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Bhogendra Sharma

Publications and source records attributed to Bhogendra Sharma.

5 recordsLinked to original sources

Cultural challenges to psychosocial counselling in Nepal.

This article describes the way in which the practice of psychosocial counselling was adapted culturally to the context of Nepal within the Centre for Victims of Torture, Nepal (CVICT). After a brief description of the Nepali setting and CVICT's counselling and training approach and the relationship of its psychosocial counselling intervention with existing methods of dealing with psychosocial problems, the cultural challenges of implementing psychosocial counselling and our response to them are sketched along with concepts deemed important in psychosocial counselling. A discussion follows in which the authors' stance on the export of psychosocial counselling to non-western cultures is outlined.

Acculturation↗

Mental illness among Bhutanese shamans in Nepal.

Despite efforts to promote traditional medicine, allopathic practitioners often look with distrust at traditional practices. Shamans in particular are often regarded with ambivalence and have been considered mentally ill people. We tested the hypothesis that shamanism is an expression of psychopathology. In the Bhutanese refugee community in Nepal, a community with a high number of shamans, we surveyed a representative community sample of 810 adults and assessed ICD-10 mental disorders through structured diagnostic interviews. Approximately 7% of male refugees and 0.5% of female refugees reported being shamans. After controlling for demographic differences, the shamans did not differ from the comparison group in terms of 12-month and lifetime ICD-10 severe depressive episode, specific phobia, persistent somatoform pain, posttraumatic stress, generalized anxiety, or dissociative disorders. This first-ever, community-based, psychiatric epidemiological survey among shamans indicated no evidence that shamanism is an expression of psychopathology. The study's finding may assist in rectifying shamans' reputation, which has been tainted by past speculation of psychopathology.

Bhutan↗

Psychiatric disability among tortured Bhutanese refugees in Nepal.

OBJECTIVE: Most refugees live in low-income countries. There is a lack of data on psychiatric disability among such refugees. The authors compared psychiatric disability in tortured and nontortured Bhutanese refugees living in Nepal and examined factors associated with psychiatric disability among the tortured refugees. METHOD: A cross-sectional survey was conducted among 418 tortured and 392 nontortured Bhutanese refugees, matched for age and gender. The Composite International Diagnostic Interview, version 2.1, and the World Health Organization Short Disability Assessment Schedule were used to measure ICD-10 psychiatric disorders and disability, respectively. RESULTS: Approximately one in five tortured and nontortured Bhutanese refugees were found to be disabled. Posttraumatic stress disorder, specific phobia, and present physical disease were identified as factors associated with disability among the tortured refugees. On the other hand, present physical disease, greater age, and generalized anxiety disorder were associated with disability among the nontortured group. CONCLUSIONS: These findings show that the tortured and nontortured refugees were equally likely to be disabled. Different sets of predictors were identified among tortured and nontortured refugees, indicating the need for comprehensive psychiatric assessment of both tortured and nontortured refugees in clinical practice.

Adult↗

The relationship between somatic and PTSD symptoms among Bhutanese refugee torture survivors: examination of comorbidity with anxiety and depression.

Previous research has indicated a relationship between posttraumatic stress disorder (PTSD) and somatic complaints. We examined whether this relationship is a result of shared comorbidity with anxiety and depression. Local doctors interviewed a random, community sample of 526 tortured and 526 nontortured Bhutanese refugees living in U.N. refugee camps in Nepal. The interview covered demographics, torture, somatic complaints, and PTSD, depression, and anxiety measures. Number of PTSD symptoms, independent of depression and anxiety, predicted both number of reported somatic complaints and number of organ systems involving such complaints. Physicians need to screen for PTSD when survivors of extreme stressors present nonspecific somatic complaints.

Adult↗