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January 20, 1999

Mental Health of Women in Afghanistan

Author Affiliations

Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(3):230-231. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120

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."