Distribution of distress in post-socialist Mongolia: a cultural epidemiology of yadargaa.

This study discusses quality of life in post-socialist Mongolia. Yadargaa, a fatigue-related illness in traditional Mongolian medicine, results from lifestyle imbalance. We examine the distribution of yadargaa and its association to socioeconomic changes under capitalism. Ethnographic interviews concerning yadargaa were conducted with health professionals, yadargaa patients, and laypersons. Epidemiological methods were used to identify risk groups, to estimate the point prevalence, and to assess the distribution of meanings and interpretations of yadargaa. The epidemiological sample included 194 individuals, half urban and half rural. Nearly half of the epidemiological sample suffered from yadargaa (49%). These yadargaa sufferers felt that they benefited less than non-yadargaa subjects from the current socioeconomic changes. Among these, perceived change in employment opportunities was one of the best predictors of yadargaa. Additionally, yadargaa sufferers were predominantly women, the elderly, and urban residents. Yadargaa varies greatly in presentation; Western psychiatric categories are only able to explain half of yadargaa cases. In conclusion, yadargaa strongly associates with disenfranchised groups in the capitalist economy. As a culturally constructed indicator of quality of life, yadargaa is a window into the lives of women and men in post-socialist Mongolia.