patients, who attend the spiritual healers are either uneducated or just had primary education.9,10

As the health seeing behaviour plays a pivotal role in the outcome of any disease, this study was conducted to asses the health seeking behaviour of our population so that steps could be taken for better provision of health facilities along with disease management and control.

Method and Results

This is a cross sectional survey done in June 2004 in former 5 districts of Karachi. The sample consisted of 50 individuals in each group: non-graduate adult female, non-graduate adult males, graduate adult females and graduate adult males, by convenience sampling.

Data was collected through pre-designed and pre-tested questionnaire, containing both open and close- ended questions. The criterion used to assess the mental illness was William C Menninger criteria.7 The inclusion criterion was those above 18 years and resident of Karachi for more than five years to exclude the effects of environment if any. Known psychiatric patients, psychiatrists, general practitioners, shamans, religious healers and other medical personnels were excluded to avoid any bias in the results. With respect to economic and demographic variables, the population was similar to general population of Karachi. The data was entered and analyzed using SPSS version 11. Frequencies were calculated and chi-square test was applied for association between variables.

Out of the total 200 sampled, 96 were found to have some mental illnesses (53 males and 43 females). Four mentally ill subjects did not give complete information, hence their forms were executed. Twenty three males and fifteen females preferred general practitioners as shown in table.

Education had a significant association with the health seeking behaviour (p<0.05) as more graduates were consulting the psychiatrists as compare to non-graduates as shown in figure.

[(0)]

[(1)]
Figure. Distribution of ealth seeking behavior by education Group of mentally ill population (N=96)


No significant difference was found in the health seeking behaviour of males and females (p>0.05).

Conclusion

Education had significant association with the health seeking behaviour of mentally ill subjects, while gender did not have significant effects on the health seeking behaviour.

References

1. www.mentalhealth.samhsa.gov/publications cited on Oct-2005

2. The World Health Report 2001, WHO, Switzerland.

3. Murray L, Lopez A. The global burden of diseases, joint publication of World Bank and Harvard University, Harvard Press, U.S.A. 1996:3-18.

4. Gadit AA, Khalid N. State of mental health in Pakistan-Service Education and Research. Hamdard Foundation, Karachi. 2003:10-53.

5. Absar A, Amin GA. Depression in cultural context. Medical Spectrum 1998;19:10-12.

6. Gadit AA. Ethno psychiatry in peds. Medical spectrum 1997;18:28.

7. Gadit A. Scope of Ethno psychiatry in Pakistan. (Editorial) J Pak Med Assoc 1996;46:119.

8. Razali M. Psychiatrists and Folk healers in Malaysia. WHO Forum, 1995;16:56-9.

9. Gadit AA. State of mental health in Pakistan. (Editorial), J Pak Med Assoc 2001;51:238-9.

10. Gadit AA. Ethno psychiatry. J Pak Med Assoc. 2003; 53:483-90.

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