Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor
To the Editor: In the article on women's
health and human rights in Afghanistan,1 the authors
provided valuable information regarding abuses promulgated by
"religious rights" in that country.
However, 3 elements of the report do not ring true. First, the rate of
"major depressions" was reported as 97% among their 160 survey
subjects. Such high rates of major depressive disorder (MDD) have not
been observed among refugees, combat veterans, rape survivors,
prisoners of war, or other victimized groups.2,3 Depressive
symptoms well short of MDD, reported in groups exposed to ongoing
social adversity,4 should not be confused with MDD. A
problem may be use of a symptom checklist "to predict the clinical
diagnosis of major depression."
Westermeyer J. Mental Health of Women in Afghanistan. JAMA. 1999;281(3):230-231. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120