title: Associations between the social organization of communities and psychiatric disorders in rural Asia.
abstract: OBJECTIVE
  We provide rare evidence of factors producing psychiatric variation in a general population sample from rural South Asia. The setting is particularly useful for demonstrating that variations in the social organization of communities, often difficult to observe in rich countries, are associated with important variations in mental health.
  
  
  METHODS
  Clinically validated survey measures are used to document variation in psychiatric disorders among 401 adults. This sample is chosen from a systematic sample of the general population of rural Nepal, in a community-level-controlled comparison design. Multilevel logistic regression is used to estimate multivariate models of the association between community-level nonfamily social organization and individual-level psychiatric disorders.
  
  
  RESULTS
  Schools, markets, health services and social support groups each substantially reduce the odds of depression, post-traumatic stress disorder (PTSD), intermittent explosive disorder and anxiety disorders. Associations between schools, health services and social support groups and depression are statistically significant and independent of each other. The association between access to markets and PTSD is statistically significant and independent of other social organization and support groups.
  
  
  CONCLUSIONS
  Community integration of some nonfamily social organizations promotes mental health in ways that may go unobserved in settings with many such organizations. More research on the mechanisms producing these associations is likely to reveal potential avenues for public policy and programs to improve mental health in the general population.
authors: Survey Research Center, College of Literature, Science, and the Arts, Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI, 48106-1248, USA. baxinn@umich.edu.
authors: William G
authors: WG
authors: Axinn
authors: Survey Research Center, Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
authors: Dirgha J
authors: DJ
authors: Ghimire
authors: Department of Sociology, University of Washington, Seattle, WA, USA.
authors: Nathalie E
authors: NE
authors: Williams
authors: Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
authors: Kate M
authors: KM
authors: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D019058:Community Networks / Q000458:organization & administration*; D003863:Depression / Q000453:epidemiology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D011618:Psychotic Disorders / Q000453:epidemiology*; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety disorders; Depression; Intermittent explosive disorder (IED); Mental health; Post-traumatic stress disorder (PTSD); Rural Asia; Social organization