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dna exclusive: Psychiatric morbidity cases among slum dwellers in Dharavi

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Mumbai’s slum community has a high prevalence of psychiatric morbidity, a study done by Preventive and social medicine department and psychiatry department of LTMG Sion Hospital has shown.

Published in Asian Journal of Psychiatry’s December 2013 edition, the study said the prevalence rate of psychiatric conditions is found to be 12.5%, much higher compared with previous studies.

Head of the psychiatry department Dr Nilesh Shah said, “This was a cross-sectional epidemiological study conducted in a health post area of Dharavi. It showed that alcohol dependence is very high among people in this community, apart from the burden of psychiatric illness.”

For the study, every household in the area was checked and individuals above the age of 15 were interviewed. All individuals who identified with a psychiatric disorder on the basis of the symptoms’ check-list were invited for a clinical interview conducted by a psychiatrist.

The study revealed that affective disorders (mood disorders) were the most common psychiatric ailment, found in 42.7% of the people surveyed, followed by anxiety disorders (30.7%) and psychoses (21.3%).

The study found that the high prevalence rate of psychiatric diseases was related to various factors such as low level of education, unemployment and family history of psychiatric ailments.

Dr Shubhangi Parker, deputy dean (academics) of KEM hospital, who has done her PhD on urban mental health, said, “The poor, especially those below the poverty line, are the worst hit. They harbour suicidal thoughts because they are frustrated. Rising costs can even turn some into murderers.”

Parker added the struggle for day-to-day survival makes these people more vulnerable and volatile by nature. “There is huge frustration that’s growing every day because of their social status. A little fight can provoke them into taking an extreme step that can turn disastrous.”

Agreeing with Parker, Dr Harish Shetty, senior psychiatrist at Hiranandani Hospital, said the sense of hopelessness has been on the rise in the last few years. “People are fed up. Cost of living is always rising. And then there is corruption, which compounds the problem. Tolerance levels are plummeting; this can be dangerous,” he said.

The study said that there is an urgent need for inclusion of psychiatric and psychosocial services to primary health care.

Study highlights
In the study, it was found that affective disorders were the most common psychiatric ailment, found in 42.7 % of people surveyed, followed by anxiety disorders (30.7%) and psychoses (21.3%)

Affective disorders are a set of psychiatric diseases, also called mood disorders. The main types of affective disorders are depression, bipolar disorder and anxiety disorder.  Psychoses, ie psychotic disorders, are severe mental disorders that cause abnormal thinking and perceptions.

People with psychoses lose touch with reality.

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