Psychiatric epidemiology in India.

Area of Science:

• Psychiatry
• Epidemiology
• Public Health

Background:

• Epidemiological studies in India report a wide range of psychiatric disorder prevalence rates (9.5–370/1000 population).
• Existing studies often overlook critical areas like anxiety disorders, substance dependence, and co-morbidity.
• Discrepancies in reported prevalence rates are linked to methodological limitations.

Purpose of the Study:

• To critically evaluate the reported prevalence rates of mental disorders in Indian epidemiological studies.
• To identify limitations in existing research methodologies and their impact on prevalence data.

Main Methods:

• Conducted an extensive literature search of PubMed, NeuroMed, and MEDLARS using terms 'psychiatry' and 'epidemiology'.
• Included a manual search of relevant literature.
• Systematically selected sixteen studies based on predefined inclusion and exclusion criteria.

Main Results:

• Most Indian epidemiological studies exhibit methodological weaknesses, including the use of insensitive screening tools and single informants.
• Systematic underreporting contributes to discrepancies and likely results in underestimated prevalence figures.
• Research has predominantly focused on broad, non-modifiable risk factors like age, gender, and social class.

Conclusions:

• The reported prevalence rates of mental disorders in Indian epidemiological surveys are likely underestimates of the true population prevalence.
• There is a need for more comprehensive research, including longitudinal, multi-center, and co-morbid studies.
• Future research should incorporate assessments of disability, functioning, family burden, and quality of life, adopting a clinical service-providing approach.