1
|
Zabarra M, Obtel M, Sabri A, El Hilali S, Zeghari Z, Razine R. Prevalence and risk factors associated with mental disorders among migrants in the MENA region: A systematic review and meta-analysis. Soc Sci Med 2024; 357:117195. [PMID: 39128248 DOI: 10.1016/j.socscimed.2024.117195] [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: 03/16/2024] [Revised: 05/27/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND The MENA region has experienced extraordinary events in recent years, resulting in an influx of refugees and displaced people who are vulnerable to mental disorders. Several previous studies have examined their prevalence, but none have focused on this region. This systematic review provided an estimate of the prevalence of mental illness and associated risk factors in the MENA region, and overcame the methodological limitations of individual studies. METHODS Thorough searches of the relevant databases were carried out to locate relevant published articles. Furthermore, cross-sectional studies were conducted to assess mental disorders in refugees, asylum seekers, migrants, or internally displaced people residing in the MENA region. Only studies meeting the aforementioned criteria were considered. For this purpose, RStudio software version 2023.12.0 + 369 with netmeta package was used for measurement and data analysis. JBI used to assess study quality. RESULTS The results, including 32 cross-sectional studies with a total of 21659 participants were obtained and discussed. The overall prevalence was 42% (95% CI; 30%, 54%) for depression, 43% (95% CI; 31%, 57%) for anxiety, 22% (95% CI; 11%, 39%) for stress, and 45% (95% CI; 36%, 53%) for PTSD. As a result, it was noted that being female was associated with depression, and being female and unemployed was associated with PTSD, however being married was protective against this later. CONCLUSION Compared to the rest of the globe, MENA has a greater rate of mental illness among refugees. Nevertheless, much effort should be devoted on listing causes associated, as well as their management and prevention.
Collapse
Affiliation(s)
- Meryem Zabarra
- Laboratory of Community Health, Preventive Médecine and Hygiene & Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco; Medical Affairs and Strategy Division, Direction CHU Ibn Sina, Rabat, 10100, Morocco.
| | - Majdouline Obtel
- Laboratory of Community Health, Preventive Médecine and Hygiene & Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Abdellah Sabri
- Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Samia El Hilali
- Laboratory of Community Health, Preventive Médecine and Hygiene & Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Zhor Zeghari
- Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Rachid Razine
- Laboratory of Community Health, Preventive Médecine and Hygiene & Laboratory of Biostatistics, Clinical and Epidemiology Resarch, Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| |
Collapse
|
2
|
Developing a gender sensitive women's mental health service in Qatar: A rewarding challenge. Asian J Psychiatr 2022; 68:102969. [PMID: 34954612 DOI: 10.1016/j.ajp.2021.102969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/15/2021] [Indexed: 12/30/2022]
Abstract
Investigations into gender differences in the epidemiology of common mental disorders have highlighted the fundamental role of socio-economic factors as the key determinants in experiencing mental ill health and access to treatment. Women are almost always at a socio-economic disadvantage across cultures throughout the world and as a result experience mental health inequality. This disparity in control over their socio-economic determinants is even more stark in the Middle Eastern and North African region. This region has additionally also cultural and legal conditions that make women empowerment and access to health difficult. Qatar launched an ambitious National Health Strategic program and identified women's mental health as a priority. This paper describes the development of a gender aware mental health service in Qatar, first of its kind in the region. It describes the challenges that exist in the region when attempting to develop such a service and some challenges that are unique to Qatar. This paper sets out a template of important principles that will be valuable for countries in the MENA region and beyond to develop evidence-based gender aware service that focuses on female empowerment and better mental health outcomes.
Collapse
|
3
|
Alzahrani O. Depressive disorders in the Arabian Gulf Cooperation Council countries: a literature review. J Int Med Res 2020; 48:300060520961917. [PMID: 33086878 PMCID: PMC7585904 DOI: 10.1177/0300060520961917] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the contributions from the six Arabian Gulf Cooperation Council (GCC) countries to the national scientific literature on depressive disorders. METHODS This literature review identified all of the published studies on all major depressive disorders as cited on the PubMed® and APA PsycInfo® databases from inception to 31 December 2016 from the six GGC countries. Data were extracted using a standardized form. The study compared the volume of research production between the countries by calculating an index that allowed for the country population size. RESULTS A total of 28 studies met the inclusion criteria. Saudi Arabia headed the list of publications (10 articles) followed by the United Arab Emirates (n = 6), Kuwait (n = 5), Qatar (n = 3); and Bahrain and Oman produced two articles each. Only six out of the 28 (21.4%) studies included a random sample or adopted good sampling strategies. The majority of studies (24 of 28; 85.7%) were cross-sectional in design. Only one study clearly stated the use of the DSM-4 criteria for diagnosis. CONCLUSION The scientific literature published by the GCC countries on depressive disorders is scant and lacking scientific depth. These findings should be considered as a wake-up call for public health researchers, mental health workers and policymakers.
Collapse
Affiliation(s)
- Owiss Alzahrani
- Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
4
|
Razzak HA, Harbi A, Ahli S. Depression: Prevalence and Associated Risk Factors in the United Arab Emirates. Oman Med J 2019; 34:274-282. [PMID: 31360314 PMCID: PMC6642715 DOI: 10.5001/omj.2019.56] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A Depression is a prevalent mental healthcare problem and a common cause of disability worldwide. The purpose of this study was to determine the prevalence and risk factors of depression in individuals living in the UAE. We used a systematic review approach, searching PubMed and Scopus electronic databases to collect studies conducted between 2007 and 2017 on the UAE population (both citizens and expatriates) relating to depression. After evaluating and screening relevant articles, a review of 14 articles was conducted. The prevalence of depression and study populations varied widely across studies with some including students and workers and others limited to those with diabetes. The most common contributing factors were female sex, financial difficulties/low socioeconomic status, stressful life events, lack of social support, serious or chronic illness (e.g., diabetes, obesity, epilepsy, multiple sclerosis), and a history of eating disorders. Vitamin D deficiency was also highlighted as a risk factor for seasonal depression. Even though previous evidence has promulgated the role of numerous causative factors, the epidemiological studies including risk factors such as personal or family history of depression, low academic performance, and the use of alcohol remain lacking. Further research is needed to identify effective strategies for treating and preventing depression in the future.
Collapse
Affiliation(s)
- Hira Abdul Razzak
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| | - Alya Harbi
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| | - Shaima Ahli
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| |
Collapse
|
5
|
Archer J. The reality and evolutionary significance of human psychological sex differences. Biol Rev Camb Philos Soc 2019; 94:1381-1415. [DOI: 10.1111/brv.12507] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/14/2019] [Accepted: 02/21/2019] [Indexed: 01/03/2023]
Affiliation(s)
- John Archer
- Department of PsychologyUniversity of Central Lancashire Preston Lancashire PR1 2HE U.K
| |
Collapse
|
6
|
Charara R, Forouzanfar M, Naghavi M, Moradi-Lakeh M, Afshin A, Vos T, Daoud F, Wang H, El Bcheraoui C, Khalil I, Hamadeh RR, Khosravi A, Rahimi-Movaghar V, Khader Y, Al-Hamad N, Makhlouf Obermeyer C, Rafay A, Asghar R, Rana SM, Shaheen A, Abu-Rmeileh NME, Husseini A, Abu-Raddad LJ, Khoja T, Al Rayess ZA, AlBuhairan FS, Hsairi M, Alomari MA, Ali R, Roshandel G, Terkawi AS, Hamidi S, Refaat AH, Westerman R, Kiadaliri AA, Akanda AS, Ali SD, Bacha U, Badawi A, Bazargan-Hejazi S, Faghmous IAD, Fereshtehnejad SM, Fischer F, Jonas JB, Kuate Defo B, Mehari A, Omer SB, Pourmalek F, Uthman OA, Mokdad AA, Maalouf FT, Abd-Allah F, Akseer N, Arya D, Borschmann R, Brazinova A, Brugha TS, Catalá-López F, Degenhardt L, Ferrari A, Haro JM, Horino M, Hornberger JC, Huang H, Kieling C, Kim D, Kim Y, Knudsen AK, Mitchell PB, Patton G, Sagar R, Satpathy M, Savuon K, Seedat S, Shiue I, Skogen JC, Stein DJ, Tabb KM, Whiteford HA, Yip P, Yonemoto N, Murray CJL, Mokdad AH. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013. PLoS One 2017; 12:e0169575. [PMID: 28095477 PMCID: PMC5240956 DOI: 10.1371/journal.pone.0169575] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/19/2016] [Indexed: 01/17/2023] Open
Abstract
The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.
Collapse
Affiliation(s)
- Raghid Charara
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Mohammad Forouzanfar
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Maziar Moradi-Lakeh
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
- Preventive Medicine and Public Health Research Center, Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - Ibrahim Khalil
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | | | | | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Khader
- Jordan University of Science and Technology, Irbid, Jordan
| | | | - Carla Makhlouf Obermeyer
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Anwar Rafay
- Contech International Health Consultants, Lahore, Pakistan
| | - Rana Asghar
- South Asian Public Health Forum, Islamabad, Pakistan
| | - Saleem M. Rana
- Contech International Health Consultants, Lahore, Pakistan
| | - Amira Shaheen
- Department of Public Health, An-Najah University, Nablus, Palestine
| | | | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Ramallah, Palestine
| | - Laith J. Abu-Raddad
- Harvard University, Boston, MA, United States of America
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Tawfik Khoja
- Health Ministers’ Council for Cooperation Council States, Riyadh, Saudi Arabia
| | | | - Fadia S. AlBuhairan
- King Abdullah Specialized Children’s Hospital, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohamed Hsairi
- Ministry of Health—Tunisia (Faculty of Medicine Tunis), Tunis, Tunisia
| | - Mahmoud A. Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Raghib Ali
- University of Oxford, Oxford, United Kingdom
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdullah Sulieman Terkawi
- Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States of America
- Department of Anesthesiology, King Fahad medical city, Riyadh, Saudi Arabia
- OUTCOMES RESEARCH Consortium, Cleveland, OH, United States of America
| | - Samer Hamidi
- Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Amany H. Refaat
- Suez Canal University, Ismailia, Egypt
- Walden University, Minneapolis, MN, United States of America
| | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | - Aliasghar Ahmad Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
| | - Ali S. Akanda
- University of Rhode Island, Kingston, RI, United States of America
| | | | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Alaa Badawi
- Public Health Agency of Canada, Toronto, ON, Canada
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
- David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Imad A. D. Faghmous
- Tehran University of Medical Sciences, Tehran, Iran
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University Heidelberg, Heidelberg, Germany
| | - Barthelemy Kuate Defo
- Department of Social and Preventive Medicine, School of Public Health of the University of Montreal, Montreal, Quebec, Canada
| | - Alem Mehari
- Howard University College of Medicine, Howard University, Washington DC, United States of America
| | - Saad B. Omer
- Emory University, Atlanta, GA, United States of America
| | | | - Olalekan A. Uthman
- Warwick—Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Ali A. Mokdad
- Department of Surgery, University of Texas Southwestern, Dallas, Texas, United States of America
| | - Fadi T. Maalouf
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | | | - Nadia Akseer
- The Hospital for Sick Children, Toronto, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Dinesh Arya
- Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | | | | | - Ferrán Catalá-López
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Alize Ferrari
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
- School of Public Health, University of Queensland, Herston, Queensland, Australia
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu—CIBERSAM, Sant Boi de Llobregat, Spain
| | - Masako Horino
- Nevada Division of Behavior and Public Health, Carson City, NV, United States of America
| | - John C. Hornberger
- National Institutes of Health, Bethesda, MD, United States of America
- Cedar Associates, Menlo Park, CA, United States of America
| | - Hsiang Huang
- Cambridge Health Alliance, Cambridge, MA, United States of America
| | | | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - Yunjin Kim
- Southern University College, Johor, Malaysia
| | - Ann Kristin Knudsen
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Philip B. Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - George Patton
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Maheswar Satpathy
- UGC Centre for Advanced Studies in Psychology, Utkal University, Vani Vihar, Bhubaneswar, Odisha, INDIA
| | - Kim Savuon
- Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia
- Mental Health Association of Cambodia, Phnom Penh, Cambodia
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Ivy Shiue
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jens Christoffer Skogen
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
- MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Karen M. Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | | | - Paul Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Social Work and Social Administration Department, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | | | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| |
Collapse
|
7
|
Al-Hamzawi AO, Bruffaerts R, Bromet EJ, AlKhafaji AM, Kessler RC. The Epidemiology of Major Depressive Episode in the Iraqi General Population. PLoS One 2015; 10:e0131937. [PMID: 26230265 PMCID: PMC4521818 DOI: 10.1371/journal.pone.0131937] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 06/08/2015] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To assess the prevalence, symptom severity, functional impairment, and treatment of major depressive episode (MDE) in the Iraqi general population. METHODS The Iraq Mental Health Survey is a nationally representative face-to-face survey of 4,332 non-institutionalized adults aged 18+ interviewed in 2006-2007 as part of the WHO World Mental Health Surveys. Prevalence and correlates of DSM-IV MDE were determined with the WHO Composite International Diagnostic Interview (CIDI). FINDINGS Lifetime and 12-month prevalence of MDE were 7.4% and 4.0%, respectively. Close to half (46%) of the 12-month MDE cases were severe/very severe. MDE was more common among women and those previously married. Median age of onset was 25.2. Only one-seventh of 12-month MDE cases received treatment despite being associated with very substantial role impairment (on average 70 days out of role in the past year). CONCLUSIONS MDE is a commonly occurring disorder in the Iraqi general population and is associated with considerable disability and low treatment. Efforts are needed to decrease the barriers to treatment and to educate general medical providers in Iraq about the recognition and treatment of depression.
Collapse
Affiliation(s)
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum—KULeuven (UPC-KUL), Leuven, Belgiumbstract
| | - Evelyn J. Bromet
- Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY, United States of America
| | | | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
8
|
Yount KM, Dijkerman S, Zureick-Brown S, VanderEnde KE. Women's empowerment and generalized anxiety in Minya, Egypt. Soc Sci Med 2014; 106:185-93. [PMID: 24576646 DOI: 10.1016/j.socscimed.2014.01.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 12/13/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
Abstract
Gender disparities in mental health are global, with women experiencing higher rates than men of anxiety disorders, mood disorders, and attempted suicide. Women's low social status may partly explain these disparities, yet evidence from Arab and Middle Eastern settings is limited. We assessed whether women's empowerment - or acquisition of enabling resources, and in turn, enhanced agency - was associated with their lower generalized anxiety. For 539 ever-married women 22-65 years who participated in the 2005 Egypt Demographic Health Survey (EDHS) and a 2012 follow-up survey in rural Minya, we estimated linear reduced-form and mediation regression models to assess the associations of women's premarital enabling resources with their generalized anxiety in 2012, overall and through measures of their marital agency in 2005. Women's higher schooling attainment, premarital economic activity, later age at first marriage, and greater proximity to natal (or birth) family had significant, adjusted associations with lower generalized anxiety. Measures of women's agency in marriage had mixed associations with generalized anxiety, but their inclusion modestly reduced the coefficients for premarital resources. Parallel qualitative findings confirmed nuanced associations between women's exclusive decision-making and their mental health. Efforts to enhance women's education and premarital economic activity might be combined with efforts to delay first marriage and ensure women's extra-marital social support to maximize their empowerment and its mental-health benefits.
Collapse
Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA; Department of Sociology, Emory University, 1555 Dickey Dr., Atlanta, GA 30322, USA.
| | - Sally Dijkerman
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
| | - Sarah Zureick-Brown
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
| | - Kristin E VanderEnde
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
| |
Collapse
|
9
|
Al-Darmaki FR. Predictors of Counseling Center Use Among College Students in the United Arab Emirates. ACTA ACUST UNITED AC 2014. [DOI: 10.1037/a0035160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
College students’ decision to seek counseling is impacted by many factors such as demographic and psychological variables. This study investigated the differences between counseled (40 men and 120 women) and noncounseled (98 men and 111 women) college students from the United Arab Emirates using 3 measures of distress and a number of demographic variables (i.e., gender, marital status, residence, nationality, area of study, and grade point average). The counseled group reported more health concerns, symptoms of anxiety and depression, and psychological distress when compared with the noncounseled. Women reported more psychological distress than men. Discriminant analysis revealed that the most important predictors of whether a student would seek counseling were measures of general health, psychological distress, depression and anxiety, area of study, and gender, in that order. Of the noncounseled students, the majority claimed to be in need of counseling. Findings were discussed within the context of Emirati culture. Findings suggested that seeking psychological help may be stigmatized in Arab culture.
Collapse
Affiliation(s)
- Fatima R. Al-Darmaki
- Department of Psychology and Counseling, United Arab Emirates University, Al-Ain, United Arab Emirates
| |
Collapse
|
10
|
Shepard LD. The impact of polygamy on women's mental health: a systematic review. Epidemiol Psychiatr Sci 2013; 22:47-62. [PMID: 22794315 PMCID: PMC6998378 DOI: 10.1017/s2045796012000121] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 02/08/2012] [Accepted: 02/14/2012] [Indexed: 01/31/2023] Open
Abstract
Aims. The purpose of this systematic review is to identify and appraise the present state of prevalence research on the mental health of polygynous women, or plural wives, and to summarize its implications for future research and social work practice. Methods. PsycInfo (1967 to November 2011) and Medline (1985 to November 2011) databases, systematic bibliography hand-searches, personal communication with a leading expert, and gray literature searching were applied in a systematic literature search of the prevalence of mental-health issues in polygynous women compared to monogamous women. Twenty-two studies meeting eligibility criteria were identified. Study characteristics, methods and findings were systematically extracted and appraised for quality. Results. The identified studies are of mixed methodological quality, but generally suggest a more significant prevalence of mental-health issues in polygynous women compared to monogamous women. Individual studies report a higher prevalence of somatization, depression, anxiety, hostility, psychoticism and psychiatric disorder in polygynous wives as well as reduced life and marital satisfaction, problematic family functioning and low self-esteem. Conclusions. The current state of the research reveals with moderate confidence, a more significant prevalence of mental-health issues in polygynous women as compared to monogamous women. Implications for practice and research are indicated.
Collapse
Affiliation(s)
- L. D. Shepard
- Department of Social Policy and Social Work, University of Oxford, Oxford, OX1 2ER, UK
| |
Collapse
|
11
|
Cultural/ethnic differences in the prevalence of depressive symptoms among middle-aged women in Israel. Menopause 2012; 19:1309-21. [DOI: 10.1097/gme.0b013e318258b1dd] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
12
|
Prevalence of depression and suicidal behaviors among male migrant workers in United Arab Emirates. J Immigr Minor Health 2012; 13:1027-32. [PMID: 21503739 DOI: 10.1007/s10903-011-9470-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Migrant workers comprise 80% of the population of the United Arab Emirates, but there is little research on their mental health. To determine the prevalence and correlates of depression among workers living in labor camps, we conducted a cross-sectional survey in labor camps in Al Ain city. The Depression Anxiety and Stress Scale (DASS-42) was used to assess depression and suicidal ideation among the study participants. Off the 319 contacted workers agreed to participate, however 239 fully completed the DASS-42. The prevalence of a score >=10 ("depression") was 25.1% (60/239). Depression was correlated with physical illness (97/301), (adjusted odds ratio-AOR = 2.9; 95% CI 2.26-5.18), working in construction industry (prevalence 124/304), AOR = 2.2; 95%CI 1.56-3.83), earning less than 1,000 UAE Dirham per month (prevalence 203/314), (AOR = 1.8; 95%CI 1.33-3.16), and working more than 8 h a day (prevalence 213/315), (AOR = 2.7; 95%CI 1.19-6.27). 20/261 (6.3%) of the study participants reported thoughts of suicide and 8/265 (2.5%) had attempted suicide. People with suicidal ideation were more likely to have a physical illness (AOR = 8.1, 95%CI 2.49-26.67), earn less than 1,000 UAE Dirham per month (AOR = 5.98, 95%CI 1.26-28.45), and work for more than 8 h a day (AOR = 8.35, 95%CI 1.03-67.23). The study identified self reported indicators of a substantial burden of depression, and thoughts of self-harm among laborers surveyed. Policy level intervention and implementation, is needed to improve working conditions, including minimum wages and regulation of working hours is recommended.
Collapse
|
13
|
El-Missiry A, Soltan M, Hadi MA, Sabry W. Screening for depression in a sample of Egyptian secondary school female students. J Affect Disord 2012; 136:e61-e68. [PMID: 21783261 DOI: 10.1016/j.jad.2011.06.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 05/28/2011] [Accepted: 06/23/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression is common in female adolescents. Data on prevalence rates, socio-demographic correlates, and putative risk factors in Egyptian population are needed along with better screening tools to inform future research and service development. We aimed to estimate the point prevalence of depression in a representative sample of Egyptian female students; to detect the sensitivity and specificity of CDI as a screening tool, and to highlight some putative risk factors associated with depression. METHOD Multistage random selection of 602 female students from public and private secondary schools in Eastern Cairo. All participants were subjected to screening using the Children Depression Inventory (CDI) and the Non-patient version of the Structured Clinical Interview for DSM-IV axis-I disorders. RESULTS Depression was estimated to be 15.3% by CDI in comparison to 13.3% by SCID-I/NP. The sensitivity and specificity of CDI were 74.8% and 97.6% respectively. Regression Analysis pointed to a number of predictive factors as; academic underachievement, quarrelsome family atmosphere, socioeconomic status, negative life events and family history of psychiatric disorders. LIMITATIONS The cross-sectional design, the lack of collateral information and access to records precluded inference of casualty. The lack of the rural comparator and samples from other governorates limits the generalisation of results. CONCLUSION Depression was prevalent in a sample of Egyptian female secondary school students. It correlated with some psychosocial factors and can be effectively screened using CDI. Hence, there is a need for better screening, Psychoeducational programmes, and services for better identification, early intervention and targeting for those at risk.
Collapse
Affiliation(s)
- A El-Missiry
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt
| | - M Soltan
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt.
| | - M Abdel Hadi
- Department of Pediatrics, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt
| | - W Sabry
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt
| |
Collapse
|
14
|
Kaplan G, Glasser S, Murad H, Atamna A, Alpert G, Goldbourt U, Kalter-Leibovici O. Depression among Arabs and Jews in Israel: a population-based study. Soc Psychiatry Psychiatr Epidemiol 2010; 45:931-9. [PMID: 19777147 DOI: 10.1007/s00127-009-0142-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 09/11/2009] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Depression is the second most common chronic disorder seen by primary care physicians. Risk factors associated with depression include medical and psychosocial factors. While in Israel, the rate and risk factors for depression are considered similar to those in other Western countries, population-based data are limited. The present study aims to estimate the prevalence of depression among Jews and Muslim Arabs, and to consider possible associations with demographic, socioeconomic, and health factors. METHODS The study group (N = 872) was equally divided according to ethnicity, gender, and age group. Depression was measured by the Harvard Department of Psychiatry National Depression Screening Day Scale (HANDS). RESULTS The rate of depression scores in the likely/very likely range was 2.5 times higher among Arabs than among Jews (24.9 vs. 10.6%; P < 0.001). Women were more likely to express symptoms of depressive episode than were men (22.0 vs. 13.6%; P = 0.001), and the depression rate increased with age, from 11.0% in the youngest group (26-35) to 25.0% in the oldest (P = 0.001). The rate of increase in depression by age was different for the genders, rising more steeply for women than for men. However, the age-gender differential was not identical for the two ethnic groups. The differences in depression prevalence between Arabs and Jews were maintained after controlling for confounding variables, except that when controlling for education, the difference between the ethnic groups was no longer significant. After adjusting for all variables in the analysis, no significant association remained between ethnicity and depression (OR = 0.80; 95% CI = 0.45-1.40).
Collapse
Affiliation(s)
- Giora Kaplan
- Unit for Mental Health Epidemiology and Research on the Psychosocial Aspects of Illness, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | | | | | | | | | | | | |
Collapse
|
15
|
|
16
|
Abstract
Researchers indicate that the prevalence of psychiatric morbidity in the Arab region is similar to that found in other parts of the world. Women, in particular, are more likely to suffer various disorders including depression, anxiety disorders, somatization, and eating disorders. In this article, the author highlights some of the research on the mental health needs of Arab women. Consideration is given to important cultural and contextual factors related to mental illness as well as potential risk factors. Finally, suggestions for future directions are provided in order to attempt to close the gap between the needs and the services available.
Collapse
Affiliation(s)
- Aisha Hamdan
- College of Medicine, Office M27-120, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates.
| |
Collapse
|
17
|
Hamdan A, Hawamdeh S, Hussein A. The prevalence and correlates of depressive symptoms among Arab women in a primary health care setting. Int J Psychiatry Med 2009; 38:453-67. [PMID: 19480358 DOI: 10.2190/pm.38.4.e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression is one of most common mental illnesses in the world, with a high prevalence in primary health care settings. Some research has been conducted in the Arab region, but this research has been limited. This study investigated the prevalence of depression in a primary health care setting in the United Arab Emirates as well as possible socio-demographic and stressful life event correlates of depression. METHODS Arabic versions of the Beck Depression Inventory (BDI), a Stressful Life Events Inventory, and socio-demographic form were used for the study. Data were collected from 224 Arab women, aged 18 and above, in the primary health care centers of Sharjah, using a convenience sampling method. RESULTS Approximately 33% of women were found to be either moderately (14.7%) or severely (18%) depressed. The following socio-demographic variables were found to be correlated with scores on the BDI (p < .05): marital status (being single, widowed or divorced), working status (working full- or part-time), and family income (lower family income). The number of stressful life events that a woman had experienced in the past year was also correlated with depression. CONCLUSIONS Depressive symptoms are common in women attending primary health care centers in the Emirate of Sharjah. Stressful life events, in particular, are related to the level of depressive symptoms experienced by these women. It will be important to consider the social, psychological, and economic variables that impact emotional health in the region. This research is considered to be an initial step in developing prevention and intervention programs to address the mental health needs of Arab women.
Collapse
Affiliation(s)
- Aisha Hamdan
- Dept of Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, United Arab Emirates.
| | | | | |
Collapse
|
18
|
Tanios CY, Abou-Saleh MT, Karam AN, Salamoun MM, Mneimneh ZN, Karam EG. The epidemiology of anxiety disorders in the Arab world: a review. J Anxiety Disord 2009; 23:409-19. [PMID: 19091509 DOI: 10.1016/j.janxdis.2008.10.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Revised: 10/10/2008] [Accepted: 10/18/2008] [Indexed: 10/21/2022]
Abstract
Epidemiological studies are quite rare in the Arab world. The Institute for Development Research Advocacy and Applied Care (IDRAAC) has conducted a systematic review of all epidemiologic research on anxiety disorders in the Arab world up to 2006. Specific keywords were used in the search for affective disorders, namely anxiety, generalized anxiety disorder, GAD, panic, separation anxiety disorder, SAD, overanxious disorder, OAD, phobia, fear, post-traumatic stress disorder, PTSD, obsessive compulsive disorder (OCD), obsessive compulsive symptom (OCS), obsession, compulsion, obsessive, compulsive. All results were screened and categorized. Epidemiological data on prevalence, gender differences, age of onset, comorbidity, risk factors and treatment of anxiety disorders in the Arab world were found in clinical and community samples. There is an evident need for national data on anxiety disorders in the Arab world in order to identify the magnitude of these diseases and their burden on the individual and community.
Collapse
Affiliation(s)
- Christine Y Tanios
- Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | | | | | | | | | | |
Collapse
|
19
|
Barnett KJ, Finucane C, Asher JE, Bargary G, Corvin AP, Newell FN, Mitchell KJ. Familial patterns and the origins of individual differences in synaesthesia. Cognition 2008; 106:871-93. [PMID: 17586484 DOI: 10.1016/j.cognition.2007.05.003] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 04/27/2007] [Accepted: 05/11/2007] [Indexed: 01/26/2023]
Abstract
The term synaesthesia has been applied to a range of different sensory-perceptual and cognitive experiences, yet how these experiences are related to each other is not well understood. Not only are there disparate types of synaesthesia, but even within types there are vast individual differences in the way that stimuli induce synaesthesia and in the subjective synaesthetic experience. An investigation of the inheritance patterns of different types of synaesthesia is likely to elucidate whether a single underlying mechanism can explain all types. This study is the first to systematically survey all types of synaesthesia within a familial framework. We recruited 53 synaesthetes and 42% of these probands reported a first-degree relative with synaesthesia. We then directly contacted as many first-degree relatives as possible and collected complete data on synaesthetic status for all family members for 17 families. We found that different types of synaesthesia can occur within the same family and that the qualitative nature of the experience can differ between family members. Our findings strongly indicate that various types of synaesthesia are fundamentally related at the genetic level, but that the explicit associations and the individual differences between synaesthetes are influenced by other factors. Synaesthesia thus provides a good model to explore the interplay of all these factors in the development of cognitive traits in general.
Collapse
|
20
|
KILZIEH NAEL, RASTAM SAMAR, MAZIAK WASIM, WARD KENNETHD. Comorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria. Int J Psychiatry Med 2008; 38:169-84. [PMID: 18724568 PMCID: PMC2556632 DOI: 10.2190/pm.38.2.d] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the comorbidity and correlates of depression in chronic diseases in the community in Aleppo, Syria. This has never been previously investigated in an Arab country. METHOD We conducted a cross-sectional, population-based study in Aleppo on adults aged 18-65 (N = 2038). We collected data utilizing a structured interview questionnaire. Socio-demographics, general health information, and self-report of physician-diagnosed depression and chronic diseases active in the past year were obtained. We used logistic regression to estimate the odds of depression in chronic diseases and socio-demographic correlates of depression comorbid with chronic diseases. RESULTS Mean age (SD) was 35.3 (12.1) years, 55% were female. In women, predictors of depression were heart disease (OR = 3.95, 95% CI: 1.50-10.40), hypertension (OR = 2.92, 95% CI: 1.53-5.55), and kidney disease (OR = 2.96, 95% CI: 1.64-5.32). Depression comorbidity with any chronic disease decreased in higher socio-economic status (middle vs. low: OR = 0.28, 95% CI: 0.12-0.65; high vs. low: OR = 0.20, 95% CI: 0.05-0.81). In men, predictors of depression were rheumatism (OR = 7.10, 95% CI: 2.58-19.60) and respiratory disease (OR = 3.77, 95% CI: 1.23-11.60). Depression comorbidity decreased in residence in formal zones (OR = 0.22, 95% CI: 0.06-0.80). CONCLUSION Depression is associated with many chronic diseases in the community in Aleppo, a finding consistent with reports from other cultures. Potential gender-related risk factors were identified. Findings inform public mental health planning and support the delivery of depression treatment in primary care settings.
Collapse
Affiliation(s)
- NAEL KILZIEH
- VA Puget Sound Health Care System, Tacoma, Washington and University of Washington, Seattle
| | - SAMAR RASTAM
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - WASIM MAZIAK
- Syrian Center for Tobacco Studies, Aleppo, Syria and University of Memphis, Tennessee
| | | |
Collapse
|
21
|
Hosain GMM, Chatterjee N, Ara N, Islam T. Prevalence, pattern and determinants of mental disorders in rural Bangladesh. Public Health 2006; 121:18-24. [PMID: 17055545 DOI: 10.1016/j.puhe.2006.06.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Revised: 05/05/2006] [Accepted: 06/28/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Very few studies have examined mental health morbidity in Bangladesh. This community-based study of rural Bangladesh in 2000-2001 estimated the burden of mental morbidity among rural people of working age. STUDY DESIGN AND METHODS Community surveys were conducted with one respondent from each household of three selected villages in the service provision area of a non-profit public health organization. General Health Questionnaire 60 (GHQ-60) was used as a screening tool in Stage I, and clinical examination by a Western-trained psychiatrist was undertaken for concurrent validation in Stage II. RESULTS The overall prevalence of psychiatric disorders in this rural area was 16.5%. Depressive disorders and anxiety disorders constituted about one-half and one-third of the total cases, respectively. A significantly higher prevalence of mental disorders was found in the economically poor respondents, those over 45 years of age, and women from large families. CONCLUSION There is a high prevalence of psychiatric disorders in rural Bangladesh. These findings should aid the planning of locally relevant and appropriate mental healthcare programmes. There is an urgent need for a national mental healthcare policy that strengthens primary mental healthcare services.
Collapse
|
22
|
Nicolosi A, Moreira ED, Villa M, Glasser DB. A population study of the association between sexual function, sexual satisfaction and depressive symptoms in men. J Affect Disord 2004; 82:235-43. [PMID: 15488252 DOI: 10.1016/j.jad.2003.12.008] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2003] [Revised: 12/08/2003] [Accepted: 12/08/2003] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and erectile dysfunction (ED) have a complex and bi-directional relationship. We examined the relationships between erectile dysfunction and depressive symptoms or diagnosed depression, sexual activity and sexual satisfaction. METHODS A population survey of men aged 40-70 years was carried out in Brazil, Italy, Japan and Malaysia in 1997-1998. A questionnaire was used to collect life style, sexual behaviors and medical data. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. ED was classified as moderate or complete if the men reported they were "sometimes" or "never" able to achieve and maintain an erection satisfactory for sexual intercourse. Only men with a sexual partner and not taking psychoactive drugs were considered. RESULTS Diagnosed depression was reported by 2.0% of the men, depressive symptoms by 21.0%. The prevalence of moderate or complete ED was 17.8%. Sexual satisfaction related to the frequency of sexual intercourse and inversely related to depressive symptoms. Depressive symptoms were positively associated with being single (odds ratio [OR] 1.7), widowed, separated or divorced (OR 2.2), moderate or complete ED (1.8), heart disease (1.6) and smoking (1.6), and negatively associated with age, physical activity and frequency of sexual intercourse. LIMITATIONS Cross-sectional studies cannot establish a temporal cause-effect relationship. However, the confirmation of known associations reassures about the validity of the original findings. CONCLUSIONS The findings suggest that depressive symptoms are linked to ED by the mediation of decreased sexual activity and the dissatisfaction generated by the inability to have a healthy sexual life.
Collapse
Affiliation(s)
- Alfredo Nicolosi
- Department of Epidemiology, Institute of Biomedical Technologies, National Research Council, Milan, Italy.
| | | | | | | |
Collapse
|
23
|
Taylor RR, Jason LA, Jahn SC. Chronic fatigue and sociodemographic characteristics as predictors of psychiatric disorders in a community-based sample. Psychosom Med 2003; 65:896-901. [PMID: 14508038 DOI: 10.1097/01.psy.0000088580.28749.7f] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the roles of chronic fatigue and sociodemographic characteristics (eg, parental status, work status, socioeconomic status, sex, age, marital status, and ethnicity) as predictors of psychiatric disorders. METHODS A stratified random sample of 18,675 adults residing in diverse neighborhoods in Chicago completed a telephone-screening questionnaire. A control group without chronic fatigue (N = 74) and a group of individuals with chronic fatigue (N = 227) were identified and administered a semi-structured psychiatric interview. Stepwise logistic regression analyses predicting occurrence of current and lifetime psychiatric disorders according to chronic fatigue status and sociodemographics were conducted on this overall sample of 301 participants. RESULTS Chronic fatigue, low socioeconomic status, and unemployment were among significant predictors of overall Axis I psychiatric disorders. Chronic fatigue functioned as a predictor for mood and anxiety disorders (including posttraumatic stress disorder), but did not function as a predictor for somatoform disorders, substance abuse/dependence, and eating disorders. Low socioeconomic status and unemployment were significantly associated with current psychiatric disorder, and low socioeconomic status was also significantly associated with mood and anxiety disorders. Women were significantly more likely to experience mood disorder, and minorities (eg, African Americans, Latinos, and individuals of other ethnicity) were significantly more likely to report posttraumatic stress disorder. CONCLUSIONS Results support prior findings for increased rates of psychiatric disorder among individuals with chronic fatigue and highlight the roles of low socioeconomic status, unemployment, being a woman, and being classified as a minority in their association with certain psychiatric disorders.
Collapse
Affiliation(s)
- Renee R Taylor
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA.
| | | | | |
Collapse
|