David B. Mumford

Survey of eating disorders in English-medium schools in Lahore, Pakistan

A survey of 369 schoolgirls was conducted in Lahore, Pakistan, using the Eating Attitudes Test (EAT-26) and Body Shape Questionnaire (BSQ) in English. Factor analyses of the EAT and BSQ supported their cross-cultural validity in these English medium schools. Girls who scored highly on either questionnaire were invited for interview. One girl met DSM-/I/-R criteria for bulimia nervosa and there were five subjects with partial syndrome bulimia nervosa. No girls suffered from anorexia nervosa. There was some evidence that the most ‘Westernized’ girls were at greatest risk of developing an eating disorder. Comparison is made with a survey con- ducted by the authors among Asian schoolgirls in Bradford, UK. The results are discussed in the light of previous claims that eating disorders should be regarded as ‘culture-bound syndromes’.

A pilot study of eating disorders in Mirpur (Pakistan) using an Urdu version of the Eating Attitudes Test

A survey of eating disorders among 271 schoolgirls was conducted in Mirpur, Pakistan, using a new Urdu translation of the Eating Attitudes Test (EAT-26). The translation of the EAT into Urdu was undertaken by a committee. After examining initial drafts by two independent translators, an agreed Urdu text was given to five back-translators, and subsequently modified further. The evaluation of the new translation was performed in three stages: (1) evaluation of linguistic and scale equivalence in bilingual populations, (2) evaluation of conceptual equivalence by factor analysis, and (3) evaluation of item comprehension at interview. Individuals scoring above 20 on the EAT were interviewed to determine whether an eating disorder was present. One case of bulimia nervosa (DSM-III-R) was identified. This result is compared with surveys conducted by the authors among Asian schoolgirls in Bradford, UK, and in Lahore, Pakistan.

Promoting Mental Health Internationally

This book originated from an international meeting held in Geneva to mark the retirement of Norman Sartorius. It offers an overview of the many achievements of the World Health Organizations (WHOs) Division of Mental Health over the previous 25 years, during which Norman Sartorius had been at the

Book reviews : Verma, Ratna (1991) Psychiatric Social Work in India. New Delhi: Sage

Health Service and Community Care Act (1990), the prospect for better practice is good. If community care programmes are to be in step with the people they exist to serve, and avoid self-perpetuating practices which are unsuited to human needs, they must be continuously reviewed. This study addresses problems which the legislators had in mind. A pity it is not on sale at a third of its price (£36). It has implications for all who are concerned with the implementation of current social policies to re-establish psychiatric patients in the community and who take seriously their social integration at a level which is both meaningful and realistic.

Book reviews : Chakraborty, Ajita (1990) Social Stress and Mental Health: A Social-Psychiatric Field Study of Calcutta. New Delhi: Sage. 200pp

This is an old-fashioned epidemiological survey of mental illness, using methodology developed in the 1960s. What makes this study interesting is the fact that it was done within a fifty-mile radius of Calcutta. The author states that her specific aims were to find confirmation of the generally held premises that (1) poverty and urban stresses were causing extensive mental health problems in Calcutta, and (2) the number of chronically ill persons in the community at large must be high, because there are no large mental hospitals in the state. Neither premise was borne out by the study. The overall prevalence of psychiatric morbidity (psychoses, neuroses, epilepsy) was 7.5 percent which is right in the middle of the range reported by major studies in urban populations worldwide. There was no evidence of especially high rates in Calcutta, in spite of poor treatment facilities and the fact that ’all known environmental and psychological stress factors operate in Calcutta’.