Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
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."
Second, the reported rate of posttraumatic stress disorder (PTSD) in this sample was 42%, based on interview by a "trained health professional." The authors do not clarify whether they were assessing acute or chronic, current or lifetime PTSD. This rate exceeds that observed among combat veterans, rape survivors, and other victimized groups5 and is in the range of lifetime (not current) PTSD observed among severely abused prisoners of war.6 Definitions, criteria, and data instruments should be specified.
Third, the percentages of families reporting "1 or more family members . . . killed in the wars" is 84%, and the number of "war-related injuries among their families" was 70%. Since the number of war wounded usually bears a ratio of 1 killed to every 3 or 4 wounded, these figures are unusual and warrant explanation. If subjects define their extended kin group as "family," it is conceivable that the "killed in action" remote relatives are better known than the "wounded in action" remote relatives.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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