Electronic Letters to:

SHORT REPORTS:
Khyati Mehta, Ganpat Vankar, and Vikram Patel
Validity of the construct of post-traumatic stress disorder in a low-income country: Interview study of women in Gujarat, India
The British Journal of Psychiatry 2005; 187: 585-586 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

Electronic letters published:

[Read eLetter] PTSD in a low-income country
Rameez Zafar   (18 January 2006)

PTSD in a low-income country 18 January 2006
Top
Rameez Zafar,
General Psychiatrist

Send letter to journal:
Re: PTSD in a low-income country

rameez.zafaar{at}lpt.nhs.uk Rameez Zafar

I read with interest the report by Mehta et al (2005) in which they have explored the experiences of some women who were traumatised by the communal riots in Ahmadabad, India, in March 2002. The authors have only interviewed women in their report, who in a developing community are traditionally seen as oversensitive and emotionally fragile. In any large scale disaster or other major traumatic events, people are always in need of urgent help and relief. In a country where resources are already limited and where health services are further stretched to limits in these events, the affecteés are even more desperate to get any help or support. Therefore in relief camps, any offer of help or treatment be it is from mental health team, was always going to be welcomed.

Mehta et al used a set of some open ended questions in a unstructurised fashion to elicit the subjective experiences of some women in relief camps. No mention has been made as to how these women were selected, how the interviews were conducted , what diagnostic criteria were used and whether or not any special instruments were used to elicit specific features of PTSD.

Even the introductory comment: “Events like riots may generate strong feelings & distress” with the offer of counselling and medication to those who were distressed, could be seen as making these women more suggestible which could potentially result in exaggeration of their emotional experiences, thereby causing a bias.

The authors in the end, concluded that the women had sought the help of mental health provider team indicating that they associated their experiences with mental illness. This assumption is quite erroneous. Although some of the symptoms mentioned in the three narratives could be described as core features of PTSD, the methodology used does not provide sound evidence in favour of the validity of the diagnostic category of PTSD in the Indian context.

Mehta, K., Vankar, G., Patel, V. (2005) Validity of Construct of Post Traumatic Stress Disorder in a low income country. Interview study of women in Gujarat, India. British Journal of Psychiatry 187, 585 – 586.

Declaration of interest – None.

R. Zafar, Consultant Psychiatrist Peter Hodgkinson Centre Greetwell Road Lincoln Lincs LN2 5UA.

Rameez.zafar@lpt.nhs.uk