Depression - lost in translation

I've developed an unhealthy obsession with trying to compile a list of words/phrases in South East Asian languages that helps capture the essence of depression. A previous post on Begum Syndrome, touched on language and cultural barriers to interpreting and understanding complex symptom clusters and subsequently conveying a presumed diagnosis of low mood.

Drawing on my East African Asian heritage I discovered that the term often used in my community to describe depression is munjaro - a Swahili word which translates as cobweb - perhaps perfectly capturing the clouded perception and thinking that can take hold with clinical depression. However, in its original usage it was probably applied more to long term psychosis rather than the more subtle but equally pervasive depression.

If the Queen spoke Gujarati she might describe depression as manshik udashinta which I suspect may correlate with it's Urdu equivalent udasi (sadness) which doesn't really hit the spot.

Tellingly, the Royal College of Psychiatrists' patient info leaflet on depression (in Urdu) merely transliterates depression.

Has anyone had any success in coining an appropriate phrase? Which other languages pose a similar challenge?

[First posted here at doc2doc]

How to measure a mountain

Managed to sneak a letter into today's Guardian review in support of the Persian polymath al-Biruni (973-1048) against Renaissance hegemony.

Letter and accompanying cartoon.

Beyond Begum Syndrome

As a house officer I think I was just too busy to dedicate time to selecting the attributes that would constitute my bespoke "heartsink patient". More senior colleagues had seemingly highly refined criteria for the awarding of such an accolade to a patient. Thankfully my own portfolio of heartsink stereotypes never really took off. Perhaps I became more empathic through my training, or perhaps I just became desensitised? However, one stereotype does live on and continues to baffle me: Begum Syndrome.

Read on here.

A GP unable to prescribe antibiotics is like...?

A (non-medic) friend recently tweeted this story from the BBC to me. The headline commands GPs 'must cut use of antibiotics'. His additional tongue-in-cheek note was "is this your career unravelling?" peddling the longstanding myth that antibiotics form the solitary weapon in a GP's armoury.

The latest diktat is from the European Centre of Disease Prevention and Control and warns against inappropriate antibiotic use and increasing bacterial resistance. This is nothing new. Fortunately the powers that be have realised that the situation is not down to an incestuous relationship between GPs and drug companies but public (un)awareness. The government apparently launched a major advertising campaign earlier this year telling people that antibiotics do not work on coughs or colds.

Anecdotally patients I've seen seem less resistant to the idea that rest, fluids and over the counter medicines should see them through a viral illness. My family have stopped asking me for advice, safe in the knowledge that they can pre-empt my suggestion of "take some paracetamol and let's review things in a couple of weeks".

This year the picture's been complicated somewhat by the perpetual fear of swine flu that appears to be regarded by most patients as just a notch down in severity from the bubonic plague. An interesting result of the heightened swine flu awareness though does appear to be an increasing appreciation that antibiotics do not treat viruses.

What are your experiences?

A principle of psychology?

Whenever two people meet, there are really six people present. There is each man as he sees himself, each man as the other person sees him, and each man as he really is.

William James, The Principles of Psychology (1890)

Luna(r)cy

Something I posted in April. Here we go again...

With the imminent advent of moonfighting committees to diffuse the havoc caused by moonsighting committees, and the launch of the new Conservative manifesto, perhaps it's time to borrow a Tory phrase and get 'back to basics'. The perennial drive to standardise the Islamic calendar may well be blinkering us from the actual ethos behind the act of moonsighting - regaining a sense of perspective.

Hamza Yusuf touches on the issue in his commentary on Sachiko Murata and William Chittick's 'Vision of Islam' by quoting an unnamed Scottish phenomenologist:

There are efforts to standardise the Islamic calendar so that Ramadhan can be started on the same day in different communities. But the relationship of the celestial bodies to the earth is a living thing and every location has its own sky. So why shouldn't religious festivals begin on dates peculiar to different places? The modern mind, however, wishes to generalise and abstract the situation so the phenomena are bypassed. As with the length of the day, the average is calculated and becomes the accepted truth to accommodate the limits of circular wheels in clocks, yet none of the celestial bodies moves in circles.

You can listen to the relevant extract (in mp3 format) from Hamza Yusuf's commentary here.

Some comments arising therefrom:

Mohammed said...
Yeah i just listened to that snippet yesterday on the zaytuna website. I found it to be insightful. I wish ppl would explain the system of moonsighting itself as well. I think 99.9% of muslims dont understand it, including me.

10/04/2005 10:55 PM

Anonymous said...
Since Islam encourages the use of technology, I (even as a girl) would say it was quite simple to click on an obervatory website (Jodrell Bank for example) and in 2 seconds flat, you can find out if the moon has been sighted. They use these MASSIVE telescopes that are awfully complicated and surprisingly accurate. Easy as pie.

11/02/2005 12:43 PM

Leo_Africanus said...
But where's the fun in that?!

11/02/2005 1:08 PM

Another New (Testament) Diet

It was only a matter of time.

Five loaves, two fish and a goblet of red wine could be on the menu for Americans if a new diet takes off.

Don Colbert, a Florida doctor, believes asking yourself "What would Jesus eat?" is the best way to stay fit, slim and trim.

In his book, which gets its title from this question, he explores some of the Old Testament dietary laws and looks at foods mentioned in the Bible.

Click here for the full story.

Luna(r)cy

With the imminent advent of moonfighting committees to diffuse the havoc caused by moonsighting committees, and the launch of the new Conservative manifesto, perhaps it's time to borrow a Tory phrase and get 'back to basics'. The perennial drive to standardise the Islamic calendar may well be blinkering us from the actual ethos behind the act of moonsighting - regaining a sense of perspective.

Hamza Yusuf touches on the issue in his commentary on Sachiko Murata and William Chittick's 'Vision of Islam' by quoting an unnamed Scottish phenomenologist:

There are efforts to standardise the Islamic calendar so that Ramadhan can be started on the same day in different communities. But the relationship of the celestial bodies to the earth is a living thing and every location has its own sky. So why shouldn't religious festivals begin on dates peculiar to different places? The modern mind, however, wishes to generalise and abstract the situation so the phenomena are bypassed. As with the length of the day, the average is calculated and becomes the accepted truth to accommodate the limits of circular wheels in clocks, yet none of the celestial bodies moves in circles.

You can listen to the relevant extract (in mp3 format) from Hamza Yusuf's commentary here.

Marburg Virus

Here's a mugshot of the villain responsible for the recent outbreak in Angola. They say you can develop an impression of someone by knowing their friends and family; Marburg virus is a cousin of Ebola!

An electron micrograph of the Marburg Virus (courtesy of I Love Science)

Intelligent Incarceration

I'm not sure if it's the author's name or the actual content of the article that leads me to quote it. Perhaps both. Although you've got to admit that 'Marcus du Sautoy' adds a certain charm to any blog.

In a comment piece for the Guardian, the professor of mathematics at Oxford University (boo!), takes an admittedly succint look at how the solitude of prison has in fact been instrumental in the development of mathematics.

In 1940, the pacifist and mathematician André Weil, brother of the famous philosopher Simone Weil, found himself in prison awaiting trial for desertion. An Indian friend of Weil's had once joked that "if I could spend six months or a year in prison, I would most certainly be able to prove the Riemann hypothesis" - the greatest unsolved problem of mathematics. Now Weil had the chance to put the theory to the test.

During those months in Rouen prison, Weil made a breakthrough on a problem closely linked to Riemann's conjecture. He wrote to his wife: "My mathematics work is proceeding beyond my wildest hopes, and I am even a bit worried - if it is only in prison that I work so well, will I have to arrange to spend two or three months locked up every year?" On hearing of his breakthrough, fellow mathematician Henri Cartan wrote back to Weil: "We're not all lucky enough to sit and work undisturbed like you..."

The Puzzle of Aspirin and Sex

In the latest issue of the prestigious New England Journal of Medicine Dr Richard Levin takes a deeper look at the differential effect of aspirin in males and females brought to the fore by the publishing of the Women's Health Trial.

To summarise, the Physicians' Health Trial conducted in the 1980s looked at an exclusively male population to see whether low-dose aspirin had any effect on reducing cardiovascular problems (e.g. heart attacks, strokes) and found "that aspirin significantly reduced the risk of myocardial infarction: the reduction was 44 percent in men 50 years of age or older who did not have clinical evidence of coronary disease. There was no significant effect on the risk of stroke and no effect on mortality from cardiovascular causes."

The current Women’s Health Study shows, at least in women younger than 65 years of age who do not have a history of cardiovascular disease, that aspirin has no significant effect either on the risk of myocardial infarction or on the risk of death from cardiovascular causes but that it is associated with a 24 percent reduction in the risk of ischemic stroke and a 17 percent reduction in the risk of stroke overall...The findings in men and women are opposite. How can this be?

This is not the first biological phenomenon wherein a gender bias has been noted. An association between autoimmune diseases and females has been long recognised and the differing hormonal millieux have been implicated.

Some fascinating insights in the editorial:

• "Concentrations of salicylate are higher in women than in men after identical doses of aspirin, and platelets from women and men who have ingested aspirin show different responses when tested in vitro."


• "Women have smaller coronary arteries, and quite remarkably, when a man receives a woman’s heart through cardiac transplantation, the smaller female arteries grow larger in the male recipients, independently of body-surface area."


• "The cardiovascular systems of women and men are not the same, differing expression of disease follows, and the disquieting results of the current study should not be a complete surprise."

The article concludes:

On the basis of the Women’s Health Study, for now it would appear reasonable to avoid prescribing “low-dose” aspirin, defined as a daily dose of 75 to 100 mg or so, as a preventative measure for coronary disease in women under the age of 65 years unless the global risk score is very high.

But what about the prevention of stroke? Ridker and colleagues conclude, correctly, that the decision to prescribe aspirin for the primary prevention of stroke and other vascular events should be left to the patient and her physician, invoking an ancient truth. Hippocrates, dean of medicine on the island of Cos some 2400 years ago, popularized white-willow salicin, the precursor of aspirin, and wrote in the first of the Aphorisms, “Life is short, the art long, opportunity fleeting, experiment treacherous, judgment difficult.”

Don't forget to use BugMeNot to get access to the full articles.

Turmeric

Spices and herbs aren't exempt from cyclical fads. Turmeric is the new black. Amongst myriad other claims, it has been linked with slowing down the progression of Alzheimer's disease, the prevention of alcoholic liver disease, the treatment/prevention of leukaemia and, most recently, being an anti-malarial agent.

The active ingredient is thought to be curcumin, the chemical that lends turmeric its distinctive yellow hue.