Table 2.

Reasons for wide variations reported in Indian epidemiological studies

Inherent nature of the psychiatric disorders Diagnostic methods Definition used to define a ‘case’ Systematic underreporting Recall bias Single informant Need for treatment Screening instrument Clinical interview, structured interview or semi-structured interview Sampling procedure Sampling bias

All the above factors played a crucial role in underreporting the prevalence rate in most of the Indian epidemiological studies. Because the screening instrument applied to the entire population had poor sensitivity in identifying minor mental disorders and also in high-risk populations such as the children and the elderly, it resulted in missing minor mental disorders during the initial screening. However, the majority of the researchers confirmed the diagnoses that were identified through the screening in the second phase avoiding false. positive cases. In addition to the poor screening instrument, recall bias, single informant and systematic underreporting have led to underreporting of mental disorders rather than over-reporting in Indian epidemiological studies