Table 5.
Generalized estimating equation for association of study design variables with magnitude of odds ratio between psychiatric category and cultural concept of distress
| Variable | Study comparisons, N (%) | Bivariate regression coefficient (95% CI) | Multivariable regression coefficient (95% CI) | |
|---|---|---|---|---|
| World region | Americas | 44 (55.7%) | Ref. | Ref. |
| Africa | 7 (8.9%) | -4.14 (−5.91, −2.36)*** | −8.23 (−13.38, −3.18)** | |
| Asia | 28 (35.4%) | 2.17 (−5.97, 10.31) | −5.44 (−10.26, −0.62)* | |
| Researcher label | ‘Culture-bound … ’ | 15 (19.0%) | Ref. | Ref. |
| ‘Idiom … ’ | 21 (26.6%) | 7.85 (−1.30, 17.01) | −4.67 (−7.63, −1.70)** | |
| ‘Popular … ’ | 9 (11.4%) | 2.08 (−1.00, 5.17) | −3.44 (−6.86, −0.01)* | |
| Other ‘ … syndrome’ | 13 (16.5%) | 3.25 (1.23, 5.27)** | −4.59 (−8.76, −0.41)* | |
| Other label | 21 (26.6%) | 0.37 (−2.01, 2.74) | −4.54 (−7.86, −1.23)** | |
| Study objective | Compare CCD and psychiatric disorder | 47 (59.5%) | Ref. | Ref. |
| Validation | 7 (8.9%) | 17.65 (9.11, 26.18)*** | 16.27 (12.75, 19.79)*** | |
| Assess risk factors | 17 (21.5%) | 2.26 (−0.24, 4.75) | −1.62 (−3.57, 0.33) | |
| Other | 8 (10.1%) | −1.67 (−3.72, 0.38) | −5.08 (−8.61, −1.55)** | |
| Sample size | 1-99 | 20 (25.3%) | Ref. | Ref. |
| 100-499 | 34 (43.0%) | 3.42 (−3.55, 10.39) | −2.13 (−4.68, 0.42) | |
| ≥ 500 | 25 (31.6%) | 3.03 (1.42, 4.64)*** | 6.92 (2.66, 11.17)** | |
| Recruitment site | Clinical | 48 (60.8%) | Ref. | |
| Community | 29 (36.7%) | −0.12 (−5.68, 5.44) | ||
| School | 2 (2.5%) | −2.72 (−9.01, 3.58) | ||
| Representative | No | 50 (63.3%) | Ref. | |
| Yes | 29 (36.7%) | 0.40 (−4.70, 5.51) | ||
| Cultural concept of distress category | Nervios-related labels | 40 (50.6%) | Ref. | Ref. |
| Dhat | 10 (12.7%) | −2.99 (−4.84, −1.15) | −0.15 (−7.72, 7.42) | |
| Hwa-byung | 2 (2.5%) | −3.52 (−5.26, −1.78)*** | 8.02 (−0.04, 16.10) | |
| Other labels | 27 (34.2%) | 3.86 (−4.26, 11.98)** | 3.58 (−2.73, 9.89) | |
| CCD self-eport | No | 19 (24.1%) | Ref. | |
| Yes | 60 (75.9%) | 2.29 (−2.44, 7.03) | ||
| Assessment method for cultural concept of distress | Single-item sel- report | 40 (50.6%) | Ref. | Ref. |
| Self-report multi-item scale score | 18 (22.8%) | 7.51 (−4.69, 19.70) | 6.10 (1.89, 10.31)** | |
| Clinician diagnosis | 8 (10.1%) | −2.28 (−3.82, −0.73)++ | 0.48 (−1.93, 2.89) | |
| Other labelled (parent, key informant) | 13 (16.5%) | 1.59 (−1.21, 4.39) | −2.81 (−5.90, 0.28) | |
| Prevalence | Lifetime | 30 (38.0%) | Ref. | Ref. |
| Current | 33 (41.8%) | 1.68 (−5.34, 8.70) | 6.65 (−0.87, 14.17) | |
| Unclear | 16 (20.3%) | −3.78 (−5.20. −2.36)*** | −6.31 (−13.00, 0.37) | |
| Psychiatric category | General psychological distress | 13 (16.5%) | Ref. | |
| Anxiety disorders | 30 (38.0%) | 2.76 (−1.87, 7.38) | ||
| Mood disorders | 21 (26.6%) | 2.18 (−2.69, 7.05) | ||
| Somatic disorders | 8 (10.1%) | 4.65 (−2.44, 11.74) | ||
| Psychotic and other disorders | 7 (8.9%) | −1.87 (−4.14, 0.39) | ||
| Controlled for comorbidity | Not controlled | 27 (34.2%) | Ref. | |
| Controlled | 52 (65.8%) | −4.56 (−13.06, 3.93) | ||
| SAQOR-CPE ranking | Very Low | 5 (6.3%) | Ref. | Ref. |
| Low | 48 (60.8%) | 2.28 (0.22, 4.33)* | −5.04 (−10.14, 0.06) | |
| Medium | 26 (32.9%) | 6.35 (−1.69, 14.40) | −7.47 (−12.63, −2.30)** |
N = 79 comparisons; number of studies 26. Only items with significant bivariate associations were included in the multivariable model.
*P < .05; **P < .01; ***P < .001.