Staff Reporter :
A recent review conducted by icddr,b found that mental disorder in Bangladesh is a serious but overlooked problem. Better data, awareness and more mental health practitioners are needed to address the unmet needs for mental health care.
Mental health disorders- such as depression, anxiety, addiction, schizophrenia and neurosis – have a serious impact on health: they contribute contribute to upto 13% of global disease burden.
Low- and middle-income countries experience a higher burden of mental disorder and yet mental health conditions are often not perceived as serious health problems in those countries and are not prioritized in prevention programs and in health care delivery.
In addition, in countries like Bangladesh, there are often few prevalence data, making recognition of the problem difficult and posing a challenge to developing effective health care responses.
A new systemic review led by icddr,b investigators examines the current prevalence and trends in the rates of mental health disorders in Bangladesh in order to fill the knowledge gap and to point the way towards addressing the burden associated with these problems.
The authors collected and evaluated literature on prevalence of mental disorders such as depression, anxiety, psychiatric and behavioral disorders, along with co morbidity with chronic diseases and service delivery and treatment options in Bangladesh. They focused on published articles that presented quantitative data and were published in English between 1975 and October 2013.
The review found that the overall prevalence of mental disorders in Bangladesh is between 6.5 to 31% among adults, with psychiatric and psychogenic disorders such as depression, anxiety and neurosis most commonly reported. The prevalence of mental disorders was much higher in overcrowded urban communities than rural ones, and among the poor. Women were vulnerable across all settings, consistent with findings from other South Asian countries like India and Pakistan.
The authors found that data on mental disorders among children are scarce; prevalence is estimated to be between 13.4 to 22.9%. Behavioural disorders were most common among children, but psychiatric disorders were also reported among socially disadvantaged children, such as those living in urban slums.
The evidence suggests that psychiatric disorders among children are associated with malnutrition, low education level of parents and a family history of mental illness.
However, due to the strong social stigma attached to mental disorders in Bangladesh, the authors caution that prevalence in both children and adults is likely to be underestimated.
Chronic diseases and mental disorders are mutually reinforcing – mental disorders can increase the risk of chronic diseases and the intensity of symptoms by deteriorating an individual’s immune system, and chronic diseases can increase the risk of mental disorders.
This study found that one third of patients with diabetes and half of cancer patients had depression. Similar findings were reported among patients with hypertension and chronic obstructive pulmonary disease.
The authors found a major shortage of qualified mental health practitioners in Bangladesh for both adults and children. At the same time, lack of knowledge, superstitious beliefs and social stigma prevents individuals with mental health conditions from seeking care.
Some believe that mental disorders are untreatable as evil influences play a role there. Women are both more vulnerable to experiencing mental disorders and less able to access treatment due to their lower social status.
The authors stressed the need for more research to better understand the magnitude of the problem in Bangladesh, better access for patients to qualified mental health professionals and mass awareness raising campaigns to reduce misconceptions and stigma about mental health conditions.
The study was conducted by icddr,b with the US National Institutes of Mental Health, Liverpool School of Tropical Medicine, UK, and Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
