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There is still much that we do not know about the effects of international migration on mental health, but we know even less about the mental health consequences of rural-to-urban migration. This may be particularly important in developing countries where the health of internal migrating populations may affect economic development. We use a large representative sample of adults residing in Kathmandu, Nepal to investigate the utility of a stress process model for understanding the mental health effects of rural-to-urban migration. Because our sample contains both migrants and non-migrants, we are able to compare the importance of stressors common to all urban dwellers and those specific to migrants (i.e. acculturation stressors) as they affect the well-being of urban residents. Results show that acculturation-related stressors and social support problems are less salient for explaining distress and mental health symptoms than common stressors and social support problems. Migrants do face more chronic stressors, have more social support problems and report higher levels of distress and symptoms. We speculate that this has more to do with the social inequality that results from migration than with specific migration-related stressors or loss of social resources. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article presents guidelines on the ethical standards for medical research in poor countries, using the example of Nepal. These are to demonstrate the sociological explanation for illness causation, and to explain that health care access can provide additional information in refining ethical guidelines. It also suggests that a sociological explanation for illness causation could provide a clear justification of including the social context in specifying ethical guidelines, and can clarify the issues that must be addressed.

Psychological disorders air a substantial part of the disease burden in many developing countries, yet few health services arc directed toward the detection and treatment of these disorders. The relationship between psychological disorders and physical health problems was investigated by means of a community survey (N = 653) in a small village in Nepal. using a shortened version of the DSM-III-R Checklist to estimate the prevalence of several psychological disorders arid a version of the Cornell Medical Index to assess physical illness symptoms. Results indicate that approximately 18.4 percent of this rural population has had a diagnosable mental illness. Moreover, there is substantial overlap between physical health problems and psychological disorder for those with a psychological disorder (32.5%). The findings indicate that health providers in developing countries need to screen for psychological disorders as a standard part of health assessments. [ABSTRACT FROM AUTHOR]

Objectives: This article attempts to document the prevalence of psychiatric disorders among elders in a rural village in Nepal. In addition, we investigate the relationship between psychiatric illness and functional disability to assess the impact of disorder on social functioning. Method: A semistructured interview checklist to diagnose six disorders was used (N = 182). In addition, elders older than age 60 were examined to assess the functional impact of mental health conditions by measuring functional disability. Results: Eighteen percent of elders seem to have a diagnosable psychiatric disorder. Furthermore, in general these elders were also less likely to receive assistance with the disabilities they report, compared with those who do not experience a psychiatric disorder. Discussion: Documenting the extent of psychiatric disorder among elders in developing societies sensitizes health planners to the growing reality of aging in their societies and the need for expanded physical and psychiatric health care services. [ABSTRACT FROM AUTHOR]

Sociologists have had only a marginal effect on the development of bioethical principles for medical research despite their interest in the effects of social and economic inequality on health and its implications for issues of social and individual justice. In this article we review existing bioethical standards for conducting medical research in very poor countries. Given the substantial differences in individual exposure to health risks and the availability of health protective resources as well as differences in the disease burden and mortality and morbidity at the population level, it is clear that illness in poor countries can be better understood using a social causation of illness perspective. In turn we suggest that such a perspective can be useful for identifying bioethical standards that better apply in this context.

Background: There is growing recognition of the importance of mental health problems in developing countries. In large part, however, we have very limited epidemiological data at national and/or community levels about the prevalence of mental illnesses., Aims: The purpose of this paper is to describe the reliability and validity characteristics of an assessment tool that may be useful for conducting community-level surveys (particularly in rural communities of developing countries) to obtain prevalence rates of mental illnesses., Methods: We used a sample of adults residing in a rural village in Nepal to assess disorders with a modified version of the DSM-III-R Checklist. We evaluated construct validity, scale reliability, convergent validity and discriminant validity., Results: There is strong evidence for the construct validity of generalized anxiety and depression in our sample. By contrast, the symptoms associated with mania and schizophrenia were not empirically distinct. Convergent validity is acceptable. As a test of validity characteristics, the pattern of sociodemographic correlations suggests that the specific social origins of disorder in Nepal will require further investigation., Conclusion: The first step in obtaining high quality information on the distribution of mental illness in developing countries is to establish some reliable and valid indicators of disorder. The checklist format for assessing disorder appears to meet this objective and offers the possibility that community-level prevalence studies can be reasonably conducted.