The Major Disorders of the Brain in Nepal
Annual report (year 2015) of the project ”The Major Disorders of the Brain in Nepal”
Instrument for psychiatric caseness (Hospital Anxiety and Depression Scale) was translated, culturally adapted and validated; and published in a reputed journal from Nepal. A paper concerning their relation with headache prevalence was presented in an international congress. I completed remaining courses in Norway. Two more papers were submitted.
Using a stepwise process of translation, trial and modification that involved semantic as well as the statistical approaches, we obtained an acceptably reliable and valid bimodal Nepali version of the Hospital Anxiety and Depression Scale (HADS). It will now serve as a psychiatric measure of symptom severity and as a screening instrument for case-finding of the common mental conditions (anxiety and depression). It can be used among the hospital patients, as well as, in the general population. Using this validated instrument, we estimated the point prevalence of anxiety and depression in Nepal, and assessed their association with sociodemographic, domiciliary (place of habitation and the altitude of residence), socio-cultural and behavioural (substances of abuse, tumpline use), as well as, the psychological and physical health related (blood pressure, obesity, neuroticism, life toughness, quality of life) aspects of the Nepali population. These findings have been submitted for publication in a reputed journal (BMC Psychiatry). Additionally, in a separate paper, we have explored the comorbidities these psychiatric conditions have with the headache disorders, which has been submitted in another prestigious scientific journal (The Journal of Headache and pain). I am expecting these two papers to be published soon. I presented a poster in an international, scientific congress (International Headache Society Congress-IHC 2015) held at Valencia, Spain, which described the association one year headache prevalence had with these psychiatric conditions in Nepal. I also stayed the second half of the year at Trondheim, Norway, while successfully completing the planned educational courses at NTNU.
Annual report (year 2014) of the project ”The Major Disorders of the Brain in Nepal”
The philosophical background (including the cultural, geographical and logistic issues) of the methodology applied during the survey in 2013 has now been published in a highly ranked journal. I presented it at an international, scientific congress and completed the planned first half of educational courses in Norway.
The anticipated methodological problems during our survey were sorted into different themes: study design; climate; geography, access and transport; sociocultural issues; safety of interviewers. Each of these was dealt with separately, and their inter-relationships explored, in finding solutions that were sometimes pragmatic. A cross-sectional questionnaire-based study, with teams of interviewers visiting households across the three physiographic divisions (with extremes in altitude) in each of the five development regions of the country, would enable national sampling with sociocultural representativeness. However, the study instruments and interviews would be in Nepali only. Transport and access challenges were considerable, and their solutions combined travel by air, bus, river and foot, with allowances for rain-damaged roads, collapsed bridges and cancelled scheduled flights. The monsoon would render many routes impassable, and therefore set an absolute time limitation. Engaging participants willingly in the enquiry would be the key to success, and several tactics would be employed to enhance the success of this, most importantly enlisting the support of local community volunteers in each study site. I presented a poster at an international, scientific congress (The European Headache and Migraine Trust International Congress, EHMTIC 2014) in Copenhagen, which described these cultural, logistic and philosophical challenges related to the survey we conducted in the first year. I also stayed for half a year in Trondheim while successfully participating in the first half of the planned educational courses at NTNU.
Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS).
Kathmandu Univ Med J (KUMJ) 2015 Apr-Jun;13(50):115-24.
PMID: 26657079 - Inngår i doktorgradsavhandlingen
Estimating prevalence and burden of major disorders of the brain in Nepal: cultural, geographic, logistic and philosophical issues of methodology.
J Headache Pain 2014;15():51. Epub 2014 aug 15
PMID: 25127664 - Inngår i doktorgradsavhandlingen