Prevalence and factors related to psychological distress among ethnic minority adults in a semi-modern village in rural Vietnam: an evolutionary mismatch framework

Abstract

Background and objectives: Psychological distress is one of the greatest health threats facing humanity and has been hypothesized to represent an evolutionary mismatch. This hypothesis can be tested in semi-traditional societies that are undergoing transitions to modern lifestyles. This study used an evolutionary medicine framework to examine the predictors of psychological distress symptomology in a semi-modern ethnic minority village in rural Vietnam that is transitioning into a developing economy. Methodology: A cross-sectional survey was conducted in Chieng Sai Village among White Thai ethnic minority adults aged 18-75. The DASS-21 scale was used to measure the prevalence of psychological distress symptoms (depression and stress), and a closed format questionnaire was used to collect data on independent variables within an evolutionary mismatch framework. Binary logistic regression analyses were used to determine associated factors of psychological distress symptomology. Results: The prevalence of psychological distress symptoms was 22% (depression = 16.9%, stress = 16.3%). Common features of modernity, such as low levels of exercise, boredom, and low income, showed positive associations with psychological distress, while lifestyle features that were more similar to those expected in the evolutionary past and that fulfill evolutionary adaptations, such as getting enough sleep, adequate physical exertion, and access to resources (higher level of income), showed negative associations with psychological distress. Conclusions and implications: This study suggests that modern lifestyles might have generated evolutionary mismatches that are negatively impacting mental health in Chieng Sai Village. Further investigations on mental health in rural Vietnam are warrented. Future research should focus on determining the causal relationship between psychological distress and evolutionary mismatches. Evolutionary medicine approaches to understanding and preventing psychological distress are potential forces of insight to be considered in public health and educational policy.