SOCIO-ECONOMIC FACTORS FOR DEPRESSION IN WOMEN OF NORTHERN PAKISTAN: A CASE-CONTROL STUDY
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Abstract
OBJECTIVE: To find out the association between socio-economic factors with depression in women of Gilgit Baltistan (GB), Pakistan.
METHODS: This case-control study was conducted at various psychiatric facilities located in three districts of GB. Out of 450 participants, recruited through convenient sampling technique, 300 were depressed women according to DSM-5 criterion of depression, while 150 were well-matched controls from the same population. Logistic regression was applied to find out the association of socio-economic factors with depression.
RESULTS: Mean age of the participants was 36±11.2 years. About 40.7% (n=122/300) of cases and 16% (n=24/150) of controls were un-educated. Majority of cases (n=222/300: 74%) and controls (n=94/150; 62.7%) were married. About 66.7% (n=200/300) of cases and 48% (n=72/200) of controls were housewives. Odds of depression were 0.334 (95% CI: 0.132-0.848), 0.524 (95% CI: 0.186-1.475), 0.17 (95% CI: 0.045-0.637), & 0.38 (95% CI: 0.127-1.158) for women having primary, secondary, higher-secondary or graduation-level education respectively. Emotional abuse (odds=34.92, 95% CI: 6.281-194.190), lack of economic independence (freedom to spend) [odds=6.39; 95% CI: 1.535-26.630] and do not own land (odds=3.40; 95% CI: 1.126-10.307) were significantly associated with depression. Families with household income >20,000 Rupees/month (odds=0.22; 95% CI: 0.051-0.961) and cordial relationships with in-laws (odds=0.55; 95% CI: 0.241-1.262) were less likely to be depressed.
CONCLUSION: The study showed significant association of low level of education, emotional abuse, and lack freedom of spending with depression in women of northern Pakistan. The study underscores that socio-economic factors need to be considered in the management of depression among women.
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References
Murray CJL, Lopez AD (eds) World Health Organization (WHO), World Bank & Harvard School of Public Health. The Global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: Summary. USA: Harvard Press;1996, pp. 2-18. [Accessed on: January 10, 2020]. Available from URL: https://apps.who.int/iris/handle/10665/41864.
Gausia K, Fisher C, Ali M, Oosthuizen J. Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Womens Ment Health 2009;12(5):351–8. DOI: 10.1007/s00737-009-0080-7.
Mumford DB, Nazir M, Baig IY. Stress and psychiatric disorder in the Hindu Kush: a community survey of mountain villages in Chitral, Pakistan. Br J Psychiatry 1996;168(3):299–307. DOI: 10.1192/bjp.168.3.299.
Charara R, Forouzanfar M, Naghavi M, Moradi-Lakeh M, Afshin A, Vos T, et al. The burden of mental disorders in the Eastern Mediterranean Region, 1990-2013. PLoS One 2017;12(1):e0169575. DOI: 10.1371/journal.pone.0169575.
Aliani R, Khuwaja B. Epidemiology of postpartum depression in Pakistan: A review of literature. Natl J Heal Sci 2017;2(1):24–30. DOI: 10.21089/njhs.21.0024.
Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci 2015;40(4):219-21. DOI: 10.1503/jpn.150205.
Niaz U. Women's mental health in Pakistan. World Psychiatry 2004;3(1):60-2.
Bano S, Asif AF, Saadat S, Muhammad N. Socioeconomic factors of depression among females visiting outpatient clinic in district Ghizar, Gilgit-Baltistan, Pakistan: A pilot study. Khyber Med Univ J 2018;10(1):23-6.
National Institute of Population Studies (NIPS) [Pakistan] and ICF. 2019. Pakistan Demographic and Health Survey 2017-18. Islamabad, Pakistan, and Rockville, Maryland, USA: NIPS and ICF. [Accessed on: January 10, 2020]. Available from URL: http://nips.org.pk/abstract_files/PDHS%202017-18%20-%20key%20%20findings.pdf
Bano S. Socio-Economic Factors of Depression Among Women in Selected Districts of Gilgit-Baltistan, Pakistan (Doctoral dissertation, University of Peshawar, Peshawar, Pakistan).
Harding TW, de Arango MV, Baltazar J, Climent CE, Ibrahim HH, Ladrido-Ignacio L, et al. Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychol Med 1980;10(2):231-41. DOI: 10.1017/s0033291700043993.
American Psychological Association. Diagnostic and statistical manual of mental disorders 5th ed. USA: American Psychological Association; 2000. [Accessed on: January 05, 2020]. Available from URL: https://www.psychiatry.org/psychiatrists/practice/dsm.
Nisar N, Billoo N, Gadit AA. Prevalence of depression and the associated risks factors among adult women in a fishing community. J Pak Med Assoc 2004;54(10):519-25.
Kessler RC, Foster C, Webster PS, House JS. The relationship between age and depressive symptoms in two national surveys. Psychol Aging 1992;7(1):119-26. DOI: 10.1037/0882-7974.7.1.119.
Patel V, Kleinman A. Poverty and common mental disorders in developing countries. Bull World Health Organ 2003;81(8):609–15.
Husain N, Creed F, Tomenson B. Depression and social stress in Pakistan. Psychol Med 2000;30(2):395–402. DOI: 10.1017/s0033291700001707.
Hussain A. Education system of Pakistan: Issues, problems and solutions. Islamabad Policy Res Institute 2015. [Accessed on: January 08, 2020]. Available from URL: https://ipripak.org/education-system-of-pakistan-issues-problems-and-solutions/.
Ayub M, Irfan M, Nasr T, Lutufullah M, Kingdon D, Naeem F. Psychiatric morbidity and domestic violence: a survey of married women in Lahore. Soc Psychiatry Psychiatr Epidemiol 2009;44(11):953-60. DOI: 10.1007/s00127-009-0016-6.
Domestic Violence and Depression - Breaking the Cycle; 2013. [Accessed on: January 08, 2020]. Available from URL: https://www.promisesbehavioralhealth.com/addiction-recovery-blog/domestic-violence-and-depression-breaking-the-cycle/
Ahmed Z, Nisa Q, Yousufzai AW, Khoja S, Chaudhry J. Trends and patterns of suicide in people of Chitral, Khyber Pakhtunkhwa, Pakistan. Khyber Med Univ J 2016;8(2):72-7
Du Rocher Schudlich TD, Papp LM, Cummings EM. Relations between spouses' depressive symptoms and marital conflict: a longitudinal investigation of the role of conflict resolution styles. J Fam Psychol 2011 Aug;25(4):531-40. DOI: 10.1037/a0024216.
Zainab S, Fatmi Z, Kazi A. Risk factors for depression among married women belonging to higher and lower socioeconomic status in Karachi, Pakistan. J Pak Med Assoc 2012;62(3):249–53.
Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. Br Med J 2004;328(7443):794. DOI: 10.1136/bmj.328.7443.794.