Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: Dr Westermeyer
suggests that the high response frequencies among Afghan women for
depression and PTSD and the number of family members reported killed in
war "do not ring true." The finding that 97% of Afghan women
reported symptoms of major depression is indeed striking. However, high
rates of depression have been observed in other populations. For
example, Carlson and Rosser-Hogan1 have demonstrated rates
of depression of 80% among a random sample of Cambodian refugees who
resettled in the United States. Since the participants in our study
continue to experience considerable hardships, it does not seem that
the rates of depression in our study are so high as to "ring
untrue." The symptom checklist we used to predict MDD was the Hopkins
Symptom Checklist-25 (HSCL-25), an instrument that has been
demonstrated to be 86% sensitive and 93% specific in identifying the
diagnosis of MDD.2 We disagree that the depressive symptoms
identified by the HSCL-25 fall "well short of MDD."
Iacopino V. Mental Health of Women in Afghanistan—Reply. JAMA. 1999;281(3):230–231. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120
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