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Pervasive Effect of Psychological Distress on General Public and Caregivers of

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 Antrocom Online Journal of Anthropology vol. 19. n. 1 (2023) 125-134 – ISSN 1973 – 2880

Antrocom Journal of Anthropology

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Pervasive Effect of Psychological Distress on General Public

and Caregivers of a Person with Mental Illness: A Review.

Abhijit Pathak
Abhijit Pathak, Research Scholar, Department of Humanities & Social Sciences, National Institute of Technology Rourkela

keywords abstract
Psychological distress is a global phenomenon arresting people with Common Mental
Disorders (CMD). Prolonged distress often leads to severe mental illness too. The current
lifestyle has created this menace affecting the general public and caregivers of people with
mental illness. The current review paper has discussed the pervasive effect of psychological
distress on different kinds of populations and how it affects them. Through legislation,
private, and public entities and government policies can effectively create a healthy lifestyle
and minimize psychological distress.

Introduction
Psychological distress is a widely discussed phenomenon worldwide, and such an issue cannot be
sidelined. When it comes to health coverage and wellbeing for all, WHO (1946) defines health as a
“state of complete physical, social and mental wellbeing and merely the absence of disease or infirmity.
In that definition, mental health is an indispensable aspect and cannot be ignored. Mental well-being
is threatened by the fast-moving consumerist society, accompanied by the rat race and cutthroat
competition, resulting in disappointment, aggressiveness, sadness, and continuous stress resulting in
psychological distress. Decker (1997) & Burnette and Mui (1997) describe psychological distress as a
state where a person lacks zeal, is troubled with sleep, feels blue, is hopeless about the future, gets sad
easily, loses interest in his hobbies and harnesses the tendency of suicide Weaver(1995).

Basically, psychological distress is generally marked with stressors if they remain consistent;
psychological distress exists and results in other kinds of severe disorders. However, if the stress
gets over, the distress might get over too if coping mechanisms with stress improve over the period
(Horwitz 2007: Ridner 2004). From the above observation, one more feature has been identified, i.e.
the disorders and psychological distress are interlinked and dependent on each other (Payton, 2009).
Psychological distress is often accompanied by somatic symptoms and is widely observed differently
across cultures (Kirmayer 1989: Kleinman 1991). The definition of psychological distress is abstract
and ambiguous few experts relate it with depression ( Decker, Burnette& Mui,1997), and few take it
as diagnostic criteria for other kinds of disorders like Obsessive Compulsive Disorder, Post Traumatic
Stress Disorder and if it gets accompanied by the emotional disturbance which obstructs in daily
functioning as stated by Wheaton (2007). It will result in major depression and Bipolar or other severe

Please cite this article as: Pathak A., Pervasive Effect of Psychological Distress on General Public and Caregivers of a Person with Mental
Illness: A Review. - Antrocom J. of Anthropology 19-1 (2023) pp. 125-134.
126 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134

disorders (Phillip, 2009 & Watson 2009). According to Kirmayer et al. (1989), somatic symptoms
are widely accompanied by psychological distress worldwide, but different somatic symptoms often
vary from culture to culture. Russ et al. (2015) did a Meta-analysis study in the United Kingdom and
found that psychological distress relates to liver disease causalities and stated that further analysis is
required to confirm the ill effects of distress on the liver. In the same way, in Arabian countries, somatic
symptoms of depression are mainly confined to the problems related to the chest and stomach portion
of the body (Al- Krenwai& Graham 2000). With different features and views, the understanding and
comprehension of psychological distress vary across cultures and the definition of it.

Psychological Distress and Health

Psychological distress, a global phenomenon that gets triggered due to various reasons, is commonly
observed all over the globe. Psychological distress is often triggered by chronic disease and physical health
conditions. Rizou et al. (2015) conducted a cross-sectional survey to find out the level of psychological
distress caused by the prevalence of epilepsy,100 patients were interviewed, and it was found that
youngsters feel that if their disease remains for a longer period it affects emotional intelligence which
results in psychological distress. In the same way, psychological distress speeds up the effects of physical
illness, which results in increased mortality in a community of specific populations, a cohort study was
conducted by Hamer et al (2009) to know the relationship between cancer mortality and psychological
distress. They took a community-based sample of 15453 men and women (including 295 people with
a cancer history) and used GHQ-12 to measure psychological distress. From the study outcome, the
cancer patients under psychological distress died more than those who were cancer patients but not
under psychological distress. So it confirms that depression and anxiety in the long run act as major tools
to disrupt the body’s normal function and onsets of the base for major illnesses. Psychological distress
thus not only the cause of major diseases but a driving force for all kinds of mortality risk, and it was being
confirmed by the study conducted on population-based by Puustinen et al. (2011) to find out whether
psychological distress is the main driving force of all-cause mortality in the Scandinavian population.
923 respondents were taken from a population base study conducted in 1997-98 in Picksanaki, Finland.
GHQ-12 was a tool used to measure distress, and National Mortality Register was used to find the people
listed in respondents who died during the 11 periods of observation. It was found that psychological
distress is associated with all-cause mortality risk during an 11-year observation.

Psychological Distress & Socio-economic Status

The socio-economic status, which has been quite unequal in society, is also a close colleague of
psychological distress. One cross-sectional study was conducted on 40,679 participants to know the
association of psychological distress with socioeconomic status in developed and developing countries.
Lazzarino et al. (2014) did the study in England and Thailand. Tools like GHQ-12 and K6-scale were
used to ascertain the level of psychological distress. Socioeconomic status was measured by linking it
with the occupational status of the respondents. The study revealed that there was a positive relationship
between socioeconomic status and psychological distress, high psychological distress was prevalent in
both England and Thailand with people having low economic status. However, there was no significant
association between low socio-economic status and poor health behaviour. Another study done by
Caron & Liu (2011) compares the level of psychological distress and its associates among low and high-
income populations in Canada. 36 984 respondents were taken through the Canadian Community
Health Survey 7, 940 were low-income respondents of the total. It was found that psychological distress
was high in the low-income populations with common traits associated with psychological distress like
social support, stress and coping abilities. Community bonding comprises social support, safety, and
trust, which are evident in reducing stress; one population study was done by Pongsavan et al. (2006)
to find out the relationship of social capital with mental health status. Population over 16 years was
 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134 127

taken for the study. Social capital attributes like the feeling of trust, safety, community participation and
neighbourhood connections and reciprocity were taken. K 10 was used to measure psychological distress
(depression & anxiety). It was found that high feelings of trust and safety, community participation,
neighbourhood connections and reciprocity are part of low psychological distress.

Psychological Distress & Occupation

Apart from health, gender differences, and teenagers, there is also a direct relationship between
the person’s distress and type of occupation. An occupation that generally comprises job insecurity
and life risk cause sleep deprivation, poor health, and few resting times also cause distress, resulting in
depression and other kinds of disorder. Pits & Hansen (2015)did a cross-sectional study focused on
reasons behind the high presentism of general practitioners than other high-earning health professionals
by considering occupational health, lifestyle, and work-related factors. Through logistic regression, the
highlighting points were imbalance between work and life, insecurity of jobs, sleep problem, moderate
psychological distress, poor health and dissatisfaction with the job are causing unwanted presentism.
Therefore interventions should be taken to achieve proper sleep, the balance between life and work, stress
reduction and demand should be met out of physical exertion. The same phenomenon associated with
psychological distress is observed worldwide. Cadieux & Marchand (2014) did a longitudinal analysis of
occupation patterns in Canada through multi-level regression analysis. They found that skill utilization,
psychological demands, and job insecurity were positive associates of psychological distress levels among
the employed under the same roof. They might have different reasons to live with stress apart from the
reasons discussed in previous studies. Few studies talk about the other factors that trigger the common
factors, which help describe a person suffering from psychological distress. Boschman et al. (2013)
conducted a cross-sectional study among 1500 masons and supervisors associated with construction
jobs to understand the mental health problems and psycho-social environment. Researchers used a
Dutch questionnaire for data collection. Scales were not clearly given in the study, but it mainly tends
to measure fatigue during work, the need to recover after work, symptoms of depression, and post-
traumatic stress disorder through multi-level regression analysis. It was found that inadequate job
control, fatigue and other aspects were marked higher in masons than supervisors. Supervisors mainly
were suffering from depression due to low decision-making participation and less social support from
seniors. Sakuma et al. (2015) did a cross-sectional study after 14 months after the earthquake that shook
eastern Japan. The study was to understand and know the Post Traumatic Stress Disorder, depression
and high psychological distress among the rescue reconstruction workers of the Great East Japan
Earthquake (GEJE). 1294 respondents were taken from firefighters, local municipalities and hospital
wings. Tools like Post Traumatic Stress Disorder (PTSD) checklist- special version, K6 scale, and Patient
Health Questionnaire- 9(PHQ-9) were taken to collect respondents’ responses. It was found that there
are differences in reason and variation in psychological consequences among different workers like lack
of rest, lack of communication, involvement in disaster rescue, and reconstruction as causes of PSTD.
Depression among municipality and medical workers but because of early mental health interventions
and the back of normal working conditions had led to sound reliance capacity among firefighters.

Long working hours, an unfriendly job environment, and risky jobs precipitate psychological distress,
but some studies have advocated that sitting idle in the home promotes psychological distress and should
not be overlooked. Sloan et al. (2013) did a cross-sectional study to determine the relationship between
Sedentary behaviour and psychological distress and moderate to vigorous physical activity (MVPA)
with psychological distress in a multi-ethnic Asian Population. 2337 respondents from the National
Health Survey 2010 of Singapore were taken into the study. GHQ 12 and Global Physical Activity
Questionnaire Version 2 (GPAQ- 2) were used for data collection. It was found that sedentary behaviour
has a direct relationship with psychological distress. Moderate or low sedentary behaviours determine
low psychological distress. Another cross-sectional study has shown the association of psychological
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distress with long sitting hours. Kilpatrick et al. (2013) surveyed state government employees consisting
of 3367 respondents in Tasmania, Australia to understand the relationship between long sitting hours
and psychological distress, independent of leisure time with physical activity in the office. Kessler’s
psychological distress scale (K10) was used to measure psychological distress, and International Physical
Activity Questionnaire (IPAQ) was used to measure physical activity. It was found that the average
sitting hours of men and women in the office are 4.8 and 4.2 respectively. Men and women working
more than 6 hrs a day were found to be in moderate to severe psychological distress. So there is a clear
association between long occupational sitting hours and psychological distress, independent of physical
activity during leisure time in the office. Thus, there are numerous spheres through which we can
associate psychological distress, and thus the above-discussed points clearly state that there is a need to
intervene among the general public to improve their mental health status.

Psychological Distress & Senior Citizens

When this connection cools down gradually with age or less interaction due to physical constraints,
it causes isolation, thus increasing physical illness and feelings of depression and persistent sadness.
Shivkumar et al. (2015) studied psychological distress, which may be relevant among senior citizens. A
total of 4886 respondents was taken in the study, and GHQ-12 and Receiver Operating Characteristic
(ROC) curves were taken to plot the standard of psychological distress. It was found that the majority of
elders were in psychological distress, and few were reported with certain kinds of neurotic and psychotic
disorders. Females, illiterate, and multiple morbid people are highly distressed. Another study based
on a cross-sectional survey done by Joshi et al (2003) consists of 200 respondents over 60 years old
in urban Chandigarh and the rural population of Haryana state in India to find out the morbidity
and psychological distress socio-demographic variables among the elderly population in North India.
The study was conducted between 1999- 2000; most citizens 60 years old had higher morbidity and
psychological distress. Variables in the socio-demographic profile were age, locality, caste, education,
occupation and income, determining morbidity and distress.

Psychological Distress & Women

Women are the worst sufferers of psychological distress in society. Women who are vulnerable
to domestic violence (which consists of physical and mental suffering) are regularly suffering from
depression and anxiety, resulting in psychological distress. A study was conducted by Vizcarra et al.
(2004) to find the prevalence of psychological distress among women facing domestic violence in
developing countries like India, Chile, the Philippines and Egypt. A total of 3973 respondents was
taken in the study between 15 to 49 years old, with at least one child 18 years above taken with the help
of random sampling. Tools like the Self Report Questionnaire (SRQ) were used to understand the
mental state of the women taken as respondents. Domestic violence was defined as being slapped, hit,
and beaten by a male. The majority of women are psychologically distressed due to physical violence
done by their partners on them. In another study, Ramiro et al. (2004) to find out the psychological
violence against women in developing countries like India, Egypt, Chile, and the Philippines. 3975
respondents were taken, which fell between the age of 15- 49 years. The study shows that most women
in all these countries were facing psychological violence, which results in persistent psychological
distress in verbal abuse, fear, and separation. Women are not getting depressed when get accompanied
by domestic violence but also suffers from the hysteria of social isolation if they are infected by a deadly
disease or become a widow at an early age because of the utopian beliefs of their cultures resulting in
the lack of social support, safety and trust for these kinds of women. Kammath et al. (2014) conducted
a study which talks about the common mental disorder (CMD) among people who have HIV/AIDs
in the Udupi district; it was a cross-sectional study conducted on 227 respondents with the help of the
Kessler Psychological Distress Scale (K10) and General Health Questionnaire (GHQ 12). The majority
 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134 129

of people suffer from CMD, and the prevalence of psychological distress was more in widows, divorced
women and people with HIV. The study also showed that females are twice more prone to common
mental health disorders than males. Liebana et al. (2014) to understand the relationship between
psychological distress and academic engagement of students of health Science colleges. 1840 nursing
and physical therapy students were taken in the study and a questionnaire was distributed among them
to collect their feedback. The study concluded that psychological distress is maximum in women than
in men. Other factors which influence psychological distress are variations in vigour, mental resilience
and energy. However, on contrary, few studies have also indicated that males have worse mental health
conditions than females by being widower, an empirical analysis was done by Walter (1989), he proposed
in his finding that widowed male’s psychological well-being is poorer in comparison to divorced females
and widowed females. The study venue was Nashville, Tennessee, in the United States. Another study
from the same country favours men in terms of psychological distress of being a widow more than
women. Umbarson et al. (1992) extracted the psychological vulnerability from the National Survey
results of 1986 by studying 3,614 respondents who have been widowed or remain at some point in life
in both and women. Moreover, findings say that men’s psychological well-being was found poorer than
women’s. It may be due to the helplessness of managing the house and family well. Nevertheless, these
differences often depend on culture across the globe, and more research is necessary to make a single
stance globally on this subject. Nevertheless, the discussion continues over depression and psychological
distress, and several studies reported depression in women during pregnancy or with child-rearing in
early childhood and babyhood stages. There are very few studies that found the effect of maternal
psychological distress on an infant’s cognitive development. Kingston et al. (2015) did a systematic
review to find the impact of maternal psychological distress on toddler cognitive development. They
took 13 out of 2448 studies and found an association between prenatal and postnatal distress with a
baby’s cognitive development at varying degrees. Thus, increasing a mother’s mental well-being will lead
to adequate cognitive development. Another study conducted by Prasad et al. (2003) conducted a cross-
sectional survey to find out the relationship between reproductive tract symptoms and psychological
distress among women in rural south India. 622 respondents were taken, and GHQ 12 in the Tamil
language was used to collect data. They have found in a majority that reproductive tract symptoms have
an association with psychological distress. Thus, due to ignorance about puberty changes in teenagers,
the cultural taboo about the discussion on these biological issues appears to sin to the locals, which has
automatically been imposed on these women, leading to psychological distress for a longer period.

Psychological Distress & Adolescents

Teens are also showing an intriguing portion of the entire population suffering from psychological
distress; they are numerous factors associated with teenagers, trapped under depression and anxiety is the
most prevalent one. Academic pressure that has been present from childhood gets strengthened during
their higher secondary’s time. The other is the biological changes when they attain puberty. Such a period
brings tension and shock since they are unaware of the transformation of the biological processes. The
children in their families hardly discuss, and the parents, in return, feel reluctant to talk to their children.
Moreover, they feel they might assume it wrong, which may be culturally inappropriate. Pilai et al.
(2009) did a cross-sectional survey in rural and urban communities of Goa to find out the prevalence
and factors associated with suicidal behaviour in adolescents in India. 3662 youngsters were taken from
an urban and rural communities, and the structured interview was used to ascertain data. A significant
amount of youngsters have been found with suicidal behaviour. Rural adolescent girls are more prone
to suicidal tendencies mainly due to physical and sexual abuse at home; common mental disorders and
substance abuse trigger the tendencies of suicide among male adolescents. Ge et al. (1996) did a four-year
longitudinal study to understand the factors associated with puberty transmission, creating psychological
distress among teenage girls. It was noted that early-maturing girls have a high level of psychological
130 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134

distress than on-time girls who mat mature late. This is because of the problem with the friends of the
opposite gender and the father’s hostile feeling about making it happen. Another longitudinal study
by Ge et al. (2001) says that early puberty maturation among boys leads to hostile behaviour, internal
uneasiness, and psychological distress. Thus, when teen is unable to control their stress and other forms
of uneasiness, they shift their preference to those activities that are harmful to their health; basically,
they indulge in bad habits and become victims of substance abuse. Teenagers get addicted to drugs and
other toxic use and generally show the characteristic of emotional distress, alienation from their batch
mates, and poor impulse control, as confirmed by the longitudinal study Shelder & Block(1990). They
said through their findings that the person is addicted to drugs or other substances used frequently or
sometimes depending on the quality of parenting they have received. Researchers also said that drug use
is a symptom of psychological distress and not the cause of psychological fragility. There are possibilities
that it may have been rooted in their culture or received hereditarily from the person in their family with
a history of taking drugs and other substances. The negative family relationship among the member of
the family is prime responsible for the adolescents’ faulty coping behaviour resulting in psychological
distress, leading to substance abuse and unlawful practices. A study conducted by Reppeti et al. (2002)
says a family with instability in a relationship marked by conflict, aggression, and non-supportive and
careless attitudes towards each other creates vulnerabilities among the offspring. The psycho-social
functioning gets distorted; her biological stress-responsive regulatory system gets weakened, resulting
in poor health behaviours and substance abuse in adolescents age. This lead to a grave risk of mental
health disorders, chronic diseases and earlier death. So child’s social environment plays a crucial role
in shaping physical and mental health in the human development process, and distortion leads to the
above risks. Teenagers get influenced by their neighbours and locality, resulting in substance abuse,
depression, and attraction towards unlawful activities. Aneshensel & Sucoff (1996) did a community-
based survey and tried to determine the impact of the neighbourhood and socio-economic conditions
on adolescents’ emotional well-being; the researchers focused on aspects like racial/ ethnic segregation,
which bring lots of disturbance. 877 respondents were taken in the county of Loss Angles. Youth living
with low economic and social status neighbours are generally carried away or more quickly involved in
crime, violence, and drug use than teens living in socially- economically sound neighbourhoods. The
greater the odd and harsh behaviour of the neighbours, the greater the chances of anxiety, depression
and oppositional defiant disorder among adolescents.

Psychological Distress among Relatives of Patients with Different Mental

Disorders
The family is the most vital component in managing the person who does not control him or herself.
The family provides care, assesses the patient’s basic needs, and tirelessly cares about their member
almost every day of the week. So it becomes necessary to understand the pressure they are under, and
continuous exposure to such conditions will affect the mental well-being of the person in charge of the
mentally unfit person to respond as an ordinary member of society. This mounting pressure is called
a burden, and the hegemonic look of the neighbour and society in which the family leaves makes the
person fall under psychological distress. It now becomes clear that mental health professionals should
focus on both patients and their relatives (Pratima et al., 2011).

In psychology, a burden is defined as the existence of problems, difficulties, or adverse conditions

generated by the mentally ill patient who deteriorates the caregiver’s quality of life (Cousineau et al.,
2003). Hoeing and Hamilton (1966) were the first who classified the caregiver’s burden into parts: a)
objective burden which refers to the behaviour which can be verified, e.g. negative patient symptoms,
disruption in the caregiver’s daily schedule, financial and employment constraints. b) Subjective burden
refers to emotional strain on caregivers: sadness, anxiousness, anger, guilt, stigma, fear and rejection. A
study was conducted by Magana et al. (2007) to find out the mental health of caregivers of people
 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134 131

who have Schizophrenia of Latin origin. Interviews were conducted in both Spanish & English, and
Zarit Burden scale and Greenley stigma scale were used to measuring the burden and stigma felt by
the caregivers of California and Texas. The findings suggested a high rate of depressive symptoms in
Latino families and the main cause for stigma and burden felt by caregivers. Depressive symptoms are
comprised of the young age of caregivers, low level of education and severe disorder among patients. The
objective burden is more found in rural areas than urban areas; Martin-Yellowe (1992) found that the
prevalence of financial burden is more in rural families of schizophrenic patients than in urban families
of schizophrenic patients. In this case, social support plays a key role; Potasznik & Nelson (1984) says
that social support reduces the objective and subjective burden of the caregivers. However, if the social
interaction dominates negatively, then it slowly creates a belligerent attitude and, in the long run, a
sense of objective burden in caregivers of severely mentally ill patients. Rauktis et al. (1995) stated that
negative social interactions were more significant predictors of a burden than social interaction. Perlick
et al. (1999) studied the burden felt by the caregivers of persons with bipolar disorder. He did a baseline
on 266 patients’ relatives and found that most caregivers are in a moderate or severe state of psychological
distress, cementing the feeling of burden that has been rooted because of the incomplete knowledge of
disease or beliefs about the illness than the patient’s clinical state and history. Even though the major
chunks of people have been identified with different kinds of disorders and mental illness, there are
hardly any effective measures to increase mental illness literacy (Kumar et al., 2012; Vijaylakshmi et al.,
2013). The burden falls on the parents who have grown old and are caregivers of their adult children,
thus leading to a more subjective burden and a higher level of psychological distress. Aschbrenner
et al. (2008) did a cross-sectional study to find out the impact on old age and parents who are going
to retire are caregivers of Bipolar Affective Disorder (BPAD). Data were collected from Wisconsin
Longitudinal Study, and 10000 respondents of Wisconsin High School were taken who passed out
in 1957. Two groups of parents were divided, one with parents having no mentally disabled child and
one with BPAD. It was found that parents of BPAD who are in their retirement age have a high level
of somatic and depressive symptoms compared to parents of normal adult children. This shows the
great depreciation of the quality of mental health, which gradually occurs over the years. Thus, the rise
in burden creates a stressful environment that slows down the patients’ recovery. Ogilivie et al. (2005)
studied different phases of burden experienced by caregivers over a period of time. They noted that the
caregiver’s perception of the disorder marks the burden felt by the caregiver. Therefore the distinction
between the objective and subjective burden becomes necessary. Caregivers’ burden is often associated
with depression which results in the slow progress of recovery of patients. It was found that the objective
burden of the caregiver is higher in patients with bipolar affective disorder, which creates a stressful
environment that hinders the recovery of the patients. Caregivers of bipolar disorder have a high level
of expressed emotion, including critical, hostile or over-involved attitudes. Chappel & Penning (1996)
studied the behavioural problems and distress of caregivers to people who have Dementia. They found
that aimlessness, aggressiveness, forgetfulness, and restlessness are signs of heightened burden. On the
other hand, losing interest in daily activities is a sign of depression.

Conclusion
The pervasiveness of psychological distress is evident in the literature. People down the socio-
economic line or due to the mounting pressure of academics, occupation, and their interaction with the
immediate surroundings, which often adversely affect nature, exert psychological distress. Most people
see it as part and partial of daily life, and thus, it goes unnoticed and comes forward more seriously. The
government’s task lies in generating awareness and facilitating the service to address the ongoing issues
in a more promising way.
132 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134

References
Al-Krenawi, A., & Graham, J. R. (2000). “Culturally sensitive social work practice with Arab clients in mental health
settings. Health & Social Work, 25(1), 9-22.
Aneshensel, C. S., & Sucoff, C. A. (1996). “The neighborhood context of adolescent mental health”. C, 293-310.
Aschbrenner, A. K., Greenberg, J. S., & Seltzer, M. M. (2008). “The long-term impact of parenting and adult child with
bipolar disorder”. Research that Matters, 17-20.
Bhatia, M. S., & Jena, S. P. K. (2011). “Caregiver Burden in Severe Mental Illness”. Delhi Psychiatry Journal, 14, 211-219.
Boschman, J. S., Van der Molen, H. F., Sluiter, J. K., & Frings-Dresen, M. H. W. (2013). “Psychosocial work environment
and mental health among construction workers”. Applied ergonomics, 44(5), 748-755.
Burnette, D., & Mui, A. C. (1997). “Correlates of psychological distress among old-old hispanics”. Journal of Clinical
Geropsychology, 3(3), 227-244.
Cadieux, N., & Marchand, A. (2014). “Psychological distress in the workforce: a multilevel and longitudinal analysis of the
case of regulated occupations in Canada”. BMC public health, 14(1), 1-13.
Caron, J., & Liu, A. (2011). “Factors associated with psychological distress in the Canadian population: a comparison of
low-income and non low-income sub-groups”. Community mental health journal, 47(3), 318-330.
Chappell, N. L., & Penning, M. (1996). “Behavioural problems and distress among caregivers of people with dementia”.
Ageing & Society, 16(1), 57-73.
Cousineau, N., McDowell, I., Hotz, S., & Hébert, P. (2003). “Measuring chronic patients’ feelings of being a burden to their
caregivers: development and preliminary validation of a scale”. Medical care, 110-118.
Decker, F. H. (1997). “Occupational and non-occupational factors in job satisfaction and psychological distress among
nurses”. Research in Nursing & Health, 20, 453-464.
Ge, X., Conger, R. D., & Elder Jr, G. H. (1996). “Coming of age too early: Pubertal influences on girls’ vulnerability to
psychological distress”. Child development, 67(6), 3386-3400.
Ge, X., Conger, R. D., & Elder, Jr, G. H. (2001). The relation between puberty and psychological distress in adolescent
boys”. Journal of Research on Adolescence, 11(1), 49-70.
Gove, W. R., & Shin, H. C. (1989). “The psychological well-being of divorced and widowed men and women: An empirical
analysis”. Journal of family issues, 10(1), 122-144.
Hamer, M., Chida, Y., & Molloy, G. J. (2009). “Psychological distress and cancer mortality”. Journal of psychosomatic
research, 66(3), 255-258.
Hoenig, J., & Hamilton, M. W. (1966). “The schizophrenic patient in the community and his effect on the household”.
International journal of social psychiatry, 12(3), 165-176.
Horwitz, A. V. (2007). “Distinguishing distress from disorder as psychological outcomes of stressful social arrangements”.
Health, 11(3), 273-289.
Joshi, K., Kumar, R., & Avasthi, A. (2003). “Morbidity profile and its relationship with disability and psychological distress
among elderly people in Northern India”. International Journal of Epidemiology, 32(6), 978-987.
Kamath, R., Robin, S., & Chandrasekaran, V. (2014). “Common mental disorders: A challenge among people living with
human immunodeficiency virus infection/acquired immunodeficiency syndrome in Udupi, India”. Annals of medical
and health sciences research, 4(2), 242-247.
Kilpatrick, M., Sanderson, K., Blizzard, L., Teale, B., & Venn, A. (2013). “Cross-sectional associations between sitting at
work and psychological distress: reducing sitting time may benefit mental health”. Mental Health and Physical Activity,
6(2), 103-109.
Kingston, D., McDonald, S., Austin, M. P., & Tough, S. (2015). “Association between prenatal and postnatal psychological
distress and toddler cognitive development: a systematic review”. PloS one, 10(5), e0126929.
Kirmayer, L. J. (1989). “Cultural variations in the response to psychiatric disorders and emotional distress”. Social Science &
Medicine, 29(3), 327-339.
Kleinman, A. 1991. Rethinking Psychiatry. From Cultural Category to Personal Experience. New York: The Free Press.
Kumar, D., Kumar, P., Singh, A. R., & Bhandari, S. S. (2012). “Knowledge and attitude towards mental illness of key
informants and general population: a comparative study”. Dysphrenia: a peer-reviewed biannual academic journal of
psychiatry, 3(1), 57.
Lazzarino, A. I., Yiengprugsawan, V., Seubsman, S. A., Steptoe, A., & Sleigh, A. C. (2014). “The associations between
unhealthy behaviours, mental stress, and low socio-economic status in an international comparison of representative
samples from Thailand and England”. Globalization and health, 10(1), 1-8.
Liébana-Presa, C., Fernández-Martínez, M., Gándara, Á. R., Muñoz-Villanueva, M., Vázquez-Casares, A. M., & Rodríguez-
Borrego, M. (2014). “Psychological distress in health sciences college students and its relationship with academic
 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134 133

engagement”. Revista da Escola de Enfermagem da USP, 48, 715-722.

Magaña, S. M., Ramirez Garcia, J. I., Hernández, M. G., & Cortez, R. (2007). “Psychological distress among Latino family
caregivers of adults with schizophrenia: The roles of burden and stigma”. Psychiatric services, 58(3), 378-384.
Martyns-Yellowe, I. S. (1992). The burden of schizophrenia on the family: a study from Nigeria”. The British journal of
psychiatry, 161(6), 779-782.
Ogilvie, A. D., Morant, N., & Goodwin, G. M. (2005). The burden on informal caregivers of people with bipolar disorder”.
Bipolar disorders, 7, 25-32.
Payton, A. R. (2009). Mental health, mental illness, and psychological distress: same continuum or distinct phenomena?”.
Journal of health and Social Behavior, 50(2), 213-227.
Perlick, D., Clarkin, J.F., Sirey, J., Raue, P., Greenfi eld, S., Struening, E. et al. (1999) “Burden experienced by care-givers of
persons with bipolar affective disorder”. British Journal of Psychiatry, 175, 56–62.
Phillips M. R. (2009). “Is distress a symptom of mental disorders, a marker of impairment, both or neither?”. World
psychiatry: official journal of the World Psychiatric Association (WPA), 8(2), 91–92.
Phongsavan, P., Chey, T., Bauman, A., Brooks, R., & Silove, D. (2006). “Social capital, socio-economic status and
psychological distress among Australian adults”. Social science & medicine, 63(10), 2546-2561.
Pillai, A., Andrews, T., & Patel, V. (2009). “Violence, psychological distress and the risk of suicidal behaviour in young
people in India”. International journal of epidemiology, 38(2), 459-469.
Potasznik, H., & Nelson, G. (1984). “Stress and social support: The burden experienced by the family of a mentally ill
person”. American Journal of Community Psychology, 12(5), 589.
Prasad, J., Abraham, S., Akila, B., Joseph, A., & Jacob, K. S. (2003). “Symptoms related to the reproductive tract and mental
health among women in rural southern India”. The National Medical Journal of India, 16(6), 303–308.
Puustinen, P. J., Koponen, H., Kautiainen, H., Mäntyselkä, P., & Vanhala, M. (2011). “Psychological distress measured
by the GHQ-12 and mortality: a prospective population-based study”. Scandinavian journal of public health, 39(6),
577-581.
Ramiro, L. S., Hassan, F., & Peedicayil, A. (2004). “Risk markers of severe psychological violence against women: a
WorldSAFE multi-country study”. Injury Control and Safety Promotion, 11(2), 131-137.
Rauktis, M. E., Koeske, G. F., & Tereshko, O. (1995). “Negative social interactions, distress, and depression among those
caring for a seriously and persistently mentally III relative”. American Journal of Community Psychology, 23(2), 279-299.
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). “Risky families: family social environments and the mental and physical
health of offspring”. Psychological bulletin, 128(2), 330-336.
Ridner, S. H. (2004). “Psychological distress: concept analysis”. Journal of advanced nursing, 45(5), 536-545.
Rizou, I., De Gucht, V., Papavasiliou, A., & Maes, S. (2015). “Illness perceptions determine psychological distress and quality
of life in youngsters with epilepsy”. Epilepsy & Behavior, 46, 144-150.
Russ, T. C., Kivimäki, M., Morling, J. R., Starr, J. M., Stamatakis, E., & Batty, G. D. (2015). “Association between
psychological distress and liver disease mortality: a meta-analysis of individual study participants”. Gastroenterology,
148(5), 958-966.
Sakuma, A., Takahashi, Y., Ueda, I., Sato, H., Katsura, M., Abe, M., ... & Matsumoto, K. (2015). “Post-traumatic stress
disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers
fourteen months after the Great East Japan Earthquake: a cross-sectional study”. BMC psychiatry, 15(1), 1-13.
Shedler, J., & Block, J. (1990). “Adolescent drug use and psychological health: A longitudinal inquiry”. American Psychologist,
45(5), 612–630.
Shivakumar, P., Sadanand, S., Bharath, S., Girish, N., Philip, M., & Varghese, M. (2015). “Identifying psychological distress
in elderly seeking health care”. Indian journal of public health, 59(1), 18-23.
Sloan, R. A., Sawada, S. S., Girdano, D., Liu, Y. T., Biddle, S. J., & Blair, S. N. (2013). “Associations of sedentary behavior
and physical activity with psychological distress: a cross-sectional study from Singapore”. BMC public health, 13(1), 1-8.
Umberson, D., Wortman, C. B., & Kessler, R. C. (1992). “Widowhood and depression: Explaining long-term gender
differences in vulnerability”. Journal of health and social behavior, 10-24.
Vijayalakshmi, P., Reddy, D., Math, S. B., & Thimmaiah, R. (2013). “Attitudes of undergraduates towards mental illness: A
comparison between nursing and business management students in India”. South African Journal of Psychiatry, 19(3), 66-74.
Vizcarra, B., Hassan, F., Hunter, W. M., Muñoz, S. R., Ramiro, L., & De Paula, C. S. (2004). “Partner violence as a risk factor
for mental health among women from communities in the Philippines, Egypt, Chile, and India”. Injury Control and
Safety Promotion, 11(2), 125-129.
Watson, D. (2009). “Differentiating the mood and anxiety disorders: A quadripartite model”. Annual Review of Clinical
Psychology, 5, 221-247.
Weaver, J.A. (1995). “Has There Been a Failure to Prepare and Support Parish-Based Clergy in Their Role as Frontline
134 Pathak A. / Antrocom Online Journal of Anthropology, vol. 19, n. 1 (2023) 125-134

Community Mental Health Workers: A Review.” The Journal of Pastoral Care, 49(2), 129-147.
Wheaton, B. (2007). “The twain meet: distress, disorder and the continuing conundrum of categories (comment on
Horwitz)”. Health: 11(3), 303-319.
Winona Pit, S., & Hansen, V. (2016). “The relationship between lifestyle, occupational health, and work-related factors with
presenteeism amongst general practitioners”. Archives of environmental & occupational health, 71(1), 49-56.
World Heath Organisation. (1946). Constitution of the World Health Organization. <https://www.who.int/about/
governance/constitution>.

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