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Singh D, Nasir S, Sharma J, Giménez-Llort L, Shahnawaz MG. Psychological Distress in Low-Income and Economically Marginalized Populations in India: Protective and Risk Factors. Behav Sci (Basel) 2024; 14:92. [PMID: 38392445 PMCID: PMC10886196 DOI: 10.3390/bs14020092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare.
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Affiliation(s)
- Dipti Singh
- Department of Psychology, Jamia Millia Islamia, New Delhi 110025, India;
| | - Shagufta Nasir
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (S.N.); (L.G.-L.)
| | - Juhi Sharma
- Light Up-Emotions Matter Foundation, New Delhi 110096, India;
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (S.N.); (L.G.-L.)
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Roberts L, Renati SJ, Solomon S, Montgomery S. Stillbirth and infant death: mental health among low-income mothers in Mumbai. BMC Pregnancy Childbirth 2021; 21:292. [PMID: 33838663 PMCID: PMC8037900 DOI: 10.1186/s12884-021-03754-0] [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] [Received: 10/06/2020] [Accepted: 03/24/2021] [Indexed: 02/26/2023] Open
Abstract
Background India has the highest number of stillbirths and the highest neonatal death rate in the world. In the context of its pronatalist society, women who experience perinatal loss often encounter significant social repercussions on top of grief. Furthermore, even when pregnancy outcomes were favorable, adverse life circumstances put some women at risk for postnatal depression. Therefore, perinatal loss and postnatal depression take a heavy toll on women’s mental health. The purpose of this study is to assess mental health among a sample of Mumbai slum-dwelling women with a history of recent childbirth, stillbirth, or infant death, who are at risk for perinatal grief, postnatal depression, or mental health sequelae. Methods We conducted a mixed method, cross-sectional study. A focus group discussion informed the development of a comprehensive survey using mainly internationally validated scales. After rigorous forward and back-translation, surveys were administered as face-to-face structured interviews due to low literacy and research naiveté among our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results Of our reproductive age (N = 260) participants, 105 had experienced stillbirth, 69 had a history of infant death, and 25 had experienced both types of loss. Nearly half of the sample met criteria for postnatal depression, and 20% of these women also met criteria for perinatal grief. Anxiety and depression varied by subgroup, and was highest among women desiring an intervention. Conclusions Understanding factors contributing to women’s suffering related to reproductive challenges in this pronatalist context is critically important for women’s wellbeing.
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Affiliation(s)
- Lisa Roberts
- School of Nursing, Loma Linda University, Loma Linda, USA.
| | - Solomon J Renati
- Veer Wajekar A. S. & C. College, University of Mumbai, Mumbai, India
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Roberts LR, Renati SJ, Solomon S, Montgomery S. Perinatal Grief Among Poor Rural and Urban Women in Central India. Int J Womens Health 2021; 13:305-315. [PMID: 33727864 PMCID: PMC7955753 DOI: 10.2147/ijwh.s297292] [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] [Received: 12/29/2020] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Given the pressures surrounding women's reproductive role in India, and persistent high rates of perinatal death, the purpose of this study is to describe and compare poor rural and urban Indian women's experiences of perinatal grief. PARTICIPANTS AND METHODS Two cross-sectional studies were compared on shared quantitative variables. Poor rural (N = 217) and urban, slum-dwelling (N = 149) Central Indian women with a history of stillbirth, and/or infant death were recruited with the aid of local community health workers. Trained, local, gender, and linguistically matched research assistants conducted the structured interviews. Shared quantitative variables include demographics, Social Provision Scale, Shortened Ways of Coping-Revised, Perinatal Grief Scale, social norms and autonomy. RESULTS While similar with respect to SES, age, number of living sons and perinatal loss experiences, these samples of poor women differed significantly across many variables, most notably women's household position, joint family living, number of live daughters, religious coping, autonomy, and degrees of perinatal grief. While perinatal grief was significantly associated with many variables bi-variably, most lost their relative influence in our stepwise multivariable modeling within site (rural/urban), with only social norms and social support remaining significant for rural (31% of variance) and wishful thinking and social norms for urban participants (38.4% of variance). In the combined sample household position, social support and social norms remained significant and explained 53.6% of the adjusted variance. CONCLUSION In both samples, perinatal grief was high following perinatal loss. Both groups of women with perinatal loss have increased risk of mental health sequelae. Notably, the context affected how they experienced perinatal grief, with rural women's grief being higher and more affected by their societal pressures and isolation. Such nuances are important considerations for much-needed tailored approaches to future interventions.
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Affiliation(s)
- Lisa R Roberts
- School of Nursing, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Solomon J Renati
- Psychology Department, Veer Wajekar A. S. & C. College, University of Mumbai, Navi Mumbai, 400702, India
| | | | - Susanne Montgomery
- School of Behavioral Health, Director of Research, Behavioral Health Institute, Loma Linda University, Loma Linda, CA, 92350, USA
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Abdi F, Rahnemaei FA, Shojaei P, Afsahi F, Mahmoodi Z. Social determinants of mental health of women living in slum: a systematic review. Obstet Gynecol Sci 2021; 64:143-155. [PMID: 33685034 PMCID: PMC7990997 DOI: 10.5468/ogs.20264] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/27/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE With the rise of urbanization globally, the problem of living in slums has become a problem for the civil society. As a vulnerable segment, women make up half of the population in these regions; therefore, women's mental health has always been a concern. The purpose of this study was to review the social determinants of mental health in women living in slum areas. METHODS We systematically reviewed articles published between 2009 and 2019 on the social determinants of women's mental health in SID, Magiran, Google scholar, PubMed, Scopus, Science Direct, Embase, MEDLINE, PsychINFO, and PsychARTICLES databases using MeSH keywords according to PRISMA guidelines. The quality of the studies was assessed depending on the type of study using Ottawa Newcastle" scale and Joanna Briggs Institute quality assessment tools. Finally, 23 studies were analyzed. RESULTS Different social determinants influenced the mental health of women living in slum areas. Among the structural determinants, the socioeconomic level had the highest frequency, and gender was in the second rank with the highest correlation with poorer women's mental health status. Among the intermediate determinants, living conditions, food insecurity, social capital, and social support were most frequently associated with mental health status. CONCLUSION Women living in slum areas are prone to developing mental disorders and poorer mental health; therefore, supporting these women and creating job opportunities to raise their incomes and, subsequently, improve their social, economic, and living conditions should be taken into consideration. In addition, this requires careful planning and comprehensive social support.
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Affiliation(s)
- Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Shojaei
- Department of Community Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Fatemeh Afsahi
- Master Student of Clinical Psychology, Department of Psychology, Islamic Azad University, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Jungari S, Chauhan BG, Bomble P, Pardhi A. Violence against women in urban slums of India: A review of two decades of research. Glob Public Health 2020; 17:115-133. [PMID: 33253046 DOI: 10.1080/17441692.2020.1850835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is estimated that about one-third of women ever experienced violence in their lifetime. India has experienced steady urban growth accompanying increase of urban populations living in slums. Several studies have reported prevalence of various forms of violence in urban slums. To our knowledge, no systematic review has been conducted exclusively reporting violence against women in India's urban slums. The review aims to synthesise the studies of violence against women conducted in the last two decades (2000-2020). We searched PubMed, Scopus and other relevant search engines to identify articles published between years 2000 and 2020, which focused on Indian women slum dwellers' experiences of violence. We included 14 studies, which satisfied the inclusion criteria in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was used to assess the studies. The prevalence of any form of violence against women, as reported in the studies, ranged from 15% to 59.3%. The major risk factors identified were husband's alcohol abuse, women justifying the violence inflicted on then, low educational levels of both women and men, dowry issues, age difference between the spouses and termination of a previous pregnancy. It is evident from the review that urban slum women experience persistent violence.
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Affiliation(s)
- Suresh Jungari
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Bal Govind Chauhan
- Population Research Centre, Gokhle Institute of Politics and Economics, Pune, India
| | - Priyanka Bomble
- Department of Public Health & Mortality Studies, International Institute of Population Sciences, Mumbai, India
| | - Ashish Pardhi
- School of Social Work, Tata Institute of Social Sciences, Mumbai, India
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Nadkarni A, Garber A, Costa S, Wood S, Kumar S, MacKinnon N, Ibrahim M, Velleman R, Bhatia U, Fernandes G, Weobong B, Rane A. Auditing the AUDIT: A systematic review of cut-off scores for the Alcohol Use Disorders Identification Test (AUDIT) in low- and middle-income countries. Drug Alcohol Depend 2019; 202:123-133. [PMID: 31349205 DOI: 10.1016/j.drugalcdep.2019.04.031] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/27/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cut-off scores recommended by the WHO. We reviewed the use and validity of AUDIT cut-off scores in low- and middle-income countries as cultural contexts are expected to influence the detection of alcohol use disorders. MATERIALS AND METHODS The systematic review was guided by an a priori defined protocol consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We searched Cochrane library, Medline, EMBASE, PsycINFO, CINAHL, Indmed, LILACS, and AJOL databases using appropriate search terms. We conducted a narrative synthesis of the data. RESULTS We identified 54 distinct studies that used AUDIT cut-off scores which were not in alignment with those recommended by the WHO. India (n = 10), Nigeria (n = 9), and Brazil (n = 9) produced most of these included studies. Most of the studies (n = 42) did not conduct psychometric evaluations of AUDIT cut-off scores. Of the twelve studies which did report psychometric results, a wide range of cut-off scores performed well. In these studies the cut-off scores to detect hazardous drinking ranged from >3 to >5, for harmful drinking from >5 to >16, and for dependent drinking from >7 to >24. DISCUSSION AUDIT is being widely used in LMICs and non-recommended cut-off scores are considered to be appropriate in these countries. It is important to systematically evaluate the psychometric properties of those cut-off scores to ensure the internal validity of the studies in which they are used.
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Affiliation(s)
- Abhijit Nadkarni
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India; Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Health Services and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
| | - Alison Garber
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India; Harvard University, Cambridge, Massachusetts, Boston, USA
| | - Sheina Costa
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Sheena Wood
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India; Harvard University, Cambridge, Massachusetts, Boston, USA
| | - Sonali Kumar
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Nathalie MacKinnon
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India; Faculty of Medicine, McGill University, Montreal, Canada
| | - Mariam Ibrahim
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Richard Velleman
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India; Department of Psychology, University of Bath, Bath, UK
| | - Urvita Bhatia
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Godwin Fernandes
- Addictions Research Group, Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | | | - Anil Rane
- Institute of Psychiatry and Human Behaviour, Bambolim, Goa, India
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Elewonibi B, BeLue R. The influence of socio-cultural factors on breast cancer screening behaviors in Lagos, Nigeria. ETHNICITY & HEALTH 2019; 24:544-559. [PMID: 28678532 DOI: 10.1080/13557858.2017.1348489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
Culture has been shown to influence health beliefs and health-related behaviors by influencing the type of health information to which women have been exposed and shapes health and illness perceptions and practices. To increase screening rates, cultural influences should be considered as important correlates of screening behaviors for breast cancer. This study used semi-structured interviews of women attending a cancer screening facility in Lagos, Nigeria guided by the PEN-3 model to describe culturally relevant factors that shape attitudes toward breast cancer and breast cancer screening. Religion was the most prominent theme and was shown to have positive, negative and existential effect on breast cancer perceptions. Other major themes observed were related to family and traditional beliefs. The results from this study could be used to develop and implement culturally relevant cancer prevention interventions, strategies, and recommendations to overcome screening barriers in an effort to increase breast cancer participation and awareness among Nigerian women.
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Affiliation(s)
- Bilikisu Elewonibi
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
| | - Rhonda BeLue
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
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Gailits N, Mathias K, Nouvet E, Pillai P, Schwartz L. Women's freedom of movement and participation in psychosocial support groups: qualitative study in northern India. BMC Public Health 2019; 19:725. [PMID: 31182064 PMCID: PMC6558745 DOI: 10.1186/s12889-019-7019-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 05/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression, the world's leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study's objective was to examine the factors influencing women's participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community's mental health. METHODS This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. RESULTS The principal barrier to participating in psychosocial support groups was restrictions on women's freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community's attitude toward gender relations, the women's own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women's ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women's freedom of movement. CONCLUSIONS Mental health access and gender inequality are inseparable in the context of Northern India, and women's mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women's freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women's freedom of movement.
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Affiliation(s)
- Nicola Gailits
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, Ontario, M5T 1P8, Canada.
| | - Kaaren Mathias
- Emmanuel Hospital Association, 808/92 Deepali Building, Nehru Place, Delhi, New Delhi, 110019, India
| | - Elysée Nouvet
- School of Health Studies, Western University, Labatt Health Sciences Bldg, Rm 215. 1151 Richmond St., London, ON, N6A 5B9, Canada
| | - Pooja Pillai
- Emmanuel Hospital Association, 808/92 Deepali Building, Nehru Place, Delhi, New Delhi, 110019, India
| | - Lisa Schwartz
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada
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Santos AGD, Monteiro CFDS, Feitosa CDA, Veloso C, Nogueira LT, Andrade EMLR. Types of non-psychotic mental disorders in adult women who suffered intimate partner violence: an integrative review. Rev Esc Enferm USP 2018; 52:e03328. [PMID: 29846484 DOI: 10.1590/s1980-220x2017030203328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identifying the types of non-psychotic mental disorders in adult women who suffered intimate partner violence in the literature. METHOD An integrative review carried out in the MEDLINE, CINAHL, LILACS, Web of Science and SCOPUS databases. RESULTS We selected 19 articles published in international journals in English, with a predominance of cross-sectional study studies (78.9%). The most common types of non-psychotic mental disorders were: depression (73.7%) and post-traumatic stress disorder (52.6%). It was observed that 78.9% of the articles presented a 2C level of evidence. CONCLUSION Studies have shown that adult women who are victims of intimate partner violence mostly suffer from depression and post-traumatic stress disorder, as well as other morbidities; a fact that highlights how devastating violence by an intimate partner can impact on the mental health of those who experience it.
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Affiliation(s)
- Ariane Gomes Dos Santos
- Programa de Pós-Graduação em Enfermagem, Universidade Federal do Piauí, Teresina, PI, Brasil
| | | | | | - Caique Veloso
- Programa de Pós-Graduação em Enfermagem, Universidade Federal do Piauí, Teresina, PI, Brasil
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Gupta A, Priya B, Williams J, Sharma M, Gupta R, Jha DK, Ebrahim S, Dhillon PK. Intra-household evaluations of alcohol abuse in men with depression and suicide in women: A cross-sectional community-based study in Chennai, India. BMC Public Health 2015; 15:636. [PMID: 26163294 PMCID: PMC4702375 DOI: 10.1186/s12889-015-1864-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/22/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India. METHODS This community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into 'low-risk', 'harmful', 'hazardous' and 'alcohol dependence' drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as 'mild', 'moderate', 'moderate-severe' and 'severe'. Multivariate logistic regression models estimated the association of depression in women with men's drinking patterns in the same household. RESULTS A significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were 'alcohol-dependent' compared to non-drinkers (OR = 2.53; 95% CI: 1.26, 5.09). However, there was no association between men's drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose-response relationship with increasing hazard-level of men's drinking (p = 0.08). CONCLUSION No significant intra-household association was observed between men's alcohol consumption and women's depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways.
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Affiliation(s)
- Adyya Gupta
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India.
| | | | | | - Mona Sharma
- Centre for Mental Health, Public Health Foundation of India, National Capital Region, India.
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India.
| | - Ruby Gupta
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India.
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India.
| | - Dilip Kumar Jha
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India.
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India.
| | - Shah Ebrahim
- Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Preet K Dhillon
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, National Capital Region, India.
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, National Capital Region, India.
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Kamimura A, Ganta V, Myers K, Thomas T. Intimate partner violence and physical and mental health among women utilizing community health services in Gujarat, India. BMC WOMENS HEALTH 2014; 14:127. [PMID: 25319589 PMCID: PMC4286938 DOI: 10.1186/1472-6874-14-127] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 10/06/2014] [Indexed: 11/23/2022]
Abstract
Background Intimate partner violence (IPV) is a significant public health threat which causes injury and acute and chronic physical and mental health problems. In India, a high percentage of women experience IPV. The purposes of this study include 1) to describe the lifetime prevalence of IPV, and 2) to examine the association between IPV and physical and mental health well-being, among women utilizing community health services for the economically disadvantaged in India. Methods Women utilizing community health services (N = 219) aged between 18 and 62 years completed a self-administered survey in Gujarat, India. Standardized instruments were used to measure perceived physical and mental health well-being. In addition, participants were asked about their lifetime experience with IPV, and socio-demographic questions. Analysis was restricted to the ever-married participants who completed the questions on IPV (N = 167). Results Participants with a lifetime history of IPV were more likely to have reported poorer physical and mental health compared to those without a lifetime history of IPV. More than half of the participants with an IPV history experienced multiple types of IPV (physical, sexual and/or emotional IPV). While being in the highest caste was a significant positive factor associated with better health, caste and other socio-demographic factors were not associated with IPV. Conclusions Women in India face risk of IPV. Yet those experiencing IPV do not seek help or rely on informal help sources. Community health organizations may take a role in IPV prevention and intervention. Diversity of intervention options would be important to encourage more women with IPV experience to seek help.
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Affiliation(s)
- Akiko Kamimura
- Department of Sociology, University of Utah, 380 S 1530 E, Salt Lake City, Utah 84112, USA.
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Colucci E, Hassan G. Prevention of domestic violence against women and children in low-income and middle-income countries. Curr Opin Psychiatry 2014; 27:350-7. [PMID: 25033276 DOI: 10.1097/yco.0000000000000088] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Violence against women and children is increasingly recognized as an important and urgent public health, social and human rights issue cutting across geographical, socioeconomic and cultural boundaries. There is a large and growing body of literature that demonstrates the negative impact of such violence on the victim's mental and physical health, as well as several other consequences on them, their families and communities. However, this literature for the most part comes from the so-called 'developed countries'. This review, at the opposite, focused on current literature on prevention of domestic/family violence against children and women in low and middle income countries (LMICs). RECENT FINDINGS Establishing effective prevention programmes for domestic violence against women and children in LMICs requires an understanding of the sociopolitical, economic and cultural settings and a multilevel collaboration among various stakeholders. SUMMARY This review confirms the lack of research in the so-called 'developing countries' and provides suggestions for further research and prevention efforts in this setting.
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Affiliation(s)
- Erminia Colucci
- aCentre for Mental Health, Global and Cultural Mental Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia bDepartment of Psychology, University of Quebec at Montreal, Montreal, Canada
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Heitzinger K, Montano SM, Hawes SE, Alarcón JO, Zunt JR. A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2014; 14:19. [PMID: 24885980 PMCID: PMC4040114 DOI: 10.1186/1472-698x-14-19] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 05/09/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND An estimated 863 million people-a third of the world's urban population-live in slums, yet there is little information on the disease burden in these settings, particularly regarding chronic preventable diseases. METHODS From March to May 2012, we conducted a cluster randomized survey to estimate the prevalence of noncommunicable diseases (NCDs) and associated risk factors in a peri-urban shantytown north of Lima, Peru. Field workers administered a questionnaire that included items from the WHO World Health Survey and the WHO STEPS survey of chronic disease risk factors. We used logistic regression to assess the associations of NCDs and related risk factors with age and gender. We accounted for sampling weights and the clustered sampling design using statistical survey methods. RESULTS A total of 142 adults were surveyed and had a weighted mean age of 36 years (range 18-81). The most prevalent diseases were depression (12%) and chronic respiratory disease (8%), while lifetime prevalence of cancer, arthritis, myocardial infarction, and diabetes were all less than 5%. Fifteen percent of respondents were hypertensive and the majority (67%) was unaware of their condition. Being overweight or obese was common for both genders (53%), but abdominal obesity was more prevalent in women (54% vs. 10% in men, p < 0.001). Thirty-five percent of men binge drank and 34% reported current smoking; these behaviors were less common among women (4% binge drank, p < 0.001; 8% smoked, p = 0.002). Increasing age was associated with an increased risk of abdominal obesity (Odds Ratio (OR) = 1.04, 95% CI = 1.01, 1.07, p = 0.02), hypertension (OR = 1.06, 95% CI = 1.02, 1.10, p = 0.006), arthritis (OR = 1.07, 95% CI = 1.03, 1.11, p < 0.001) and cancer (OR = 1.13, 95% CI = 1.07, 1.20, p < 0.001) in adjusted models. The prevalences of other NCDs and related risk factors were similar when stratified by age or gender. CONCLUSIONS This study underlines the important burden of noncommunicable disease in informal settlements in Peru and suggests that prevention and treatment interventions could be optimized according to age and gender.
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Affiliation(s)
| | | | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Jorge O Alarcón
- Instituto de Medicina Tropical “Daniel A. Carrión”, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Joseph R Zunt
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Departments of Neurology, Global Health, and Medicine, University of Washington, Seattle, WA, USA
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Reproductive health concerns of women contending with spousal violence and husband's alcohol use in a Mumbai slum community. Int J Gynaecol Obstet 2013; 122:268-9. [PMID: 23796257 DOI: 10.1016/j.ijgo.2013.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/08/2013] [Accepted: 05/23/2013] [Indexed: 11/21/2022]
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