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Kanougiya S, Daruwalla N, Osrin D. Mental health on two continua: mental wellbeing and common mental disorders in a community-based cross-sectional study with women in urban informal settlements in India. BMC Womens Health 2024; 24:555. [PMID: 39385168 PMCID: PMC11463130 DOI: 10.1186/s12905-024-03389-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 09/25/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND We considered the suggestion that mental health is the product of two intersecting continua: psychological distress and mental wellbeing. OBJECTIVES To understand prevalences of low mental wellbeing, depression and anxiety, and examine associations between them and with sociodemographic variables. METHODS In a cross-sectional survey in informal settlements, 4906 women aged 18-49 years answered questions on mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale: SWEMWBS) and symptoms of depression (Patient Health Questionnaire: PHQ-9) and anxiety (Generalised Anxiety Disorder: GAD-7). We used regression models to examine associations of lower mental wellbeing with symptoms suggesting moderate-to-severe depression and anxiety, and with sociodemographic characteristics. RESULTS About 15% of women reported symptoms of low wellbeing, 9% symptoms of moderate-to-severe depression, and 6% symptoms of moderate-to-severe anxiety. Women with low wellbeing did not necessarily report symptoms suggesting anxiety or depression, and women with anxiety or depression did not necessarily report low wellbeing. In adjusted models, poorer and less educated women were more likely to report low wellbeing. Symptoms of anxiety or depression were more likely to be reported by widowed, separated, or divorced women, women who were in paid employment, and women who used drugs or alcohol themselves or whose partners did. Women with low wellbeing had at least double the odds of reporting symptoms of moderate-to-severe depression or anxiety than women who reported greater wellbeing. CONCLUSION The findings support the idea of two continua of mental health. How individual women cope with mental illness and nevertheless enjoy a state of wellbeing deserves more study.
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Affiliation(s)
- Suman Kanougiya
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, 603203, India.
| | - Nayreen Daruwalla
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra, 400017, India
| | - David Osrin
- Institute for Global Health, University College London, London, WC1N IEH, UK
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Gala P, Ticku A, Pawar T, Sapre S, Gupta P, Iyer K, Kapoor H, Kalahasthi R, Kulkarni S, Iyer P. Perspectives and presentation of mental health among women from rural Maharashtra (India): A qualitative study. Glob Ment Health (Camb) 2024; 11:e40. [PMID: 38618481 PMCID: PMC11016358 DOI: 10.1017/gmh.2024.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/21/2024] [Accepted: 02/23/2024] [Indexed: 04/16/2024] Open
Abstract
Objectives A significant gap is observed between the proportion of individuals suffering from mental health (MH)-related conditions and those receiving adequate MH care services, especially in rural areas. This study highlights and contextualizes MH concerns and its extant knowledge as well as gender roles in rural Maharashtra (India). Methods Using in-depth interviews, MH themes were highlighted analytically among 72 female beneficiaries of Svatantra from the six administrative divisions (Konkan, Nashik, Pune, Aurangabad, Amravati and Nagpur) in the state of Maharashtra, India. Results The notion that MH concerns exist among women from rural communities was well supported. Along with MH concerns, the participants reported somatic concerns in the context of adverse life experiences. Furthermore, systemic issues such as financial problems, familial concerns, presence of addictions and pressures of gender role-related responsibilities were significant triggers for MH problems. Conclusions Overall, this study aimed at improving the understanding of the MH needs of women in rural Maharashtra, which can further catalyze an exploration of their general MH and devise suitable interventions for the same.
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Affiliation(s)
| | | | | | | | - Pooja Gupta
- Department of Psychiatry, National institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Hansika Kapoor
- Department of Psychology, Monk Prayogshala, Mumbai, India
| | | | | | - Poorvi Iyer
- London School of Economics and Political Science, London, UK
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Petarli GB, Cattafesta M, Viana MCM, Bezerra OMDPA, Zandonade E, Salaroli LB. Depression in Brazilian farmers: prevalence and associated factors. J Ment Health 2024; 33:127-135. [PMID: 35521667 DOI: 10.1080/09638237.2022.2069701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/23/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND The unique characteristics of rural areas and agricultural work can contribute to the genesis of diseases, including mental disorders such as depression. AIMS To estimate the prevalence of and factors associated with depression symptoms in Brazilian farmers. METHODS A cross-sectional epidemiological study involving 784 farmers of the state of Espírito Santo/Brazil was carried out. Depression was identified using the Mini-International Neuropsychiatric Interview. Hierarchical logistic regression was used to assess the associated factors. RESULTS The prevalence of depression symptoms among farmers was 16.8% (n = 132). Of those experiencing symptoms, 6.1% (n = 48) we're currently experiencing a depressive episode, and 10.7% (n = 84) a recurrent depressive episodes. The associated factors were: female gender (OR 1.63; 95% CI 1.04-2.54), not owning the land (OR 1.79; 95% CI 1.11-2.89), professional dissatisfaction (OR 1.99; 95% CI 1.18-3.35), previous pesticide poisoning (OR 2.87; 95% CI 1.45-5.67), complex multimorbidity (OR 1.95; 95% CI 1.15-3.31) and occurrence of previous depressive episodes (OR 9.83; 95% CI 4.39-21.99). CONCLUSIONS A high prevalence of depression symptoms was identified among rural workers. Sociodemographic, occupational, clinical, and professional dissatisfaction factors were associated with a higher risk of depression symptoms in this population.
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Affiliation(s)
- Glenda Blaser Petarli
- Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Esspírito Santo, Brazil
| | - Monica Cattafesta
- Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Esspírito Santo, Brazil
| | - Maria Carmen Moldes Viana
- Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Esspírito Santo, Brazil
| | - Olívia Maria de Paula Alves Bezerra
- Department of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Eliana Zandonade
- Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Esspírito Santo, Brazil
| | - Luciane Bresciani Salaroli
- Postgraduate Program in Nutrition and Health and Postgraduate Program in Collective Health, Center for Health Sciences, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Alwis I, Baminiwatta A, Chandradasa M. Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024; 59:353-373. [PMID: 37256323 PMCID: PMC10230494 DOI: 10.1007/s00127-023-02495-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, assess its variability across subgroups, and identify associated factors within each subgroup. METHODS PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. RESULTS A total of 33 studies representing a total of 52,778 participants were included. Overall, the pooled prevalence of depression was 19.4% [14.44-25.54%]. Among subpopulations, the highest prevalence was reported among young persons (39%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 16.9%, respectively. Prevalence estimates were higher when based on screening instruments (21.2%) compared to diagnostic interviews (4.3%). A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances and broader environmental factors, is reported for each age group. CONCLUSION Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. The heterogeneity of studies limits the inferences drawn from this review.
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Affiliation(s)
- Inosha Alwis
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
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Vidyasagaran AL, McDaid D, Faisal MR, Nasir M, Muliyala KP, Thekkumkara S, Wright J, Huque R, Benkalkar S, Siddiqi N. Prevalence of mental disorders in South Asia: A systematic review of reviews. Glob Ment Health (Camb) 2023; 10:e78. [PMID: 38161740 PMCID: PMC10755414 DOI: 10.1017/gmh.2023.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024] Open
Abstract
Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental disorders and intentional self-harm in the region. Multiple databases were searched and systematic reviews reporting the prevalence of at least one mental disorder from countries in SA were included. Review data were narratively synthesised; primary studies of common mental disorders (CMDs) among adults were identified from a selected subset of reviews and pooled. We included 124 reviews. The majority (n = 65) reported on mood disorders, followed by anxiety disorders (n = 45). High prevalence of mental disorders and intentional self-harm was found in general adult and vulnerable populations. Two reviews met our pre-defined criteria for identifying primary studies of CMDs. Meta-analysis of 25 primary studies showed a pooled prevalence of 16.0% (95% CI = 11.0-22.0%, I 2 = 99.9%) for depression, 12.0% (5.0-21.0%, I 2 = 99.9%) for anxiety, and 14.0% (10.0-19.0, I 2 = 99.9%) for both among the general adult population; pooled estimates varied by country and assessment tool used. Overall, reviews suggest high prevalence for mental disorders in SA, but evidence is limited on conditions other than CMDs.
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Affiliation(s)
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Muhammad Nasir
- Department of Economics, Institute of Business Administration (IBA), Karachi, Pakistan
| | - Krishna P. Muliyala
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | | | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Najma Siddiqi
- Department of Health Sciences, University of York, Heslington, UK
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Akhouri D, Bashir T, Kumar S. Management of post-COVID-19 depression among patients of Western Uttar Pradesh of Northern India. Ind Psychiatry J 2023; 32:S236-S242. [PMID: 38370966 PMCID: PMC10871436 DOI: 10.4103/ipj.ipj_234_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/26/2023] [Accepted: 09/08/2023] [Indexed: 02/20/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) affects not only individual's physical health but also their well-being and makes them vulnerable in different ways. Post-COVID-19 depression is dependent on the dynamic interaction between social, medical, economic, geographical, and political factors determining the availability, vulnerability, and distribution of pandemic outbreaks that create fear apprehension and instability among the population. Aim To evaluate the level of depression (pre and post) and the management of depression among patients from Western Uttar Pradesh of Northern India after the pandemic of COVID-19. Materials and Methods It was a longitudinal study involving a total of 156 patients with depression. Through chit randomization methods, patients are allocated into two groups, that is, experimental (n=92) and control (n=64). Both groups received appropriate pharmacotherapy. The experimental group in addition also underwent eight therapeutic sessions of cognitive behavior therapy (CBT) (relaxation breathing exercise, activity scheduling, and cognitive restructuring). The period of study was from July 2021 to January 2022. Depression was assessed by applying the Beck Depression Inventory (BDI-II) pre- and post-intervention. Results According to BDI II, 59.78% of patients report severe levels, 25% of patients report moderate levels, and 15.21% report mild levels of depression. Patients who received medications plus CBT showed significantly better improvement than the patients who received only medications. Conclusion Patients with post-COVID-19 depression showed better improvement with medications plus CBT than medications alone. The finding of this study underline the importance of CBT in the treatment of depression.
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Affiliation(s)
- Deoshree Akhouri
- Department of Psychiatry, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tabassum Bashir
- Department of Psychiatry, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shravan Kumar
- Department of Psychiatry, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Ubbla SR, Kodali PB, Thankappan KR. Depressive Disorders and Associated Factors among Farmers in Andhra Pradesh: Results from a Cross-Sectional Study. Indian J Occup Environ Med 2023; 27:235-240. [PMID: 38047172 PMCID: PMC10691518 DOI: 10.4103/ijoem.ijoem_33_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/03/2023] [Accepted: 04/15/2023] [Indexed: 12/05/2023] Open
Abstract
Background In the two decades from 1995 to 2018, approximately 48 farmers committed suicide every day, accounting for over 0.4 million deaths. Despite farmer's mental health being a priority, studies on farmers' mental health in general and depressive disorders in particular are limited. Aim This study was conducted to find out the prevalence and factors associated with depressive disorders among farmers in Andhra Pradesh. Materials and Methods We conducted a cross-sectional survey among a random sample of 360 farmers. Depressive disorders were measured using the Patient Health Questionnaire (PHQ)-9. Mild-to-moderate depressive disorders were the outcome variable. Factors associated with depressive disorders were identified using binary logistic regression. Results The overall prevalence of depressive disorders was 22.2% (95% CI = 18.0%-26.9%). Female farmers (AOR = 4.16; 95% CI = 1.19-14.57), farmers aged ≥57 years (AOR = 4.90; 95% CI = 1.44-16.63), and single farmers (AOR = 4.96; 95% CI = 2.08-11.80) have greater odds of having depressive disorders. Conclusion Efforts are required to address depressive disorders among farmers focusing on females, older farmers, and households reporting hospitalization. Since depressive disorders are closely associated with suicide attempts, these efforts are essential to avoid suicides resulting from depressive disorders.
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Affiliation(s)
- Sparjan Raj Ubbla
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Prakash Babu Kodali
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Kavumpurathu Raman Thankappan
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
- Department of Public Health, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Melo APS, Bonadiman CSC, Andrade FMD, Pinheiro PC, Malta DC. Depression Screening in a population-based study: Brazilian National Health Survey 2019. CIENCIA & SAUDE COLETIVA 2023; 28:1163-1174. [PMID: 37042897 DOI: 10.1590/1413-81232023284.14912022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 04/13/2023] Open
Abstract
This study evaluated the prevalence of positive screening for depression in Brazil and its associated factors. We used data from National Health Survey 2019 (Pesquisa Nacional de Saúde - PNS), a population-based survey with 88,531 adults. The Patient Health Questionnaire (PHQ-9) was used with two scoring methods, the algorithm and the cutoff point≥10. The variables included sociodemographic characteristics. The prevalence ratios and 95% confidence intervals (95%CI) were estimated using Poisson regression. The positive screening for depression was 10.8% (95%CI: 10.4-11.0), at the cutoff point ≥10 and 5.7% (95%CI: 5.4-6.0) for algorithm. Significant differences were found in prevalence in some Brazilian states. Multivariable analyses showed that being female, black, under 70 years of age, having little education, being single, and living in an urban area were independently associated with a depressive symptoms. The highest association was found in the states of Sergipe, Goiás, Piauí, Espírito Santo, São Paulo, Alagoas and lowest in Pará, Mato Grosso and Maranhão. The prevalence of positive screening for depression in Brazil has increased in recent years. More investment in mental health resources is necessary and surveys such as the PNS should be continued.
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Affiliation(s)
- Ana Paula Souto Melo
- Faculdade de Medicina, Universidade Federal de São João Del-Rei. Av. Sebastião Gonçalves Coelho 400, Sala 209A, Chanadour. 35501-296 Divinópolis MG Brasil.
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
| | | | - Fabiana Martins de Andrade
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
| | - Pedro Cisalpino Pinheiro
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
| | - Deborah Carvalho Malta
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
- Faculdade de Enfermagem, UFMG. Belo Horizonte MG Brasil
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Srivastava A, Davis JP, Patel P, Daniel EE, Karkal S, Rice E. Polyvictimization, Sex Work, and Depressive Symptoms Among Transgender Women and Men Who Have Sex With Men. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11089-NP11109. [PMID: 33530842 DOI: 10.1177/0886260521990840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article examined the association among polyvictimization, sex work, and depressive symptomology among transgender women and men who have sex with men (MSM) in India. Data comes from a cross-sectional epidemiological study with 1,366 transgender women (from three states) and 2,182 MSM participants from five states of India. Multivariate regressions were used to examine how polyvictimization and sex work are associated with depressive symptoms. In total, 70% of transgender women and 44% of MSM participants in the sample reported being in sex work; 30% of transgender women and 17% of MSM reported at least one experience of abuse in last 6 months. In bivariate analysis, transgender women in sex work were more likely to report sexual abuse, and MSM in sex work more likely to report all types of abuse (physical, sexual, verbal, and property), compared to their peers. In multivariate models (with transgender women and MSM), increase in endorsement on types of abuses (polyvictimization) and being in sex work were associated with higher odds of reporting depressive symptoms. Both models controlled for age and marital status, while the model with transgender women also controlled for gender transitioning, and the model with MSM controlled for identity typology. National intervention program on HIV risk reduction must prioritize victimization screening and crisis management as part of their work. In addition, the interventions must be responsive to the diversity of the population, including those who engage in sex work, and address issues of access and support to gender transitioning services, and focus on psychosocial interventions to reduce stress due to gender-based stigma and discrimination among transgender women and MSM.
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Affiliation(s)
| | | | - Prachi Patel
- Catalyst Management Services, Bengaluru, Karnataka, India
| | | | | | - Eric Rice
- University of Southern California, Los Angeles, CA, USA
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Estimating the global treatment rates for depression: A systematic review and meta-analysis. J Affect Disord 2021; 295:1234-1242. [PMID: 34665135 DOI: 10.1016/j.jad.2021.09.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/02/2021] [Accepted: 09/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification. METHODS We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683). RESULTS We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%. LIMITATION We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression. CONCLUSION Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.
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Marmamula S, Kumbham TR, Modepalli SB, Barrenkala NR, Yellapragada R, Shidhaye R. Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India. Sci Rep 2021; 11:16189. [PMID: 34376737 PMCID: PMC8355224 DOI: 10.1038/s41598-021-95576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged ≥ 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2-73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4-28.8) among those with VI only and 37.8% (95% CI: 26.6-46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, 500034, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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Srivastava A, Davis JP, Patel P, Daniel EE, Karkal S, Rice E. Sex work, gender transition, family rejection and depressive symptoms among transgender women in India. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2021; 24:49-58. [PMID: 36713140 PMCID: PMC9879189 DOI: 10.1080/26895269.2021.1939220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background: Transgender women in India face unique stressors associated with minority experiences, such as experiences of gender transition and participation in sex work. However, the relationship between sex work, transition and mental health outcomes is understudied in this population. Aims: This article aims to examine the association between gender transition status, sex work, family rejection and depressive symptoms among transgender women in India. Methods: Data comes from a cross-sectional epidemiological study with transgender women from three states of India; Karnataka, Maharashtra and Tamil Nadu (N = 1366). Multivariate regressions were used to examine the association between sex work status and gender transition and how gender transition, and sex work are associated with depressive symptoms. Results: 70% of the sample reported being in sex work and over 82% endorsed taking some form of gender transition service. Those who reported being in sex work were significantly more likely to have undergone breast augmentation, hormonal therapy and gender affirming surgery. Those who reported ever being married were less likely to report gender affirming surgery and were more likely to report hormonal therapy. Additionally, being in sex work, undergoing transition, leaving home because of sexual orientation, and being married were significantly associated with depressive symptoms. Discussion: Community-led organizations and other service agencies must incorporate intersectional experiences and identities, including sex work and gender transition, in their programs to further social and health justice for transgender women in India. Policy and programmatic implications are discussed. Supplemental data for this article is available online at https://doi.org/10.1080/26895269.2021.1939220.
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Affiliation(s)
- Ankur Srivastava
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute of Addiction Science, University of Southern California, Los Angeles, California, USA
| | | | | | | | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, University of Southern California, Los Angeles, California, USA
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Komanapalli V, Rao D. The mental health impact of caste and structural inequalities in higher education in India. Transcult Psychiatry 2021; 58:392-403. [PMID: 33131461 DOI: 10.1177/1363461520963862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to identify how mental health practice and policy in India can better address the needs of Dalit women and men in Indian institutions of higher education. Left unexamined, psychiatric and mental health practices and policies have become complicit in a legal and political network that actively denies the reality of caste discrimination in modern India. Frequently, Dalit students who choose to end their lives are described as having personal problems and depression, which enables institutional authorities to circumvent legal justice against caste discrimination and violence. Using an anthropological methodology of close readings of Dalit biographies and a review of ethnographic research, government reports, and online documentaries on the experiences of Dalit men and women, this study suggests that mental health practice and policy can change confidentiality laws, decriminalize student support groups, and build networks of institutional and policy support for Dalit students.
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Johnson Pradeep R, Ekstrand ML, Selvam S, Heylen E, Mony PK, Srinivasan K. Risk factors for severity of depression in participants with chronic medical conditions in rural primary health care settings in India. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 3. [PMID: 33681860 PMCID: PMC7929528 DOI: 10.1016/j.jadr.2020.100071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Depression and chronic medical disorders are strongly linked. There are limited studies addressing the correlates of the severity of depression in patients with co-morbid disorders in primary care settings. This study aimed to identify the socio-demographic and disease-specific risk factors associated with the severity of depression at baseline among patients participating in a randomized controlled trial (HOPE study). Methods Participants were part of a randomized controlled trial in 49 primary care health centers in rural India. We included adults (≥ 30 years) with at least mild Depression or Anxiety Disorder and at least one Cardiovascular disorder or Type 2 Diabetes mellitus. They were assessed for the severity of depression using the PHQ-9, severity of anxiety, social support, number of co-morbid chronic medical illnesses, anthropometric measurements, HbA1c, and lipid profile. Results Proportionately there were more women in the moderate category of depression than men. Ordinal logistic regression showed co-morbid anxiety and a lower level of education significantly increased the odds of more severe depression, while more social support was significantly negatively associated with depression severity in women. In men, anxiety was positively associated with greater depression severity; while reporting more social support was negatively associated with depression. Limitations This is a cross-sectional study and thus, no causal conclusions are possible. Conclusions Anxiety and poor social support in both genders and lower educational levels in women were associated with increased severity of depression. Early identification of risk factors and appropriate treatment at a primary care setting may help in reducing the morbidity and mortality associated with depression.
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Affiliation(s)
- R Johnson Pradeep
- Department of Psychiatry, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Maria L Ekstrand
- Division of Mental Health and Neurosciences, St. John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India.,Division of Prevention Sciences, University of California, San Francisco, United States
| | - Sumithra Selvam
- Division of Epidemiology & Population Health, St John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Elsa Heylen
- Division of Prevention Sciences, University of California, San Francisco, United States
| | - Prem K Mony
- Division of Epidemiology & Population Health, St John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Krishnamachari Srinivasan
- Department of Psychiatry, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India.,Division of Mental Health and Neurosciences, St. John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
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Ransing R, Kukreti P, Raghuveer P, Mahadevaiah M, Puri M, Pemde H, Karkal R, Patil S, Nirgude A, Kataria D, Sagvekar S, Deshpande SN. Development of a brief psychological intervention for perinatal depression (BIND-P). Asia Pac Psychiatry 2021; 13:e12436. [PMID: 33098740 DOI: 10.1111/appy.12436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lack of recognition in national programs, poor referral system, and non-availability of trained human resources are the important barriers for the delivery of perinatal depression (PND) services in low- and middle-income countries (LAMICs). To address this there is an urgent need to develop an integrative and non-specialist-based stepped care model. As part of its research thrust on target areas of India's National Mental Health Programme (NMHP), the Indian Council of Medical Research funded a research project on the outcome of PND at four sites. In this article, we describe the development of the primary health care worker-based stepped care model and brief psychological intervention for PND. METHODS A literature review focused on various aspects of PND was conducted to develop a model of care and intervention under NMHP. A panel of national and international experts and stakeholders reviewed the literature, opinions, perspectives, and proposal for different models and interventions, using a consensus method and WHO implementation toolkit. RESULTS A consensus was reached to develop an ANM (Auxillary nurse midwife)-based stepped-care model consisting of the components of care, training, and referral services for PND. Furthermore, a brief psychological intervention (BIND-P) was developed, which includes the components of the low-intensity intervention (eg, exercise, sleep hygiene). CONCLUSION The BIND-P model and intervention provide a practical approach that may facilitate effective identification, treatment, and support women with PND. We are currently evaluating this model across four study sites in India, which may help in the early detection and provision of appropriate and integrative care for PND.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Prerna Kukreti
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Pracheth Raghuveer
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Mahesh Mahadevaiah
- Department of Psychiatry, Dharwad Institute of Mental Health and Neurosciences (DIMHANS), Dharwad, Karnataka, India
| | - Manju Puri
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Harish Pemde
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Ravichandra Karkal
- Department of Psychiatry, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Suvarna Patil
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Abhay Nirgude
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Dinesh Kataria
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Shraddha Sagvekar
- Department of Mental Health Nursing, SVJCT's Samarth Nursing College, Sawarde, Ratnagiri, Maharashtra, India
| | - Smita N Deshpande
- Department of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental health, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Raghuveer P, Ransing R, Kukreti P, Mahadevaiah M, Elbahaey WA, Iyengar S, Pemde H, Deshpande SN. Effectiveness of a Brief Psychological Intervention Delivered by Nurse for Depression in Pregnancy: Study Protocol for a Multicentric Randomized Controlled Trial from India. Indian J Psychol Med 2020; 42:S23-S30. [PMID: 33487799 PMCID: PMC7802037 DOI: 10.1177/0253717620971559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Perinatal depression (PD) has important implications for maternal and infant well-being but largely goes undetected. There is a need to develop low-intensity psychosocial interventions applicable to obstetric health care facilities. OBJECTIVE To assess the effectiveness of a brief psychological intervention for mild to moderate PD delivered by a nurse as compared to treatment-as-usual (TAU). METHODS This study is a randomized, open-label, parallel-group, multicentric trial being conducted in four sites of India. A total of 816 pregnant women with mild to moderately severe depression (Patient Health Questionaire-9 score of 5-19) are being assessed for the effectiveness of the intervention. Participants are randomly allocated to two groups of trial intervention (psychological intervention given by nurse) and TAU. The primary outcome is to compare the proportion of women reporting improvement across both groups. Participants are serially followed-up in each trimester and at 6, 10, 14 weeks, and 6 months postpartum. Secondary outcomes include pregnancy outcomes, feeding practices, physical growth, and immunization status of the infants. CONCLUSION It is a prospective pregnancy birth cohort with a robust design and long-term follow-up. This is one of the largest studies utilizing non-specialist health workers for the screening and management of PD. This study also holds promise to cast light on the course and outcome of depression during pregnancy in different parts of India. It is envisaged to help in developing a sound screening and referral-based protocol for obstetric settings.
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Affiliation(s)
- Pracheth Raghuveer
- Dept. of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Ramdas Ransing
- Dept. of Psychiatry, BKL Walawalkar Rural Medical College, Sawarde, Maharashtra, India
| | - Prerna Kukreti
- Dept. of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Mahesh Mahadevaiah
- Dept. of Psychiatry, Dharwad institute of Mental Health and Neurosciences (DIMHANS), Dharwad, Karnataka, India
| | | | - Satish Iyengar
- Dept. of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Harish Pemde
- Dept. of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Smita N. Deshpande
- Dept. of Psychiatry, De-Addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental health, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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17
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Ransing R, Deshpande SN, Shete SR, Patil I, Kukreti P, Raghuveer P, Mahadevaiah M, Bhosale N, Ramesh VO, Puri M, Bantwal P. Assessing antenatal depression in primary care with the PHQ-2 and PHQ-9: Can It Be carried Out by auxiliary nurse midwife (ANM)? Asian J Psychiatr 2020; 53:102109. [PMID: 32474343 PMCID: PMC10035069 DOI: 10.1016/j.ajp.2020.102109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/01/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023]
Abstract
Antenatal Depression (AD) is prevalent in India but remains unidentified and untreated in primary care settings. The Auxiliary Nursing Midwife (ANM), a non-specialist health care worker at antenatal care (ANC) clinic or at a primary care centre can improve the detection of women with AD. In this study, we aimed to estimate the inter-rater reliability of the Patient Health Questionnaire (PHQ-9) and PHQ-2, administered by ANMs, with mental health professionals, that is, Clinical Psychologists(CP). The prospective, blind, observational study was conducted in an antenatal clinic of tertiary care rural hospital of India. PHQ-2 and PHQ-9(Marathi) valid and translated versions were administered to consecutive antenatal women (n = 108) aged 18-45 years by two raters (CP, ANM) independently. Raters and data analyst were blinded to each other's scores. Kappa Coefficient, weighted kappa, Intra-class correlation coefficients (ICC) were used to assess Inter-rater reliability. The mean age of the study participants was 25.91 ± 4.39 years. Inter-rater reliability for PHQ-2 (Screen -Positive or Negative for depression) and PHQ-9 (Severity of depression) was (k = 0.675) and (kw = 0.732) respectively, which suggested the 'substantial' agreement between ANMs and CP. Among raters, the ICC (95 % confidence interval) was 0.90 (0.85, 0.93) for the PHQ-9 score and for the PHQ-2 was 0.873 (0.819-0.911), which was suggestive of excellent and good reliability respectively. The 'substantial' agreement and 'good to excellent' inter-rater reliability among ANM and CP suggest that these two scales can be used to screen and assess the severity of AD by either qualified or minimally trained, community health workers.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Maharashtra, 415606, India.
| | - Smita N Deshpande
- Dept. of Psychiatry, De-Addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental health, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India.
| | - Shreya R Shete
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Maharashtra, 415606, India.
| | - Ishwar Patil
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Maharashtra, 415606, India.
| | - Prerna Kukreti
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, 110001, India.
| | - Pracheth Raghuveer
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, 575018, India.
| | - Mahesh Mahadevaiah
- Department of Psychiatry, Dharwad institute of Mental Health and Neurosciences (DIMHANS), Dharwad, 580008, India.
| | - Nandkumar Bhosale
- Department of Obstetrics and gynecology, BKL Walwalkar Rural Medical College, Sawarde, Maharashtra, 415606, India
| | | | - Manju Puri
- Department of Obstetrics & Gynecology, Lady Hardinge Medical College, New Delhi, 110001, India.
| | - Priyanka Bantwal
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, 575018, India.
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Amit N, Ismail R, Zumrah AR, Mohd Nizah MA, Tengku Muda TEA, Tat Meng EC, Ibrahim N, Che Din N. Relationship Between Debt and Depression, Anxiety, Stress, or Suicide Ideation in Asia: A Systematic Review. Front Psychol 2020; 11:1336. [PMID: 32765333 PMCID: PMC7381269 DOI: 10.3389/fpsyg.2020.01336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/20/2020] [Indexed: 01/10/2023] Open
Abstract
Background: This article aims to review research manuscripts in the past 5 years that focus on the effects of debt on depression, anxiety, stress, or suicide ideation in Asian countries. Methods: A search for literature based on the PRISMA guidelines was conducted on Medline, PubMed, Web of Science, Scopus, and ScienceDirect, resulting in nine manuscripts meeting inclusion criteria. The studies were conducted in Thailand, Korea, Singapore, Pakistan, India, Cambodia, and China. Results: The findings of the studies show that there is evidence to support that being in debt is related to Asian participants experiencing depression, anxiety, stress, or suicide ideation. However, the studies are limited to quantitative studies only. The definition of debt is also unclear in most manuscripts. Few manuscripts also examined how other factors influence the relationship between debt and mental illness. Conclusion: There are limited studies on the psychological effects of debt on the Asian population. Future studies should focus on the relationship between debt and psychological well-being among this population.
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Affiliation(s)
- Noh Amit
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Psychology and Human Wellbeing Research Centre (PsiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Abdul Rahim Zumrah
- Faculty of Leadership and Management, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Mohd Azmir Mohd Nizah
- Faculty of Leadership and Management, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | | | - Edbert Chia Tat Meng
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Srinivasan M, Reddy MM, Sarkar S, Menon V. Depression, Anxiety, and Stress among Rural South Indian Women-Prevalence and Correlates: A Community-Based Study. J Neurosci Rural Pract 2020; 11:78-83. [PMID: 32140007 PMCID: PMC7055615 DOI: 10.1055/s-0039-1700595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background
The burden of common mental disorders (CMDs) which includes depression, anxiety, and stress-related disorders are on the rise in India. Women in rural areas form one of the high-risk groups with respect to CMDs due to their compromised status of living.
Objective
The aim of the study was to estimate the prevalence of depression, anxiety, and stress, and the predictors to depression among women in rural Puducherry.
Methods
A community-based, cross-sectional study was performed in 2016, among women aged 18 to 59 years, residing in the rural area of Puducherry. Prevalence of CMDs was determined using the Depression Anxiety Stress Scale (DASS)-21. Using a systematic random sampling method, women were interviewed in their houses. The socio-demographic characteristics along with risk factors for depression were captured using a semi-structured proforma. A multivariable logistic regression model was used to determine the predictors of depression.
Results
A total of 301 women were surveyed and their mean age (SD) was 34.9 (10.2) years. The prevalence of depression, anxiety, and stress was found to be 15% (95% CI: 11.3–19.3), 10.6% (95% CI: 7.5–14.5), and 5% (95% CI: 3–8), respectively. Multivariable analysis identified that lesser education and living separately/divorced to be significant predictors for depression in these women.
Conclusion
About one in six adult women living in a rural area was found to be depressed, which is considerably high. This emphasizes the need for screening among women for common mental disorders in primary care settings, especially in rural areas so that early diagnoses happen and thus reduce the impact due to mental disability.
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Affiliation(s)
- Manikandan Srinivasan
- Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - Mahendra M Reddy
- Department of Community Medicine, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
| | - Sonali Sarkar
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry (JIPMER), India
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Bhattacharyya S, Venkatesh P, Aditya KS, Burman RR. The Macro and Micro Point of View of Farmer Suicides in India. NATIONAL ACADEMY SCIENCE LETTERS 2020. [DOI: 10.1007/s40009-020-00920-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Distance to health services and treatment-seeking for depressive symptoms in rural India: a repeated cross-sectional study. Epidemiol Psychiatr Sci 2020; 29:e92. [PMID: 31928567 PMCID: PMC7214702 DOI: 10.1017/s204579601900088x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
AIMS Research from high-income countries has implicated travel distance to mental health services as an important factor influencing treatment-seeking for mental disorders. This study aimed to test the extent to which travel distance to the nearest depression treatment provider is associated with treatment-seeking for depression in rural India. METHODS We used data from a population-based survey of adults with probable depression (n = 568), and calculated travel distance from households to the nearest public depression treatment provider with network analysis using Geographic Information Systems (GIS). We tested the association between travel distance to the nearest public depression treatment provider and 12 month self-reported use of services for depression. RESULTS We found no association between travel distance and the probability of seeking treatment for depression (OR 1.00, 95% CI 0.98-1.02, p = 0.78). Those living in the immediate vicinity of public depression treatment providers were just as unlikely to seek treatment as those living 20 km or more away by road. There was evidence of interaction effects by caste, employment status and perceived need for health care, but these effect sizes were generally small. CONCLUSIONS Geographic accessibility - as measured by travel distance - is not the primary barrier to seeking treatment for depression in rural India. Reducing travel distance to public mental health services will not of itself reduce the depression treatment gap for depression, at least in this setting, and decisions about the best platform to deliver mental health services should not be made on this basis.
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Walther A, Tsao C, Pande R, Kirschbaum C, Field E, Berkman L. Do dehydroepiandrosterone, progesterone, and testosterone influence women's depression and anxiety levels? Evidence from hair-based hormonal measures of 2105 rural Indian women. Psychoneuroendocrinology 2019; 109:104382. [PMID: 31374371 PMCID: PMC6842697 DOI: 10.1016/j.psyneuen.2019.104382] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/16/2019] [Accepted: 07/16/2019] [Indexed: 01/19/2023]
Abstract
Depressive and anxiety disorders substantially contribute to the global burden of disease, particularly in poor countries. Higher prevalence rates for both disorders among women indicate sex hormones may be integrated in the pathophysiology of these disorders. The Kshetriya Gramin Financial Services study surveyed a random sample of 4160 households across 876 villages in rural Tamil Nadu, India. An interviewer-administered questionnaire was conducted to quantify depressive (K6-D) and anxiety (K6-A) symptoms. Alongside, hair samples for sex hormone profiling were collected from a subsample of 2105 women aged 18-85 years. Importantly, 5.9%, 14.8%, and 46.3% of samples contained non-detectable hormone levels for dehydroepiandrosterone, progesterone, and testosterone, respectively. Our primary analysis imputes values for the non-detectable sample and we check robustness of results when non-detectable values are dropped. In this cohort of women from rural India, higher depressive symptomatology is associated with lower levels of dehydroepiandrosterone and higher depressive and anxiety symptoms are associated with higher levels of testosterone. Progesterone shows no clear association with either depressive or anxiety symptoms. These results support a potential protective effect of higher endogenous dehydroepiandrosterone levels. An important caveat on the potential negative effect of hair testosterone levels on women's mental health is that the testosterone analysis is sensitive to how non-detectable values are treated.
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Affiliation(s)
- A Walther
- Biological Psychology, TU Dresden, Germany.
| | - C Tsao
- Princeton University, USA
| | - R Pande
- Department of Economics, Yale University, USA
| | | | - E Field
- Economics Department, Duke Trinity College of Arts & Sciences, USA
| | - L Berkman
- Center for Population and Development Studies, Harvard University, USA
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Viswanathan DJ, Veerakumar AM, Kumarasamy H. Depression, Suicidal Ideation, and Resilience among Rural Farmers in a Drought-Affected Area of Trichy District, Tamil Nadu. J Neurosci Rural Pract 2019; 10:238-244. [PMID: 31001011 PMCID: PMC6454957 DOI: 10.4103/jnrp.jnrp_257_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Changes in climatic conditions and other factors including trade and commerce have influenced agriculture worldwide. These factors have created a crisis among farmers. Objectives: The objective of this study was to find out the prevalence of depression and suicidal ideation, to measure the resilience, and to find out the factors that influence depression and resilience among farmers. Materials and Methods: A community-based cross-sectional analytical study was performed among farmers residing in a drought-affected area of Tiruchirappalli district of Tamil Nadu. The sample size was 191 and cluster sampling was used to select the participants. Structured, pretested questionnaires were used to find the prevalence of depression, suicidal ideation, and resilience among farmers. Pearson Correlation, Student's t-test, analysis of variance, and Pearson Chi-square test were used to identify the factors influencing depression and resilience. Results: A total of 194 farmers participated in the study. The mean age of the farmers was 46.68 ± 12.6 years, majority 64% were males and 89% were literates. Among the participants, 97.4% had some form of depression, and 67% had severe depression. About 60% of the farmers had suicidal ideation. Male farmers, farmers with few years of farming experience, and severe reduction in yield had a higher level of depression. Suicidal ideation was influenced by gender, small-scale farming, fewer years of experience in farming, and the impact of drought on yield. The mean resilience score was 49.4 ± 10. Gender and years of experience in farming had a significant association with resilience. Conclusion: High prevalence of depression and suicidal ideation and low level of resilience has been observed among the farmers. Interventions need to be provided for marginal and small-scale farmers, male farmers in the affected area to reduce the impact of drought in these farmers.
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Affiliation(s)
| | - A M Veerakumar
- Government Theni Medical College, Theni, Tamil Nadu, India
| | - Hemalatha Kumarasamy
- Trichy SRM Medical College Hospital and Research Centre, Tiruchirappalli, Tamil Nadu, India
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Arvind BA, Gururaj G, Loganathan S, Amudhan S, Varghese M, Benegal V, Rao GN, Kokane AM, B S C, P K D, Ram D, Pathak K, R K LS, Singh LK, Sharma P, Saha PK, C R, Mehta RY, T M S. Prevalence and socioeconomic impact of depressive disorders in India: multisite population-based cross-sectional study. BMJ Open 2019; 9:e027250. [PMID: 31253618 PMCID: PMC6609075 DOI: 10.1136/bmjopen-2018-027250] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 03/01/2019] [Accepted: 04/05/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The National Mental Health Survey (NMHS) of India was undertaken with the objectives of (1) estimating the prevalence and patterns of various mental disorders in representative Indian population and (2) identifying the treatment gap, healthcare utilisation, disabilities and impact of mental disorders. This paper highlights findings pertaining to depressive disorders (DD) from the NMHS. DESIGN Multisite population-based cross-sectional study. Subjects were selected by multistage stratified random cluster sampling technique with random selection based on probability proportionate to size at each stage. SETTING Conducted across 12 states in India (representing varied cultural and geographical diversity), employing uniform, standardised and robust methodology. PARTICIPANTS A total of 34 802 adults (>18 years) were interviewed. MAIN OUTCOME MEASURE Prevalence of depressive disorders (ICD-10 DCR) diagnosed using Mini International Neuropsychiatric Interview V.6.0. RESULTS The weighted prevalence of lifetime and current DD was 5.25% (95% CI: 5.21% to 5.29%, n=34 802) and 2.68% (95% CI: 2.65% to 2.71%, n=34 802), respectively. Prevalence was highest in the 40-59 age groups (3.6%, n=10 302), among females (3.0%, n=18 217) and those residing in cities with population >1 million (5.2%, n=4244). Age, gender, place of residence, education and household income were found to be significantly associated with current DD. Nearly two-thirds of individuals with DD reported disability of varying severity, and the treatment gap for depression in the study population was 79.1%. On an average, households spent INR1500/month (~US$ 23.0/month) towards care of persons affected with DD. CONCLUSION Around 23 million adults would need care for DD in India at any given time. Since productive population is affected most, DD entails considerable socioeconomic impact at individual and family levels. This is a clarion call for all the concerned stakeholders to scale up services under National Mental Health Programme in India along with integrating care for DD with other ongoing national health programmes.
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Affiliation(s)
- Banavaram Anniappan Arvind
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Santosh Loganathan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Senthil Amudhan
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Girish N Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Arun Mahadeo Kokane
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Chavan B S
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Dalal P K
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Kangkan Pathak
- Department of Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India
| | - Lenin Singh R K
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Lokesh Kumar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Pradeep Sharma
- Department of Psychiatry, Sawai Man Singh Medical COllege, Jaipur, Rajasthan, India
| | - Pradeep Kumar Saha
- Department of Psychiatry, Institute of Mental Health, Kolkata, West Bengal, India
| | - Ramasubramanian C
- State Nodal Officer, Mental Health Program, Chennai, Tamil Nadu, India
| | - Ritambhara Y Mehta
- Department of Psychiatry, Government Medical College, Surat, Gujarat, India
| | - Shibukumar T M
- Department of Psychiatry, Institute of Mental Health and Neuro Sciences, Kozhikode, Kerala, India
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Sarda A, Munuswamy S, Sarda S, Subramanian V. Using Passive Smartphone Sensing for Improved Risk Stratification of Patients With Depression and Diabetes: Cross-Sectional Observational Study. JMIR Mhealth Uhealth 2019; 7:e11041. [PMID: 30694197 PMCID: PMC6371066 DOI: 10.2196/11041] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 01/03/2023] Open
Abstract
Background Research studies are establishing the use of smartphone sensing to measure mental well-being. Smartphone sensor information captures behavioral patterns, and its analysis helps reveal well-being changes. Depression in diabetes goes highly underdiagnosed and underreported. The comorbidity has been associated with increased mortality and worse clinical outcomes, including poor glycemic control and self-management. Clinical-only intervention has been found to have a very modest effect on diabetes management among people with depression. Smartphone technologies could play a significant role in complementing comorbid care. Objective This study aimed to analyze the association between smartphone-sensing parameters and symptoms of depression and to explore an approach to risk-stratify people with diabetes. Methods A cross-sectional observational study (Project SHADO—Analyzing Social and Health Attributes through Daily Digital Observation) was conducted on 47 participants with diabetes. The study’s smartphone-sensing app passively collected data regarding activity, mobility, sleep, and communication from each participant. Self-reported symptoms of depression using a validated Patient Health Questionnaire-9 (PHQ-9) were collected once every 2 weeks from all participants. A descriptive analysis was performed to understand the representation of the participants. A univariate analysis was performed on each derived sensing variable to compare behavioral changes between depression states—those with self-reported major depression (PHQ-9>9) and those with none (PHQ-9≤9). A classification predictive modeling, using supervised machine-learning methods, was explored using derived sensing variables as input to construct and compare classifiers that could risk-stratify people with diabetes based on symptoms of depression. Results A noticeably high prevalence of self-reported depression (30 out of 47 participants, 63%) was found among the participants. Between depression states, a significant difference was found for average activity rates (daytime) between participant-day instances with symptoms of major depression (mean 16.06 [SD 14.90]) and those with none (mean 18.79 [SD 16.72]), P=.005. For average number of people called (calls made and received), a significant difference was found between participant-day instances with symptoms of major depression (mean 5.08 [SD 3.83]) and those with none (mean 8.59 [SD 7.05]), P<.001. These results suggest that participants with diabetes and symptoms of major depression exhibited lower activity through the day and maintained contact with fewer people. Using all the derived sensing variables, the extreme gradient boosting machine-learning classifier provided the best performance with an average cross-validation accuracy of 79.07% (95% CI 74%-84%) and test accuracy of 81.05% to classify symptoms of depression. Conclusions Participants with diabetes and self-reported symptoms of major depression were observed to show lower levels of social contact and lower activity levels during the day. Although findings must be reproduced in a broader randomized controlled study, this study shows promise in the use of predictive modeling for early detection of symptoms of depression in people with diabetes using smartphone-sensing information.
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Affiliation(s)
- Archana Sarda
- Sarda Centre for Diabetes and Selfcare, Aurangabad, India
| | - Suresh Munuswamy
- DST Health Informatics Rapid Design Lab, Indian Institute of Public Health-Hyderabad, Hyderabad, India
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Prevalence of and factors contributing to anxiety, depression and cognitive disorders among urban elderly in Odisha – A study through the health systems’ Lens. Arch Gerontol Geriatr 2019; 80:38-45. [DOI: 10.1016/j.archger.2018.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 11/18/2022]
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Wilkerson JM, Di Paola A, Rawat S, Patankar P, Rosser BRS, Ekstrand ML. Substance Use, Mental Health, HIV Testing, and Sexual Risk Behavior Among Men Who Have Sex With Men in the State of Maharashtra, India. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:96-107. [PMID: 29688773 PMCID: PMC6214349 DOI: 10.1521/aeap.2018.30.2.96] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Among 433 men who have sex with men in Maharashtra, India who completed an online survey, 23% reported hazardous drinking, 12% illicit substance, and 9% polysubstance use. The overall prevalence of depression and intimate partner violence (IPV) were 58% and 56%, respectively. Participants engaging in hazardous drinking had more sexual partners and were less likely to be married to women. Participants reporting illicit substance use or polysubstance use were more likely to have been out, had more sexual partners, or experienced IPV. Those reporting illicit substance use were more likely to engage in condomless anal sex. Based on our findings, we suggest that public health interventions integrate HIV, substance use, and mental health services.
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Affiliation(s)
- J Michael Wilkerson
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Angela Di Paola
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | | | | | - B R Simon Rosser
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Maria L Ekstrand
- University of California San Francisco Center for AIDS Prevention Studies, San Francisco, California
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Çakıcı M, Gökçe Ö, Babayiğit A, Çakıcı E, Eş A. Depression: point-prevalence and risk factors in a North Cyprus household adult cross-sectional study. BMC Psychiatry 2017; 17:387. [PMID: 29202790 PMCID: PMC5716299 DOI: 10.1186/s12888-017-1548-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 11/20/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Depression is one of the most common diagnosed psychiatric disorders in the world. Besides individual risk factors, it is also found that environment and socio-cultural factors are the other main risk factors for depression. In this article, the results of the 2016 national household survey of depression in North Cyprus (NC) are presented. The aim of the study is to determine the prevalence and possible risk factors of depression in NC households. METHODS The study was conducted between April and June 2016, the sample consisting of Turkish-speaking individuals between 18 and 88 years of age living permanently in NC. A multi-stage stratified (randomized) quota was used in the survey, and 978 people were selected according to the 2011 census. A 21 item questionnaire prepared by the researchers and a Turkish version of the Beck Depression Inventory scales were used for obtaining data. RESULTS This cross-sectional study found a point prevalence of 23.4% for relatively high BDI scores (≥17) suggesting clinical depression. Being female, a widow, unemployed, having a limited education and low income level, having a physical illness, living alone, and using illicit substances were defined as possible risk factors for depression. CONCLUSIONS When we consider the world prevalence, NC has one of the higher depression prevalence. NC has environmental and socio-cultural characteristics such as a history of war, migration and colonization, high unemployment rates, socioeconomic problems, similar to other extremely high prevalence depression countries and regions, which give a strong indication of the importance of socio-cultural factors on depression.
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Affiliation(s)
- Mehmet Çakıcı
- Department of Psychology, Near East University, Arts and Science Faculty, Lefkosa-Kibris, Mersin 10, Turkey
| | - Özlem Gökçe
- Department of Psychology, Near East University, Arts and Science Faculty, Lefkosa-Kibris, Mersin 10, Turkey
| | - Asra Babayiğit
- Department of Psychology, Near East University, Arts and Science Faculty, Lefkosa-Kibris, Mersin 10, Turkey
| | - Ebru Çakıcı
- Department of Psychology, Near East University, Arts and Science Faculty, Lefkosa-Kibris, Mersin 10, Turkey
| | - Ayhan Eş
- Department of Psychological Counselling and Guidance, Near East University, Faculty of Education, Lefkosa-Kibris, Mersin 10, Turkey
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Shidhaye R, Lyngdoh T, Murhar V, Samudre S, Krafft T. Predictors, help-seeking behaviour and treatment coverage for depression in adults in Sehore district, India. BJPsych Open 2017; 3:212-222. [PMID: 28904815 PMCID: PMC5592386 DOI: 10.1192/bjpo.bp.116.004648] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/28/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND National Mental Health Survey found that in India, the point prevalence of major depressive disorder (MDD) was 2.7% and the treatment gap was 85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and the treatment gap was 80%. AIMS To describe the baseline prevalence of depression among adults, association of various demographic and socioeconomic variables with depression and estimation of contact coverage for the same. METHOD Population-based cross-sectional survey of 3220 adults in Sehore district of Madhya Pradesh, India. The outcome of interest was a probable diagnosis of depression that was measured using the Patient Health Questionnaire (PHQ-9) and the proportion of individuals with depression (PHQ-9>9) who sought care for the same. The data were analysed using simple and multiple log-linear regression. RESULTS Low educational attainment, unemployment and indebtedness were associated with both moderate/severe depression (PHQ-9 score >9) and severe depression only (PHQ-9 score >14), whereas age, caste and marital status were associated with only moderate or severe depression. Religion, type of house, land ownership and amount of loan taken were not associated with either moderate/severe or only severe depression. The contact coverage for moderate/severe depression was 13.08% (95% CI 10.2-16.63). CONCLUSIONS There is an urgent need to bridge the treatment gap by targeting individuals with social vulnerabilities and integrating evidence-based interventions in primary care. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
- Rahul Shidhaye
- , MD, Associate Professor, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India; CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, The Netherlands, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tanica Lyngdoh
- , MD, MSc, PhD, Associate Professor, Indian Institute of Public Health Delhi, Public Health Foundation of India, New Delhi, India
| | - Vaibhav Murhar
- , MA (Applied Psychology), MSW, Project Director (PRIME), Sangath, Bhopal, India
| | - Sandesh Samudre
- , MPH, Senior Research Associate, Center for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India, and Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research Department, King's College London, London, UK
| | - Thomas Krafft
- , PhD, Professor, CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, The Netherlands, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, China, and Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India
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Brown CR, Hambleton IR, Sobers-Grannum N, Hercules SM, Unwin N, Nigel Harris E, Wilks R, MacLeish M, Sullivan L, Murphy MM. Social determinants of depression and suicidal behaviour in the Caribbean: a systematic review. BMC Public Health 2017; 17:577. [PMID: 28619069 PMCID: PMC5472962 DOI: 10.1186/s12889-017-4371-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 05/07/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Depressive disorder is the largest contributor to years lived with disability in the Caribbean, adding 948 per 100,000 in 2013. Depression is also a major risk factor for suicidal behaviour. Social inequalities influence the occurrence of depression, yet little is known about the social inequalities of this condition in the Caribbean. In support of the 2011 Rio Political Declaration on addressing health inequities, this article presents a systematic review of the role of social determinants on depression and its suicidal behaviours in the Caribbean. METHODS Eight databases were searched for observational studies reporting associations between social determinants and depression frequency, severity, or outcomes. Based on the PROGRESS-plus checklist, we considered 9 social determinant groups (of 15 endpoints) for 6 depression endpoints, totalling 90 possible ways ('relationship groups') to explore the role of social determinants on depression. Studies with ≥50 participants conducted in Caribbean territories between 2004 and 2014 were eligible. The review was conducted according to STROBE and PRISMA guidelines. Results were planned as a narrative synthesis, with meta-analysis if possible. RESULTS From 3951 citations, 55 articles from 45 studies were included. Most were classified as serious risk of bias. Fifty-seven relationship groups were reported by the 55 included articles, leaving 33 relationship groups (37%) without an evidence base. Most associations were reported for gender, age, residence, marital status, and education. Depression, its severity, and its outcomes were more common among females (except suicide which was more common among males), early and middle adolescents (among youth), and those with lower levels of education. Marriage emerged as both a risk and protective factor for depression score and prevalence, while several inequality relationships in Haiti were in contrast to typical trends. CONCLUSION The risk of bias and few numbers of studies within relationship groups restricted the synthesis of Caribbean evidence on social inequalities of depression. Along with more research focusing on regional social inequalities, attempts at standardizing reporting guidelines for observational studies of inequality and studies examining depression is necessitated. This review offers as a benchmark to prioritize future research into the social determinants of depression frequency and outcomes in the Caribbean.
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Affiliation(s)
- Catherine R Brown
- George Alleyne Chronic Disease Research Centre, Bridgetown, Barbados
| | - Ian R Hambleton
- George Alleyne Chronic Disease Research Centre, Bridgetown, Barbados
| | | | - Shawn M Hercules
- George Alleyne Chronic Disease Research Centre, Bridgetown, Barbados
- McMaster University, Hamilton, Canada
| | - Nigel Unwin
- George Alleyne Chronic Disease Research Centre, Bridgetown, Barbados
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Shidhaye R, Murhar V, Gangale S, Aldridge L, Shastri R, Parikh R, Shrivastava R, Damle S, Raja T, Nadkarni A, Patel V. The effect of VISHRAM, a grass-roots community-based mental health programme, on the treatment gap for depression in rural communities in India: a population-based study. Lancet Psychiatry 2017; 4:128-135. [PMID: 28063879 DOI: 10.1016/s2215-0366(16)30424-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/11/2016] [Accepted: 11/11/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND VISHRAM was a community-based mental health programme with the goal of addressing the mental health risk factors for suicide in people from 30 villages in the Amravati district in Vidarbha, central India. We aimed to assess whether implementation of VISHRAM was associated with an increase in the proportion of people with depression who sought treatment (contact coverage). METHODS A core strategy of VISHRAM was to increase the demand for care by enhancing mental health literacy and to improve the supply of evidence-based interventions for depression and alcohol-use disorders. Intervention for depression was led by community-based workers and non-specialist counsellors and done in collaboration with facility-based general physicians and psychiatrists. From Dec 25, 2013, to March 10, 2014, before VISHRAM was introduced, we did a baseline cross-sectional survey of adults randomly selected from the electoral roll (baseline survey population). The structured interview was administered by field researchers independent of the VISHRAM intervention and included questions about sociodemographic characteristics, health-care service use, depression (measured using the Patient Health Questionnaire [PHQ]-9), and mental health literacy. 18 months after VISHRAM was enacted, we repeated sampling methods to select a separate population of adults (18 month survey population) and administered the same survey. The primary outcome was change in contact coverage with VISHRAM, defined as the difference in the proportion of individuals with depression (PHQ-9 score >9) who sought treatment for symptoms of depression between the baseline and the 18 month survey population. Secondary outcomes were whether the distribution of coverage was equitable, the type of services sought, and mental health literacy. FINDINGS 1887 participants completed the 18 month survey interview between Sept 18, and Oct 8, 2015. The contact coverage for current depression was six-times higher in the 18 month survey population (27·2%, 95% CI 21·4-33·7) than in the baseline survey population (4·3%, 1·5-7·1). Contact coverage was equitably distributed across sex, education, income, religion, and caste. Most providers consulted for care were general physicians. We observed significant improvements in a range of mental health literacy indicators, for example, conceptualisation of depression as a mental health problem and the intention to seek care for depression. INTERPRETATION A grass-roots community-based programme in rural India was associated with substantial increase in equitable contact coverage for depression and improved mental health literacy. It is now crucially important to translate this knowledge into real-world practice by scaling-up this programme through the National Mental Health Programme in India. FUNDING Tata Trusts.
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Affiliation(s)
- Rahul Shidhaye
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | | | | | - Luke Aldridge
- TPO Nepal, Kathmandu, Nepal; Global Health Corps, New York, NY, USA
| | | | - Rachana Parikh
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India
| | - Ritu Shrivastava
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India
| | | | | | - Abhijit Nadkarni
- Sangath, Goa, India; Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Vikram Patel
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India; Sangath, Goa, India; Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK.
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Salcedo-Arellano MJ, Lozano R, Tassone F, Hagerman RJ, Saldarriaga W. Alcohol use dependence in fragile X syndrome. Intractable Rare Dis Res 2016; 5:207-13. [PMID: 27672544 PMCID: PMC4995423 DOI: 10.5582/irdr.2016.01046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 06/28/2016] [Accepted: 06/29/2016] [Indexed: 11/05/2022] Open
Abstract
Alcohol use disorders (AUDs) have been reported in a limited number of individuals with cognitive impairment but rarely in those with fragile X syndrome (FXS). However, in Colombia, culturally, alcohol consumption is very common. Here, we report eight cases of patients with FXS who have frequent alcohol consumption in Ricaurte, Colombia. Some of these patients have also used tobacco and illegal substances, including cocaine, which use has not been previously reported in those with FXS. Alcohol and substance use dependence is associated with exacerbation of their behavioral problems, such as increased impulsivity and aggression, as well as of medical problems such as an increased frequency of seizures.
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Affiliation(s)
- María J Salcedo-Arellano
- School of Medicine, Universidad del Valle, Cali, Colombia
- Research Group in Congenital & Perinatal Malformations, Dysmorphology and Clinical Genetics (MACOS), Universidad del Valle, Cali, Colombia
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Reymundo Lozano
- Seaver Autism Center. Departments of Genomic Sciences, Psychiatry and Pediatrics. Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Flora Tassone
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, Sacramento, CA, USA
- Department of Biochemistry and Molecular Medicine, University of California, Davis, USA
| | - Randi J Hagerman
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, Sacramento, CA, USA
- Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Wilmar Saldarriaga
- School of Medicine, Universidad del Valle, Cali, Colombia
- Research Group in Congenital & Perinatal Malformations, Dysmorphology and Clinical Genetics (MACOS), Universidad del Valle, Cali, Colombia
- Departments of Morphology and Obstetrics & Gynecology, Universidad del Valle, Hospital Universitario Del Valle, Cali, Colombia
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