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In both cultural settings the doctors who were sensitive to socio cultural factors used tools beyond pharmacotherapy and those who held improved quality of life as the goal of treatment as opposed to cure, reported greater success in managing people with these problems. Ariyananda, former Dean, Faculty of Medicine, University of Ruhuna, for support in obtaining study leave and a travel grant Dr Chandanie Hewage, Head, Department of Psychiatry at the Faculty of Medicine, University of Ruhuna, for constant support and encouragement over the study leave period My colleagues in the Department of Psychiatry, Faculty of Medicine, for covering the additional work during my study leave period Mrs Alex Motley, for help with correspondence and formatting Dr Simon Stockley, General Practitioner, for assistance with the pilot study Dr Amanda Gash, Consultant Psychiatrist and Dr Suresh Babu, Consultant Psychiatrist at the Tees Esk and Wear Valleys NHS Trust, Dr Deepak Dwarakanath, Consultant Gastroenterologist and Dr Anne Ryall, Consultant Gynaecologist at North Tees and Hartlepool NHS Trust, who were the co investigators for the UK arm of the qualitative study My co investigators from Sri Lanka for the prevalence study, Dr Gamini Jayawardene, Dr Gayani Punchihewa and Dr Ajith Jayasekera, Consultant Psychiatrists, from Teaching Hospital Karapitiya Galle, Professor Thilak Weerarathna and Dr Arosha Dissanayake, Consultant Physicians from Teaching Hospital Karapitiya Galle, Professor Malik Goonawardene and Dr Dammika Jayasooriya, Consultant Obstetricians from Teaching Hospital Mahamodera, Galle vi Dr Rachel Casiday, Dr Helen Hancock, Dr Helen Close, Dr Sharyn Maxwell, Dr Eileen Scott, Durham University, for helping with the methodological aspects of the research Professor James Mason, Director of Research, School of Medicine and Health, Durham University, for advice on statistical matters Dr J. Howse, Doctoral Researcher, Durham University, for second coding of transcripts Mrs Judith Walsh, Mrs Susan Williams, Durham University, for assistance with administrative matters Members of the NHS National Research Ethics Committee, Durham and Tees Valley Research Ethics Committee 2, and Research Ethics Committee, Faculty of Medicine, University of Ruhuna, for helping conduct an ethically sound research study Staff at the North Tees and Hartlepool NHS Trust, Research and Development Office for guidance on methodological and ethical aspects of the research Directors of Teaching Hospital Karapitiya, Galle and Teaching Hospital, Mahamodera, Galle, for permitting the analysis of patient records for the prevalence study All the participants in the research Mrs Barbara Hungin for encouragement and support Sri Lankan expatriate community for assistance with logistical aspects Staff at the Keenan House, where I was accommodated during my stay in the UK My family members for their constant encouragement and support during three long years of researching ..

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