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Dhara S, Thakur J, Pandey N, Mozumdar A, Roy S. Prevalence of major depressive disorder and its determinants among young married women and unmarried girls: Findings from the second round of UDAYA survey. PLoS One 2024; 19:e0306071. [PMID: 38954722 PMCID: PMC11218953 DOI: 10.1371/journal.pone.0306071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India. METHODS Data from "Understanding the Lives of Adolescents and Young Adults" (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis. RESULTS The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence <10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (>25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws' to conceive (for young married women only) were associated with MDD. CONCLUSIONS For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes.
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Affiliation(s)
- Shromona Dhara
- Department of Anthropology, University of Calcutta, Kolkata, West Bengal, India
| | | | | | | | - Subho Roy
- Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India
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Shenoy RR, Prabhu DA, Pandey AK, Praharaj SK, Shetty RS. Common Mental Disorders and Their Correlates: A Community-based Survey Among Women in Southern Karnataka, India. Indian J Psychol Med 2024; 46:330-337. [PMID: 39056038 PMCID: PMC11268283 DOI: 10.1177/02537176231220543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
Background About 10% of Indians have common mental disorders (CMDs) which include depression and anxiety. These disorders are common in women, which not only impacts on their quality of life but also their family members. The objective of the study was to estimate the prevalence of CMDs, and factors associated with them among women residing in coastal Karnataka. Methods A cross-sectional study was carried out among 980 women aged between 18 and 60 years from 2019 to 2021. Women were administered a baseline questionnaire along with Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder questionnaire-7 (GAD-7) and Cohen's Perceived Stress Scale-4 (PSS-4). Data were collected using Epi-info and were analysed using SPSS version 15.0. Association between CMDs and socio-demographic, reproductive health and behavioural factors were expressed as crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results The prevalence of CMDs among women was 5.7%, with 4.6% having depression and 3.37% with anxiety disorders. Multivariate logistic regression analysis showed that residing in urban areas (OR = 2.15; 95% CI:1.10-4.17), having a chronic illness (OR = 2.38; 95% CI:1.14-4.97), history of recent bereavement in the family (OR = 2.20; 95% CI:1.02-4.75), early marriage (OR = 2.63; 95% CI:1.09-6.33), history of abortion (OR = 2.89; 95% CI:1.42-5.92), and exposure to domestic violence (OR = 3.08; 95% CI:1.14-8.33) were significantly correlated with CMDs in this sample. Conclusions The study revealed that CMDs were prevalent among the surveyed women, which calls for routine screening of women for CMDs in primary care settings for early identification and appropriate interventions.
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Affiliation(s)
- Rakshitha R Shenoy
- Dept. of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Divya Arvind Prabhu
- Dept. of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akhilesh Kumar Pandey
- Dept. of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Samir Kumar Praharaj
- Dept. of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ranjitha S. Shetty
- Dept. of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Patel AR, Dixon KE, Nadkarni A. Unpacking the 'black box' of suicide: A latent class analysis predicting profiles of suicidal ideation in a longitudinal cohort of adolescent girls from India. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003130. [PMID: 38718080 PMCID: PMC11078369 DOI: 10.1371/journal.pgph.0003130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Indian women account for 37% of global suicide-related deaths. As suicide is a growing concern among adolescent girls, identifying the social determinants of suicide with this group targeted prevention. We selected social determinants that include intersectional identities and broader syndemics; we then used longitudinal data from a prospective cohort of adolescent girls from Northern India to classify them into unique profiles across multiple socioecological levels. METHODS Girls aged 10-19 (N = 11,864) completed self-report questionnaires measuring socio-demographic and trauma exposure variables. At three-year follow-up, they were asked to indicate current suicidal ideation (SI). We conducted latent class analysis (LCA) to classify profiles and then predicted risk of current SI at three-year follow-up. RESULTS LCA supported a four-class solution: a 'privileged' class (Class 1; n = 1,470), a 'modal' class (Class 2; n = 7,449), an 'intergenerational violence' class (Class 3; n = 2,113), and a 'psychological distress' class (Class 4; n = 732). Classes significantly predicted odds ratios (OR) for SI at follow up; women in Class 4 were associated with the greatest likelihood of SI (OR 1.84, 95% CI 1.38, 2.47), suggesting that psychological distress factors confer greatest risk. CONCLUSION Results of the distinct classes of risk and protective factors indicate targets for policy-level interventions. Disrupting cycles of psychological distress and substance use, increasing access to behavioral interventions, and intervening to mitigate intergenerational violence may be particularly impactful with this population.
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Affiliation(s)
- Anushka R. Patel
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Kelly E. Dixon
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Abhijit Nadkarni
- Addictions and Related Research Group, Sangath, Goa, India
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Sathya T, Selvamani Y, Nagarajan R, Arumai MM. Association between Multimorbidity and Psychological Distress among Older Adults in India: The Moderating Role of Elder Abuse. Clin Gerontol 2024:1-11. [PMID: 38315752 DOI: 10.1080/07317115.2024.2309942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVES In this study, we examine the association between multimorbidity and psychological distress and to what extent elder abuse mediates the association. METHODS We analyzed cross-sectional nationally representative data from the "Building Knowledge Base on Population Ageing in India (BKPAI)." Multivariate logistic regression was used to understand the association between multimorbidity and psychological distress. We used Karlson-Holm- Breen (KHB) method to understand the role of elder abuse in mediating the association between multimorbidity and psychological distress. RESULTS Older adults who ever experienced abuse (OR = 1.92 95%CI = 1.62, 2.26, p < .001) or in last one month (OR = 2.09 95%CI = 1.65, 2.64, p < .001) reported higher odds of psychological distress. Further, older adults with four or more chronic diseases are thrice more likely to report psychological distress (OR = 3.03 95%CI = 2.38, 3.82, p < .001). The results further suggest the mediating role of abuse on the association between multimorbidity and psychological distress. CONCLUSIONS The results suggest the role of elder abuse on the association between multimorbidity and psychological distress among older population in India. CLINICAL IMPLICATIONS Creating an environment to reduce the abuse among older adults who have multimorbidity will be essential to reducing the psychological distress among older adults in India.
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Affiliation(s)
- T Sathya
- School of Public Health, SRM Institute of Science and Technology (SRMIST), University Wellness Program Coordinator, Chennai, India
| | - Y Selvamani
- School of Public Health, SRM Institute of Science and Technology (SRMIST), Chennai, India
| | - R Nagarajan
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, India
| | - M Mathew Arumai
- Department of Social Work, College of Science & Humanities, SRM Institute of Science and Technology (SRMIST), Chennai, India
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Cao H, Wu Y, Yin H, Sun Y, Yuan H, Tao M. Global Trends in the Incidence of Anxiety Disorders From 1990 to 2019: Joinpoint and Age-Period-Cohort Analysis Study. JMIR Public Health Surveill 2024; 10:e49609. [PMID: 38285497 PMCID: PMC10862248 DOI: 10.2196/49609] [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: 06/03/2023] [Revised: 08/25/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Anxiety disorders (ADs) are the most common mental illness with high prevalence, chronicity, and comorbidity. Despite rapid economic and cultural development, the global incidence of ADs continues to increase, with predominance in male individuals. OBJECTIVE To address the above issues, we analyzed the dynamic trends of the global incidence and disease burden of ADs from 1990 to 2019 and their different effects on age, period, and birth cohort and predicted the future trend of AD incidence. METHODS The data were obtained from the Global Burden of Disease study in 2019. A joinpoint regression model was used to calculate the annual percent change in AD incidence, and age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort. Nordpred age-period-cohort analysis was used to predict the incidence of ADs from 2020 to 2044. RESULTS The age-standardized incidence rate of ADs increased by 1.06% for both sexes, and the age-standardized disability-adjusted life-year (DALY) rate (ASDR) decreased by 0.12%. Joinpoint regression indicated that increments in average annual percent changes in the age-standardized incidence rate (0.068 vs 0.012) and ASDR (0.035 vs -0.015) for ADs globally were higher among male individuals than female individuals. The age-period-cohort analyses revealed that the relative risk (RR) of the incidence and DALYs of ADs among people of different sexes increased with age in adolescence and middle age and then decreased. For the period effect, the RR of incidence decreased, whereas the RR of DALYs increased in both sexes. Moreover, the RR of the incidence gradually increased and DALYs slowly decreased with birth year for both male and female individuals. New cases of ADs in male individuals are predicted to increase in the coming 25 years. CONCLUSIONS This study provided the changing trend of the global incidence and disease burden of ADs in the past 3 decades, indicating that early prevention and effective control cannot be ignored. We analyzed the age-period-cohort effect of potential trends in ADs and predicted future incidence trends. The results suggest that we should take active intervention measures, focusing on high-risk groups and developing effective management and control policies to reduce the global burden of disease.
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Affiliation(s)
- Huiru Cao
- Department of Gastroenterology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yang Wu
- Department of Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Hui Yin
- Department of Hospital Infection, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yanqi Sun
- Department of Prevention and Health Care, People's Hospital of Rizhao, Rizhao, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Mengjun Tao
- Department of Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Pai M, Muhammad T. Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis. Sci Rep 2024; 14:442. [PMID: 38172263 PMCID: PMC10764745 DOI: 10.1038/s41598-023-50613-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
The purpose of this study was to examine (a) the socioeconomic status (SES)-related inequalities associated with handgrip strength (HGS); and (b) the extent to which several demographic, health, and behavioral factors contributed to such SES disparities in HGS among older adults in India. Data were drawn from the 2017-2018 wave 1 of the Longitudinal Ageing Study of India (LASI). The study sample included 27,707 older adults (13,199 men and 14,508 women) aged 60 years and older. HGS was assessed using a handheld Smedley's Hand Dynamometer with a cut-off of 19.5 kg for men and 12.5 kg for women. Bivariate analysis showed the weighted percentage distribution of weak HGS across respondent characteristics. Multivariate logistic regression assessed factors linked to weak HGS. The concentration curve and index (CCI) was used to determine the inequalities in the prevalence of weak HGS by wealth index scores. Wagstaff's decomposition approach was used to test the contribution of each explanatory variable to weak HGS. Around 9% of older adults in this study reported a weak HGS. It was significantly higher among those aged 80 or older (19.21%) and males (15.55%). Weak HGS was concentrated among older adults from poor SES (CCI: 0.05, p < 0.001). A higher percentage of wealth-based inequality in weak HGS was explained by being underweight (38.83%), belonging to the richest wealth quintile (27.95%), and having a higher subjective social status (32.20%). Moreover, about 23.29% of the inequality in weak HGS was explained by Western region and 22.54% by female gender. Additionally, having a secondary level of education explained a higher percentage (22.09%) of inequality, followed by current working status (- 20.68%). Rural residence (13.08%), limitations in instrumental activities of daily living (IADL) (12.21%), and engagement in yoga-related activities (11.55%) explained a higher percentage of wealth-based inequalities. The findings provide evidence of significant SES-related inequalities in HGS and the contribution of various demographic, health, and behavioral factors to such inequality. As such, public health policies and programs focusing on reducing the burden of disability must consider the contribution of social and economic equity to the preservation of muscle strength among older adults.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Pennsylvania State University, University Park, PA, 16802, USA.
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Annajigowda HH, Nirisha LP, Ganjekar S, Rao GN, Gururaj G, Varghese M, Benegal V. Common mental disorders among women in reproductive age group: An analysis of national mental health survey, India 2016. Indian J Psychiatry 2023; 65:1238-1243. [PMID: 38298883 PMCID: PMC10826868 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_832_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background Common mental disorders (CMDs) have a higher prevalence among women in their reproductive age (WRA) compared to the general population. Large Indian epidemiological studies focusing on the prevalence and socioeconomic correlates of CMDs among WRA are lacking. The associated disability and treatment gap particularly in the women population is unknown. Aim To estimate the current prevalence, correlates, disability, socioeconomic impact, and treatment gap of CMDs among WRA from a nationally representative sample from India. Materials and Methods The National Mental Health Survey of India 2016 is a multisite nationwide household survey conducted across India using a uniform methodology. Overall, 39,532 adults were surveyed with a response rate of 88%. The diagnosis was based on Mini International Neuropsychiatric Interview 6.0.0. CMDs among WRA (18-49 years) for this secondary analysis included depression and anxiety disorders. Results The prevalence of CMDs among WRA in India was 5.83%. Two important risk factors for CMDs included being divorced and living in the urban metro. Nearly 70% of women reported disabilities of varying severity. The overall treatment gap was around 82% (urban nonmetro > metro > rural population). On average, the cost of treatment of CMDs was ₹ 2,000 per month. Conclusion CMDs are prevalent among WRA groups with significant disabilities and treatment gaps in India. The disability and treatment gap associated with CMDs among WRA can be handled by integrating mental health into general medical/obstetric care.
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Affiliation(s)
- Harshitha H. Annajigowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lakshmi P. Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, WHO Collaborative Centre for Injury Prevention and Safety Promotion, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Sharma S, Patnaik L, Sahu T. Effect of lifestyle interventions to reduce depression, anxiety and stress among married women of reproductive age group: A non-randomised controlled trial in urban slums of Bhubaneswar. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:347. [PMID: 38144035 PMCID: PMC10743840 DOI: 10.4103/jehp.jehp_1149_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/08/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Women are more prone to develop mental disorders as compared to men and the role of physical activities to reduce its burden by improving self-esteem is appreciable. This study aimed to evaluate the effect of lifestyle interventions to reduce depression, anxiety and stress among women in urban slums. MATERIALS AND METHODS This study was a non-randomized controlled trial carried out in two slums of Bhubaneswar in married women of reproductive age group (15 years-49 years) from June 2019 to September 2021 after approval from the institutional ethics committee. A total of 128 married women were recruited, 64 women in each arm. DASS-21 was used for assessing depression, anxiety, and stress of all participants. The lifestyle intervention program was provided to 64 women in the intervention group and educational materials were provided to the control arm. DASS score was assessed again and compared with follow-up scores in both groups. Descriptive statistics were expressed as frequency, mean, median, and standard deviations. Independent t-test and paired t-tests were done where applicable. RESULTS There was no significant difference in socio-demographic factors and DASS-21 scores in both groups during baseline. Depression, Anxiety, and stress score were significantly lower in the intervention arm than control arm in the follow-up (P < 0.05). There was a significant difference between the pre-intervention and post-intervention levels of depression, anxiety, and stress among the intervention group (P = 0.05). CONCLUSIONS Simple community-based physical activities as in our intervention program focusing on the reduction of depression, anxiety, and stress levels in women may prevent the rising problems of common mental disorders.
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Affiliation(s)
- Sumita Sharma
- Department of Community Medicine, IMS & SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Lipilekha Patnaik
- Department of Community Medicine, IMS & SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Trilochan Sahu
- Department of Community Medicine, IMS & SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
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Muhammad T. Life course rural/urban place of residence, depressive symptoms and cognitive impairment among older adults: findings from the Longitudinal Aging Study in India. BMC Psychiatry 2023; 23:391. [PMID: 37268912 DOI: 10.1186/s12888-023-04911-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/29/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Given the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms and cognitive impairment, among older adults in India. The study also examined the relationship between older individuals' life-course rural/urban place of residence and late-life mental and cognitive health. METHODS Utilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults. RESULTS Childhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05-1.80] but not men. Childhood [aOR: 1.88, CI: 1.16-3.04], adulthood [aOR: 2.00, CI: 1.26-3.16] and current rural residence [aOR: 1.93, CI: 1.27-2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 1.71, CI: 1.29-2.27] was associated with cognitive impairment in women. There was no significant association between life-course place of residence and depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -0.14, CI: -0.21- -0.07] compared to those with rural-rural-rural place of residence. There were significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants, showing an urban advantage in cognitive function among older adults. CONCLUSIONS This study showed significant associations between life-course residence and depressive symptoms among permanent rural/urban residents. The study also showed significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants. Considering the rural disadvantage in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. The findings also urge social scientists and gerontologists in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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Mavragani A, Goud BR, Kalidindi B, Ruben JP, Devadass D, Waghmare A, Collins PY, Raj T, Srinivasan K. Mobile Mental Health in Women's Community-Based Organizations: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e42919. [PMID: 36753310 PMCID: PMC9947759 DOI: 10.2196/42919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Of every 10 women in rural India, 1 suffers from a common mental disorder such as depression, and untreated depression is associated with significant morbidity and mortality. Several factors lead to a large treatment gap, specifically for women in rural India, including stigma, lack of provider mental health workforce, and travel times. There is an urgent need to improve the rates of detection and treatment of depression among women in rural India without overburdening the scarce mental health resources. OBJECTIVE We propose to develop, test, and deploy a mental health app, MITHRA (Multiuser Interactive Health Response Application), for depression screening and brief intervention, designed for use in women's self-help groups (SHGs) in rural India. METHODS We will use focus groups with SHG members and community health workers to guide the initial development of the app, followed by iterative modification based on input from a participatory design group consisting of proposed end users of the app (SHG members). The final version of the app will then be deployed for testing in a pilot cluster randomized trial, with 3 SHGs randomized to receive the app and 3 to receive enhanced care as usual. RESULTS This study was funded in June 2021. As of September 2022, we have completed both focus groups, 1 participatory design group, and app development. CONCLUSIONS Delivering app-based depression screening and treatment in community settings such as SHGs can address stigma and transportation-related barriers to access to depression care and overcome cultural and contextual barriers to mobile health use. It can also address the mental health workforce shortage. If we find that the MITHRA approach is feasible, we will test the implementation and effectiveness of MITHRA in multiple SHGs across India in a larger randomized controlled trial. This approach of leveraging community-based organizations to improve the reach of depression screening and treatment is applicable in rural and underserved areas across the globe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42919.
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Affiliation(s)
| | | | | | - Johnson Pradeep Ruben
- St John's Medical College, Bengaluru, India.,St John's Research Institute, Bengaluru, India
| | | | | | - Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Tony Raj
- St John's Research Institute, Bengaluru, India
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Nair AR, Shivanna YKG, Illimoottil JP, Rachana A, Mahasampath GS, Abraham S, Kurian S. Common mental disorders among women and its social correlates in an urban marginalized populace in South India. Int J Soc Psychiatry 2022; 68:1394-1402. [PMID: 34130540 DOI: 10.1177/00207640211025556] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Common mental disorders (CMD) cause a range of health, social and economic burden, and disorders like depression and anxiety are more prevalent among women. Prevalence and factors contributing to increased vulnerability for CMDs have regional variation. Identification of factors contributing to the vulnerability is essential to both psychiatric epidemiology and in addressing mental health challenges in the community. METHODS This cross-sectional study aimed at understanding the burden of CMD and its association with social determinants of mental health. Women hailing from urban slum attending the outpatient family care facility for their medical problems constituted the sample. Data was collected using a clinical research form with variables such as sociodemographic profile, health profile, and psychosocial profile. The questionnaire had specific questions on indicators of poverty, certain stressors, and support system. Presence of CMD was assessed using Clinical Interview Schedule-Revised (CIS-R), a standard tool for CMD research in primary care settings. A cut off score of 12 and above was considered for detecting CMD. Research ethical principles were adhered to and data was analyzed using SPSS 21.0. RESULTS Among 172 women, 77 (44.8%) were diagnosed to have CMDs. Univariate analysis revealed a significant association between age, marital status, living arrangement, educational level, difficulty with buying food, presence of debt, chronic medical illness, husband's alcohol use, marital satisfaction, experiencing abuse, family support, religious participation, and a diagnosis of CMD. Multivariate analysis showed high burden with nuclear family arrangement, difficulty to buy food, experiencing abuse and, low burden with higher educational level, family support, and religious participation. CONCLUSION Considering the high prevalence and the treatment gap of CMDs in primary setting, family-physician should be sensitized for detection and management of CMDs. Social interventions targeting poverty, women's education and empowerment, and support system are likely to decrease the burden of CMDs in this population.
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Affiliation(s)
- Aiswarya R Nair
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Arun Rachana
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gowri S Mahasampath
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sunil Abraham
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suja Kurian
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Analysis of Antidepressants Utilization for Patients Visiting Psychiatric Out-Patient Clinic in a Tertiary Care Hospital. Healthcare (Basel) 2022; 10:healthcare10102081. [PMID: 36292530 PMCID: PMC9602627 DOI: 10.3390/healthcare10102081] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022] Open
Abstract
Depression is a prevalent mental health condition treated with antidepressants and other psychotropic medications. This study aimed to assess the utilization pattern of antidepressants among patients visiting the outpatient clinic of the psychiatry department of a tertiary care hospital. The study included the patients who visited the study site and fulfilled the mental and behavioral diagnostic criteria for depression. The demographic and clinical details, including drugs prescribed, were documented in a study-specific data collection form. The ratio of Prescribed Daily Dose to Defined Daily Dose (PDD: DDD) was calculated to assess the adequacy of antidepressant utilization. Data total of 154 patients were collected. A total of 22 psychotropic drugs were used among the study patients as mono (n = 70), dual (n = 69), triple (n = 10), or quadruple therapy (n = 1). Escitalopram was the most often prescribed antidepressant out of the nine antidepressants alone and in combination and was used in slightly high doses (PDD: DDD ratio 1.6). Sertraline, paroxetine, and desvenlafaxine, were used in adequate doses (PDD: DDD between 1 and 1.1), and fluoxetine, duloxetine, amitriptyline, imipramine, and mirtazapine, were used in inadequate doses (PDD: DDD <0.5). Our study findings reveal the need for continuous assessment of antidepressants medications usage in a hospital set up.
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Patel AR, Kovacevic M, Hinton D, Newman E. "I put a stone on my heart and kept going": An explanatory model of how distress is generated and regulated among Indian women from slums reporting gender-based violence. Transcult Psychiatry 2022; 59:522-538. [PMID: 34860626 DOI: 10.1177/13634615211055003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinical variation in the expression of panic disorder, depression and anxiety, and posttraumatic stress disorder (PTSD) has have been documented across cultures. However, local (emic) cultural models that explain how people make sense of their illness experiences remain relatively understudied in India among trauma-exposed populations. Further, the integration of emic findings into clinical care is limited, underscoring the need for emic perspectives following trauma to improve the development or adaptation of trauma-focused treatments in India. This study describes an emic explanatory model of distress, which includes idioms of distress, perceived causes of distress, and coping/help-seeking behaviors among Indian women from slums reporting gender-based violence. This explanatory model can be used as a culturally grounded way to develop clinical case conceptualizations to adapt and deliver psychological treatments for this under-served population.
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Affiliation(s)
| | | | - Devon Hinton
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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14
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Rahmani A, Afsharnia E, Fedotova J, Shahbazi S, Fallahi A, Allahqoli L, Ghanei-Gheshlagh R, Abboud S, Alkatout I. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022; 19:1098-1115. [PMID: 35752457 DOI: 10.1016/j.jsxm.2022.03.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.
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Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Afsharnia
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Julia Fedotova
- International Research Centre "Biotechnologies of the Third Millennium", St. Petersburg, Russian Federation. Laboratory of Neuroendocrinology, ITMO University, I.P. Pavlov Institute of Physiology RASci., St. Petersburg, Russia
| | - Shirin Shahbazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran; Breastfeeding Research Center-Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Fallahi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Reza Ghanei-Gheshlagh
- Social Determinants of Health Research Center, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan University of Medical, Sciences, Sanandaj, Iran
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany
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15
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Symptoms of psychological distress reported by women from indigenous communities in South India: implications for methodology and future studies. Arch Womens Ment Health 2022; 25:667-670. [PMID: 35260932 DOI: 10.1007/s00737-022-01215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/16/2022] [Indexed: 11/02/2022]
Abstract
'Indigenous peoples' across the globe suffer a disproportionate burden of mental illness. However, this burden is not fully explored in India despite having the second largest absolute concentration of indigenous peoples in the world. We did a secondary analysis of data from a cross-sectional survey in indigenous populations from the Nilgiri Biosphere Reserve in South India. Symptoms suggestive of psychological distress were reported by 39.9% participants. Being alone, tobacco use, hypertension, hypertension in family member, and violent conflict in household were independently associated with psychological distress. More epidemiological studies need to be conducted to map the burden and elaborate the relationships between mental health problems and socio-cultural factors in indigenous populations in India.
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Muhammad T, Skariah AE, Kumar M, Srivastava S. Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff's decomposition analysis of data from the LASI baseline survey, 2017-2018. BMJ Open 2022; 12:e054730. [PMID: 35649601 PMCID: PMC9161106 DOI: 10.1136/bmjopen-2021-054730] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017-2018. The effective sample size was 30 888 older adults aged 60 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff's decomposition were used to fulfil the objectives of the study. RESULTS There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was -0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults. CONCLUSIONS Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | | | - Manish Kumar
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Muhammad T, Drishti D, Srivastava S. Prevalence and correlates of vision impairment and its association with cognitive impairment among older adults in India: a cross-sectional study. BMJ Open 2022; 12:e054230. [PMID: 35523503 PMCID: PMC9083423 DOI: 10.1136/bmjopen-2021-054230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the predictors of vision impairment in old age and how impaired vision is associated with cognitive impairment among the ageing population. DESIGN A cross-sectional study was conducted using a large country-representative survey data. SETTING AND PARTICIPANTS This study used data from the 'Building a Knowledge Base on Population Ageing in India' survey, conducted in 2011. Participants included 9541 older adults aged 60 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variables were vision impairment and cognitive impairment. Descriptive statistics along with bivariate analysis were presented. Additionally, multivariable binary logistic regression analysis was performed to fulfil the objectives. RESULTS A proportion of 59.1% of the respondents had vision impairment. Nearly 60% of the participants had cognitive impairment. Those who had vision impairment were 11% more likely to have cognitive impairment compared to their counterparts (OR: 1.11, 95% CI: 1.01 to 1.23). low psychological health (OR: 1.55; 95% CI: 1.36 to 1.77), low activities of daily living (OR: 1.80; 95% CI: 1.43 to 2.27), low instrumental activities of daily living (OR: 1.26; 95% CI: 1.14 to 1.40), poor self-rated health (OR: 1.28; 95% CI: 1.15 to 1.41) and chronic morbidity (OR: 1.27; 95% CI: 1.14 to 1.41) were found to be risk factors for cognitive impairment among older adults. CONCLUSIONS Additional efforts in terms of advocacy, availability, affordability and accessibility especially in a country with big illiteracy issue are mandatory to increase the reach of eye-care services and reduce the prevalence of avoidable visual impairment and vision losses that lead to cognitive deficits among the older population.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Drishti Drishti
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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18
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Muhammad T, Srivastava S, Sekher TV. Assessing socioeconomic inequalities in cognitive impairment among older adults: a study based on a cross-sectional survey in India. BMC Geriatr 2022; 22:389. [PMID: 35505289 PMCID: PMC9066837 DOI: 10.1186/s12877-022-03076-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/21/2022] [Indexed: 01/17/2023] Open
Abstract
Background The rapidly aging population is a major concern for countries, especially where cognitive health in older age is poor. The study examined the socioeconomic and health-related factors associated with cognitive impairment among older adults and the contribution of those factors to the concentration of low cognitive functioning among older adults from economically poor households. Methods Data this study were derived from the “Building Knowledge Base on Population Ageing in India” (BKPAI) survey, which was carried out in seven major states of India. The effective sample size for the analysis was 9176 older adults aged 60 years and above. Results from descriptive and bivariate analysis were reported in the initial stage. Multivariable logistic regression analysis was conducted to explore the associations. Additionally, the concentration index and concentration curve were used to measure socioeconomic inequality in cognitive impairment among older adults. Wagstaff decomposition was employed to explore the key contributors in the concentration index. Results Nearly 60% of older adults suffered from cognitive impairment in the study. The likelihood of cognitive impairment were higher among older adults with a low level of self-perceived income sufficiency [coefficient: 0.29; confidence interval (CI): 0.07- 0.52] compared to older adults with higher levels of perceived income status. Older adults with more than 10 years of schooling were less likely to be cognitively impaired [coefficient: -1.27; CI: − 1.50- -1.04] in comparison to those with no education. Cognitive impairment was concentrated among older adults from households with the lowest wealth quintile (concentration index (CCI): − 0.10: p < 0.05). Educational status explained 44.6% of socioeconomic inequality, followed by 31.8% by wealth status and 11.5% by psychological health. Apart from these factors, difficulty in instrumental activities of daily living (3.7%), caste (3.7%), and perceived income sufficiency to fulfil basic needs (3.0%) explained socioeconomic inequality in cognitive impairment among older adults. Conclusions Findings suggest that older adults with lower perceived income, lower levels of education, poor physical and mental health, and poor physical and social resources were more likely to be cognitively impaired. Education, wealth and psychological health are major contributors in socioeconomic inequality in late-life cognitive impairment, which may be target areas in future policy formulation to reduce the inequality in cognitive impairment in older Indian adults.
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Affiliation(s)
- T Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - T V Sekher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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19
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Magnitude of common mental disorders and factors associated among people living in Addis Ababa Ethiopia 2018: community based cross-sectional study. BMC Psychiatry 2022; 22:160. [PMID: 35241022 PMCID: PMC8892794 DOI: 10.1186/s12888-022-03783-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms, affecting individuals in different age groups, causes suffering to the individuals, families and community. OBJECTIVE This study assessed the magnitude of Common mental disorder and associated factors among people living in Addis Ababa, Ethiopia. METHODS Community based cross sectional study design was conducted from November 1 to 30, 2018 among people living in Addis Ababa, Ethiopia. Multistage sampling technique was used to get a total of 755 samples. Common Mental Disorder was assessed through interview using Self-Reported questionnaire (SRQ-20). The collected data were coded, entered into EPI-Info 7 and analysed by using SPPS version 20. Descriptive, analytical statistical procedure; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was accepted at p value < 0.05. RESULT In this study a total of 723 study subjects were participated, with response rate of 95.7%.The prevalence of common mental disorders was 24.7% with [95%CI; 21.6 - 27.7]. Females (AOR=2.1; 95% CI; 1.39- 3.23), Divorced/widowed (AOR=2.55; 95% CI; 1.16- 5.59), daily labourers (AOR=2.52; 95% CI; 1.3- 4.88, chronic medical illness (AOR=4.5; 95% CI; 2.46- 8.24). are independent predictors of CMD and educational status (primary, secondary and diploma) was positively associated with CMD. in this study. Regarding education (primary, secondary and diploma) (AOR=0.34; 95% CI; 0.17-0.66) and (AOR=0.35; 95% CI; 0.19-0.67) has positively associated with common mental disorders. CONCLUSION The prevalence of common mental disorders was found high. Female sex, marital status like Divorced/Widowed, daily labour workers and chronic medical illness were found to be independent predictors of CMD and educational status (primary, secondary school and diploma holders) was were found to be protective factors.
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Patel AR, Newman E, Richardson J. A pilot study adapting and validating the Harvard Trauma Questionnaire (HTQ) and PTSD checklist-5 (PCL-5) with Indian women from slums reporting gender-based violence. BMC Womens Health 2022; 22:22. [PMID: 35090450 PMCID: PMC8795349 DOI: 10.1186/s12905-022-01595-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/04/2022] [Indexed: 01/07/2023] Open
Abstract
Background Despite high rates of gender-based violence (GBV) in India, culturally sensitive measures that examine universal and culturally relevant trauma reactions are lacking. Although the Harvard Trauma Questionnaire (HTQ) has been used in India, no study has adapted the measure in full for use with this population. Similarly, the PTSD checklist-5 (PCL-5) has not yet been validated in India. This study describes the adaptation, validation, and results from the adapted HTQ, and embedded PCL-5, for Indian women from slums reporting GBV. Method This study used the adaptation framework proposed by the HTQ measure developers. The adapted HTQ contained a (1) trauma screen relevant for stressors faced by Indian women from slums, (2) description of the index trauma, (3) description of any ongoing stressors, (4) universal trauma reactions (i.e., PTSD measured by the PCL-5), and culturally relevant trauma reactions (i.e., idioms of distress measured by a scale developed for the study). This measure was piloted on 111 women from Indian slums in face-to-face interviews. Trauma characteristics, types of ongoing stressors, and psychometric properties of the PCL-5 and idioms of distress scale were explored. These scales were validated against measures of depression (PHQ-9), anxiety (GAD-7), and somatic complaints (PHQ-15). Results The majority of participants (77%) reported physical beatings, 18% reported unwanted sexual touch, and 28.8% reported infidelity as the primary emotional abuse. Further, 96.7% of GBV was perpetrated by partner or family member and over half reported ongoing stressors (e.g., poverty-related strain). The PCL-5 embedded in the HTQ yielded good internal consistency (Cronbach’s alpha = .88) as did the idioms of distress scale with deletion of one item (Cronbach’s alpha = .80). Both scales were externally valid, yielding large correlations with depression, anxiety, and somatic complaints (rs between .54 and .80, ps < .05). Discussion This is the first study to develop a comprehensive measure of trauma exposure with universal and culturally relevant trauma reactions in India. This study also enhances HTQ usage in India by delineating all the steps in the adaptation process. Results can inform the development of trauma-focused interventions for Indian women from slums. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01595-3.
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Affiliation(s)
- Anushka R Patel
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74135, USA. .,Department of Psychiatry and Behavioral Sciences, Trauma Recovery Center, University of California San Francisco, 2727 Mariposa St, San Francisco, CA, 94110, USA.
| | - Elana Newman
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74135, USA
| | - Julia Richardson
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74135, USA
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21
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Muhammad T, Srivastava S. Tooth loss and associated self-rated health and psychological and subjective wellbeing among community-dwelling older adults: A cross-sectional study in India. BMC Public Health 2022; 22:7. [PMID: 34983470 PMCID: PMC8729065 DOI: 10.1186/s12889-021-12457-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Losing teeth has been considered as part of normal aging. However, in developing countries, tooth loss among older adults is shown to be more negatively associated with self-image and quality of life compared to their western counterparts. This study examines the association of tooth loss with self-rated health and psychological and subjective wellbeing among older adults in India. Methods Data were derived from the "Building Knowledge Base on Population Ageing in India" (BKPAI) survey which was carried out in 2011. The final sample size for the analysis was 9231 older adults. Descriptive statistics and bivariate analysis along with binary logistic regression analysis were conducted to fulfil the objective of the study. Results A proportion of 12.3% of older adults reported complete tooth loss. It was found that older adults who reported tooth loss were 2.38 times significantly more likely to have poor self-rated health (SRH) [2.38; CI: 1.99,2.83] than older adults who did not report tooth loss. The odds of low psychological health were high among older adults who suffered from tooth loss than their counterparts [OR: 1.59; CI: 1.33,1.91]. Older adults who reported tooth loss had 65% significantly higher odds of low subjective well-being than older adults who did not report tooth loss [OR: 1.65; CI: 1.38,1.97]. Conclusion Complete loss of teeth is associated with older individuals’ poor SRH as well as low psychological and subjective well-being, but such a consequence is avoidable by practising the efforts to maintain good oral health.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
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Satyanarayana VA, Krishnamachari S. Integrated cognitive-behavioral intervention reduced alcohol use and perpetration of intimate partner violence in a man with alcohol dependence syndrome: A case study. J Clin Psychol 2021; 78:15-25. [PMID: 34897685 DOI: 10.1002/jclp.23297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/12/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022]
Abstract
Heavy alcohol use poses an increased risk for intimate partner violence. We present here a novel therapeutic treatment, integrated cognitive-behavioral intervention (ICBI), a treatment approach for men with alcohol dependence who also perpetrate intimate partner violence (IPV). ICBI includes a meaningful integration of cognitive-behavioral and interpersonal therapy techniques. In this case study of an adult married male with alcohol dependence, who also self-reported perpetration of IPV, we found that ICBI was an effective treatment approach not only in reducing alcohol consumption and perpetration of IPV but also in improving symptoms of depression, anxiety, and stress in his wife. Important limitations, however, were the short duration of follow-up and concurrent pharmacological treatment. Salient aspects of psychotherapy process and outcome, indications for, and utility of integrated approaches to treatment are discussed.
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Affiliation(s)
- Veena A Satyanarayana
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Srinivasan Krishnamachari
- Division of Mental Health and Neurosciences, Department of Psychiatry, St John's Medical College and Head, St. Johns Research Institute, Bangalore, India
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O'Connor M, Lee A. The health impacts of dowry abuse on South Asian communities in Australia. Med J Aust 2021; 216:11-13. [PMID: 34854086 PMCID: PMC9299937 DOI: 10.5694/mja2.51358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Manjula O'Connor
- University of Melbourne, Melbourne, VIC.,University of New South Wales, Sydney, NSW
| | - Amanda Lee
- Harmony Alliance, Migration Council Australia, Canberra, ACT
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Fellmeth G, Kishore MT, Verma A, Desai G, Bharti O, Kanwar P, Singh S, Thippeswamy H, Chandra PS, Kurinczuk JJ, Nair M, Alderdice F. Perinatal mental health in India: protocol for a validation and cohort study. J Public Health (Oxf) 2021; 43:ii35-ii42. [PMID: 34622290 PMCID: PMC8498097 DOI: 10.1093/pubmed/fdab162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Common mental disorders (CMD) are among the largest contributors to global maternal morbidity and mortality. Although research on perinatal mental health in India has grown in recent years, important evidence gaps remain, especially regarding CMD. Our study aims to improve understanding of CMD among perinatal and non-perinatal women of reproductive age across two settings in India: Bangalore (Karnataka) and Tanda (Himachal Pradesh). METHODS The study is embedded within the Maternal and Perinatal Health Research Collaboration India (MaatHRI). This mixed-methods observational study comprises three consecutive phases: (i) focus group discussions and individual interviews to explore women's knowledge and seek feedback on CMD screening tools; (ii) validation of CMD screening tools; and (iii) prospective cohort study to identify CMD incidence, prevalence and risk factors among perinatal and non-perinatal women. Results of the three phases will be analyzed using inductive thematic analysis, psychometric analysis and multivariable regression analysis, respectively. CONCLUSION Improving understanding, detection and management of CMD among women is key to improving women's health and promoting gender equality. This study will provide evidence of CMD screening tools for perinatal and non-perinatal women in two diverse Indian settings, produce data on CMD prevalence, incidence and risk factors and enhance understanding of the specific contribution of the perinatal state to CMD.
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Affiliation(s)
- G Fellmeth
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M T Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - A Verma
- Department of Obstetrics and Gynaecology, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - G Desai
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - O Bharti
- State Institute of Health and Family Welfare, Department of Health and Family Welfare, Government of Himachal Pradesh, India
| | - P Kanwar
- Department of Psychiatry, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - S Singh
- Department of Psychiatry, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - H Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - P S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - J J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - F Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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Srivastava S, Shaw S, Chaurasia H, Purkayastha N, Muhammad T. Feeling about living arrangements and associated health outcomes among older adults in India: a cross-sectional study. BMC Public Health 2021; 21:1322. [PMID: 34225690 PMCID: PMC8258997 DOI: 10.1186/s12889-021-11342-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Advancement in the field of gerontology has been concerned with the well-being of older adults in a family setup that is associated with caregiving and support. While family life and well-being are defined by emotion, caregiving, and support activities, dissatisfaction/discontent with living arrangements is a public health concern, which is increasing with a rise in the proportion of the older population in the country. The study examines the association of dissatisfaction with living arrangements with health outcomes among older men and women in India. METHODS The present research used data from the 'Building a Knowledge Base on Population Aging in India'. The effective sample size for the analysis was 9181 older adults. Descriptive statistics and bivariate analysis were performed to present the preliminary estimates. For finding the association between various health outcomes over explanatory variables, binary logistic regression model was used separately for men and women. RESULTS About 22.8% of men and 30.8% of women who were living alone were dissatisfied with their present living arrangement. It was revealed that both men and women who were dissatisfied with their present living arrangements had significantly higher odds of experiencing poor self-rated health [OR:4.45, 3.25 ~ 6.09 and OR:3.32, 2.54 ~ 4.34], low psychological health [OR: 2.15, 1.61 ~ 2.86 and OR: 1.99, 1.57 ~ 2.53], low subjective well-being [OR: 3.37, 2.54 ~ 4.45 and OR: 3.03, 2.36 ~ 3.38], low ADL [OR: 1.77, 1.2 ~ 2.62 and OR: 1.59, 1.17 ~ 2.18, low IADL] [OR: 1.32, 1.03 ~ 1.69 and OR: 1.57, 1.24 ~ 1.98] and low cognitive ability [OR: 1.26, 0.98 ~ 1.61 and OR:1.44, 1.13 ~ 1.82] in comparison to their counterpart from men and women respectively. CONCLUSION It is found that dissatisfaction with the living arrangement of older men and women is negatively associated with major health outcomes. Hence, appropriate policies and programs must be developed to promote increased family care and support and an improved residential environment that would create a feeling of comfort and happiness among older individuals.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Subhojit Shaw
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Himanshu Chaurasia
- National Institute for Research in Reproductive Health, ICMR, Parel, Mumbai, 400088 India
| | - Naina Purkayastha
- Department of Statistics, Dibrugarh University, Dibrugarh, Assam India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Stroope S, Kroeger RA, Fan J. Gender contexts, dowry and women's health in India: a national multilevel longitudinal analysis. J Biosoc Sci 2021; 53:508-521. [PMID: 32772940 PMCID: PMC10865775 DOI: 10.1017/s0021932020000334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Gender-biased contexts may impact women's lives across a variety of domains. This study examined whether changes in district prevalence of a salient gendered practice - dowry - are associated with changes in poor health for women in India. Two waves of national multilevel panel data were used to assess the relationship between changes in district-level dowry prevalence and changes in self-rated health for 23,785 ever-married women aged 15-50 years. Increased dowry prevalence was found to be associated with increased poor self-rated health for women. This relationship remained when controlling for potentially confounding factors including household socioeconomic status, caste, infrastructure, mobility and state fixed-effects.
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Affiliation(s)
- Samuel Stroope
- Department of Sociology, Louisiana State University, Baton Rouge, USA
| | | | - Jiabin Fan
- Department of Sociology, Louisiana State University, Baton Rouge, USA
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income status with psychological distress and subjective well-being: a cross-sectional study among older adults in India. BMC Psychol 2021; 9:82. [PMID: 34006311 PMCID: PMC8130272 DOI: 10.1186/s40359-021-00588-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As the older population aged 65 and over worldwide, is estimated to increase from 9% in 2019 to 16% in 2050, rapid aging will transform the aspects such as economic security, employment status, and family structure. The effects of lower levels of perceived income and poor socioeconomic status on the mental health of older adults appear to be large and enduring. Therefore, the present study contributes to the literature on understanding the association of socioeconomic conditions and self-perceived income status in particular, with self-assessed mental health outcomes (psychological distress and subjective well-being) among older adults in India. METHODS Data for the present study was derived from the Building Knowledge Base on Population Ageing (BKPAI) in India. Bivariate and binary logistic regression analyses were conducted to understand the relationship between socioeconomic status and outcome variables. RESULTS About 43% of older adults had no income whereas 7% had income but perceived as not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost 70% older adults had received no pension and nearly 18% of older adults had no asset ownership. It is revealed that older adults with income that is partially sufficient to fulfil their basic needs were 2.23 times [OR: 2.23, CI: 1.75-2.84] and 1.96 times [OR: 1.96, CI: 1.55-2.47] significantly more likely to suffer from psychological distress and low subjective well-being than those who had income which was sufficient to fulfil their basic needs. CONCLUSIONS By focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.
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Affiliation(s)
- T. Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - T. V. Sekher
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India. BMC Psychiatry 2021; 21:256. [PMID: 34001051 PMCID: PMC8130352 DOI: 10.1186/s12888-021-03257-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. METHODS Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. RESULTS About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21-1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72-0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. CONCLUSION The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.
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Affiliation(s)
- T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. V. Sekher
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Srivastava S, Purkayastha N, Chaurasia H, Muhammad T. Socioeconomic inequality in psychological distress among older adults in India: a decomposition analysis. BMC Psychiatry 2021; 21:179. [PMID: 33823847 PMCID: PMC8025542 DOI: 10.1186/s12888-021-03192-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Older people coming from a lower wealth gradient are more vulnerable to have stressful life events further adding more risk for common mental health disorders and psychological distress situations. The present study explores the associations between socioeconomic and health-related variables and psychological distress among older adults in India and the contribution of such factors to the inequalities in psychological distress. METHODS A cross-sectional survey of 9181 older adults conducted as 'Building a Knowledge Base on Population Ageing in India' was assessed. Logistic regression and decomposition models were used to analyze the data. Psychological distress was measured from General Health Questionnaire (GHQ-12). The value of Cronbach's alpha was 0.90. It was having a scale of 0 to 12 on the basis of experiencing stressful symptoms and was re-coded as 0 (representing 6+ stressful symptoms) and 1 (representing 5 and fewer symptoms). RESULTS Older adults from the poored, suffering from multi-morbidity, disabled, with low activities of daily living and low instrumental activities of daily living and poor cognitive ability were suffering from high psychological distress in India. Further, factors such as religion, caste, education, living arrangements, and self-worth in the family were major contributors to the concentration of psychological distress in older adults from poor households (concentration index: - 0.23). CONCLUSION The study suggests that among older people, there is a wide disparity of experiencing psychological distress across different socio-economic groups with significant factors being responsible for inequality in psychological distress. There is a need to build a "win-win" circumstance across sectors, including a broad spectrum of health, social and economic benefits to the vulnerable older population.
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Affiliation(s)
- Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Naina Purkayastha
- grid.412023.60000 0001 0674 667XDepartment of Statistics, Dibrugarh University, Dibrugarh, Assam India
| | - Himanshu Chaurasia
- grid.416737.00000 0004 1766 871XNational Institute for Research in Reproductive Health, ICMR, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Srivastava S, Chauhan S, Muhammad T, Simon DJ, Kumar P, Patel R, Singh S. Older adults’ psychological and subjective well-being as a function of household decision making role: Evidence from cross-sectional survey in India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.100676] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Patel R, Marbaniang SP, Srivastava S, Kumar P, Chauhan S, Simon DJ. Gender differential in low psychological health and low subjective well-being among older adults in India: With special focus on childless older adults. PLoS One 2021; 16:e0247943. [PMID: 33684164 PMCID: PMC7939372 DOI: 10.1371/journal.pone.0247943] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 02/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Gender and health are two factors that shape the quality of life in old age. Previous available literature established an associaton between various demographic and socio-economic factors with the health and well-being of older adults in India; however, the influence of childless aged is neglected. Therefore, the study examined the gender differential in psychological health and subjective well-being among older adults, focusing on childless older adults. METHODOLOGY This study utilized data from Building a Knowledge Base on Population Aging in India (BKPAI). Psychological health and subjective well-being were examined for 9541 older adults aged 60 years & above. Descriptive statistics and bivariate analysis were used to find the preliminary results. Further, multivariate analysis has been done to fulfill the objective of the study. RESULTS Around one-fifth (21.2%) of the men reported low psychological health, whereas around one-fourth (25.5%) of the women reported low psychological health. Further, around 24 per cent of men and 29 per cent of women reported low subjective well-being. Results found that low psychological well-being (OR = 1.87, C.I. = 1.16-3.01), as well as low subjective well-being (OR = 1.78, C.I. = 1.15-2.76), was higher in childless older women than in childless older men. Higher education, community involvement, good self-rated health, richest wealth quintile, and residing in urban areas significantly decrease the odds of low subjective well-being and low psychological well-being among older adults. CONCLUSION There is a need to improve older adults' psychological health and subjective well-being through expanded welfare provisions, especially for childless older adults. Moreover, there is an immediate requirement to cater to the needs of poor and uneducated older adults.
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Affiliation(s)
- Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Strong P. Marbaniang
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
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Srivastava S, Muhammad T. Violence and associated health outcomes among older adults in India: A gendered perspective. SSM Popul Health 2020; 12:100702. [PMID: 33304986 PMCID: PMC7708932 DOI: 10.1016/j.ssmph.2020.100702] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Since older population in India continue to rely on family and social networks for care and support, understanding the health outcomes associated with violence within and outside family may direct the development of policies and measures to aid the victims of violence. The present paper examines the health consequences of violence against older adults and its gender differentials in India. METHODS Using data from Building Knowledge Base on Population Ageing in India (BKPAI), we employed bivariate and logistic regressions on a sample of 9181 older adults to fulfil the aims and objective of the paper. RESULTS About 10.7% and 11.3% of men and women faced violence after turning 60 years respectively. Older adults who ever faced violence after turning age 60 years had 60%, 41% and 33% higher likelihood to have poor-SRH, low ADL and low IADL respectively in comparison to their counterparts. Further, it was found that older adults who ever faced violence after turning age 60 years had 97% and 62% higher likelihood to have lower psychological health and low subjective well-being. Additionally, it was found that women who faced violence had higher odds of having low psychological health [OR: 1.18, CI: 1.06, 1.63], low subjective well-being [OR: 1.70, CI: 1.24, 2.33] and low cognitive ability [OR: 1.32, CI: 1.04, 1.79] in comparison to men who faced violence. CONCLUSION Violence against older adults must be recognized as a key public health issue for older adults in India. Study findings indicate the immediate need for assessing victim health outcomes following any type of violence in later years to determine related policies and programs to protect the victims. Reducing violence will have a positive impact on physical and mental health outcomes late in life as well as the functional abilities of older adults, especially older women.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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Why Rotational Living Is Bad for Older Adults? Evidence from a Cross-Sectional Study in India. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09312-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ler P, Sivakami M, Monárrez-Espino J. Prevalence and Factors Associated With Intimate Partner Violence Among Young Women Aged 15 to 24 Years in India: A Social-Ecological Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4083-4116. [PMID: 29294780 DOI: 10.1177/0886260517710484] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intimate partner violence (IPV) is a critical public health issue that has reached epidemic proportions. Research investigating IPV among young women in India using large-scale population data is lacking. This study examined the prevalence and factors associated with IPV among women aged 15 to 24 years in India through a social-ecological approach. This cross-sectional study analyzed data from the National Family Health Survey, a population-based survey conducted in India from 2005 to 2006. The past-year prevalence of emotional, physical, and sexual forms of IPV, among ever-married women aged 15 to 24 years were computed. Multivariate logistic regression was conducted to evaluate the association of factors at various levels of the social-ecological framework with the past-year experience of emotional, physical, sexual, and any form of IPV. The past-year prevalence of IPV among women aged 15 to 24 years (n = 16,285) was 29%. Physical IPV was the most common, affecting 23% in the past year. The past-year prevalence of sexual IPV among women aged 15 to 24 years at 9.5% was higher than older women. Individual factors significantly associated with the past-year experience of all forms of IPV were the young age at first marriage, parental IPV, and ever had a terminated pregnancy. At the relationship level, husband's controlling behaviors, his consumption of alcohol, and experience of violence from other family members were positively associated with all forms of IPV in the past year. Poverty and acceptance of IPV increased the women's odds of experiencing IPV. IPV was associated with multiple factors occurring at all levels of the social-ecological framework. Actions to prevent and eliminate IPV in India demand multidisciplinary and collaborative efforts that are tailored specifically for adolescents and young women. It is imperative to protect the girls and young women from IPV; it protects the future of India.
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Affiliation(s)
- Peggy Ler
- Karolinska Institutet, Stockholm, Sweden
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Khanna T, Garg P, Akhtar F, Mehra S. Association between gender disadvantage factors and postnatal psychological distress among young women: A community-based study in rural India. Glob Public Health 2020; 16:1068-1078. [PMID: 32928069 DOI: 10.1080/17441692.2020.1820066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Common mental health disorders are studied extensively among adult women globally. However, they remain under-researched among young women. This study aims to determine whether gender disadvantage factors are associated with psychological distress among young women in rural India, where the child sex ratio is lower than the national average. A cross-sectional survey was conducted in rural Pune, India. A total of 229 young married women who had a live birth in the last 12 months were screened for psychological distress. The predictors of psychological distress were estimated using multivariable logistic regression analyses. Psychological distress was found among 50 respondents (21.9%). Young women who were married before 18 years had 2.19 times higher odds of distress than women who were married after 18 years. Young women who gave birth to a female infant had 2.43 times higher odds of distress than those who gave birth to a male infant. Lack of partner support and experience of postnatal health complications were other predictors. Study findings ascertain the role of gender disadvantage factors in causing psychological distress. From a public health perspective, early identification and treatment of psychological distress, is imperative, along with addressing gender inequitable practices.
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Affiliation(s)
- Tina Khanna
- MAMTA Health Institute for Mother and Child, Delhi, India.,Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Priyanka Garg
- MAMTA Health Institute for Mother and Child, Delhi, India
| | - Faiyaz Akhtar
- MAMTA Health Institute for Mother and Child, Delhi, India
| | - Sunil Mehra
- MAMTA Health Institute for Mother and Child, Delhi, India
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Soares PSM, Meucci RD. [Epidemiology of Common Mental Disorders among women in the rural zones of Rio Grande, RS, Brazil]. CIENCIA & SAUDE COLETIVA 2020; 25:3087-3095. [PMID: 32785544 DOI: 10.1590/1413-81232020258.31582018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/18/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is to describe the prevalence and the factors associated with common mental disorders in women aged 18 to 49, residents in the rural zone of the municipality of Rio Grande-RS. A cross-sectional study was carried out with data collection conducted in 2017. A systematic sampling process of the residences of the rural area of the municipality was utilized. The General Health Questionnaire-12 (GHQ-12) was used to track common mental disorders. Crude and adjusted Poisson regression was used to estimate the prevalence ratios (PR) and respective 95% confidence intervals. The overall prevalence of Common Mental Disorders was 36.4%, being more common among women with lower levels of education, who had had an abortion and were smokers. In quantifying the occurrence and factors associated with common mental disorders in a population of women in a rural area, this study provides an original scientific contribution on the burden of this important outcome in a population that has not been studied in epidemiological surveys. The results can contribute to the health services by identifying the women most susceptible to this outcome, thus, improving the adequacy of the services offered to the health needs of rural residents.
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Affiliation(s)
- Pedro San Martin Soares
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Gen. Osório s/n, Centro. 96200-400 Rio Grande RS Brasil.
| | - Rodrigo Dalke Meucci
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Gen. Osório s/n, Centro. 96200-400 Rio Grande RS Brasil.
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Khobragade B, Sharma V, Deshpande SN. A study on tobacco use in women with major mental illnesses- schizophrenia, bipolar disorder and recurrent depression. Psychiatry Res 2020; 290:113121. [PMID: 32505927 DOI: 10.1016/j.psychres.2020.113121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
About 14.2% of women in the general Indian population and 4.8% in Delhi use tobacco but its use among women with Major Mental Illness (MMI) in developing countries has not been adequately studied. We assessed tobacco use in women with MMI in a tertiary care psychiatry outpatient department through a cross-sectional, observational study, with sample size of at least n= 77 each for schizophrenia-SZ, bipolar disorder-BD and Recurrent Depressive Disorder-RDD. Fagerstrom Test for Nicotine Dependence (FTND) both for smoke and smokeless tobacco were applied along with a subset of questions from Global Adult Tobacco Survey 2016. After diagnosis and referral by the treating psychiatrist and written informed consent, in our total sample of 321 women participants, lifetime use of tobacco was reported by 14.64%. Of all those who had ever used tobacco, 12.14% used it currently as well. As for diagnosis, those with BD (16.25%) used tobacco most frequently followed by SZ (14.18%) and RDD (6%). The FTND score was higher for schizophrenia indicating greater dependence. Tobacco use among women with MMI was thrice as common as women in general population of Delhi State, with smoke and smokeless tobacco use being equally prevalent, a grave cause for concern and intervention.
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Affiliation(s)
- Bhupendra Khobragade
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Vikas Sharma
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Smita N Deshpande
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001.
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Sun KS, Lam TP, Lam KF, Chan HY, Lo TL, Chao DVK, Yu YTT, Lam EWW. Associations between demographic factors and psychological distress among Chinese residents in Hong Kong: beyond socioeconomic classes. PSYCHOL HEALTH MED 2020; 25:1049-1061. [PMID: 31941369 DOI: 10.1080/13548506.2020.1714063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Most studies highlighted the association between psychological distress and socioeconomic status (SES). There were weaker explanations for distress found in the middle classes, especially in Asian countries. We conducted a questionnaire survey with 1626 adult Chinese primary-care attenders from 13 private and 6 public clinics in different districts of Hong Kong. Their demographic background and distress level measured by GHQ-12 were analysed. We found that respondents with younger age, better education, and lower income were more likely to be distressed. In a multiple logistic regression model, age and income, but not education, were significant predictors for distress. Highest rates of distress were found among the unemployed (45.5%) and the students (37.1%), followed by service workers and shop sales workers (33.0%), associate professionals (32.0%), and clerks (29.2%). Craftworkers (9.1%), plant and machine operators (11.5%), and retired people (12.8%) were least likely to be distressed, followed by professionals (21.0%). Apart from SES, the findings suggest that young age, academic and job stressors, and low self-esteem are significant factors for distress. These factors may be intensified in a Chinese context by peer comparison resulting in a state of relative deprivation.
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Affiliation(s)
- Kai Sing Sun
- Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, The University of Hong Kong , Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong, China
| | | | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital , Hong Kong, China
| | - Yee Tsun Tiffany Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong , Hong Kong, China
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Richardson R, Nandi A, Jaswal S, Harper S. The effect of intimate partner violence on women's mental distress: a prospective cohort study of 3010 rural Indian women. Soc Psychiatry Psychiatr Epidemiol 2020; 55:71-79. [PMID: 31177309 PMCID: PMC7140984 DOI: 10.1007/s00127-019-01735-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/03/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Intimate partner violence (IPV) encompasses physical, sexual, and psychological abuse, as well as controlling behavior. Most research focuses on physical and sexual abuse, and other aspects of IPV are rarely investigated. We estimated the effect of these neglected aspects of IPV on women's mental distress. METHODS We used data from 3010 women living in rural tribal communities in Rajasthan, India. Women completed baseline interviews and were re-interviewed approximately 1.5 years later. We measured IPV with questions adopted from the Demographic and Health Survey's Domestic Violence Module, which asked seven questions about physical abuse, three questions about psychological abuse, and five questions about partner controlling behavior. Mental distress was measured with the 12-item General Health Questionnaire (score range 0-12). We used Poisson regression models to estimate the relation between changes in IPV and mental distress, accounting for time-fixed characteristics of individuals using individual fixed effects. RESULTS Women reported an average of 2.1 distress symptoms during baseline interviews. In models that controlled for time-varying confounding (e.g., wealth, other types of abuse), experiencing psychological abuse was associated with an increase of 0.65 distress symptoms (95% CI 0.32, 0.98), and experiencing controlling behavior was associated with an increase of 0.31 distress symptoms (95% CI 0.18, 0.44). However, experiencing physical abuse was not associated with an increase in distress symptoms (mean difference = - 0.15, 95% CI - 0.45, 0.15). CONCLUSIONS Psychological abuse and controlling behavior may be important drivers of the relation between IPV and women's mental health.
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Affiliation(s)
- Robin Richardson
- Department of Epidemiology, Columbia University, 722 West 168 th, New York, NY, 10032, USA.
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada,Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Surinder Jaswal
- Centre for Health and Mental Health, Tata Institute of Social Sciences, Mumbai, India
| | - Sam Harper
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada,Institute for Health and Social Policy, McGill University, Montreal, Canada
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Richardson RA, Harper S, Bates LM, Nandi A. The effect of agency on women's mental distress: A prospective cohort study from rural Rajasthan, India. Soc Sci Med 2019; 233:47-56. [PMID: 31176057 DOI: 10.1016/j.socscimed.2019.05.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022]
Abstract
Agency, the ability to identify goals and then act upon them, is a core component of women's empowerment and has important implications for the rights and well-being of women and girls. However, inadequate measurement of agency impedes empirical investigation, and few studies have investigated the relation between agency and health. Using a theory-based measure of women's agency, we investigated the longitudinal association between agency and mental distress among women living in rural Rajasthan, India. Women completed baseline interviews between June and October 2016 and follow-up interviews between June and November 2017 (n = 2859). We measured mental distress with the Hindi version of the 12 item General Health Questionnaire, which asked women 12 questions about symptoms of mental distress (score range: 0-12). We measured agency using a measurement model which was composed of 23 indicators tapping into four domains of agency and validated in a prior research study. We modeled the relation between women's agency and mental distress using Poisson regression and an individual-level fixed effects approach to account for time-fixed characteristics of individuals. In models that controlled for time-varying confounding (e.g., household wealth, number of sons), a one standard deviation increase in agency was associated with a reduction of 0.21 distress symptoms (95% CI: -0.32, -0.09), which corresponds to a 7% reduction (95% CI: 3%, 11%) relative to the mean. We found that specific domains of agency varied in their association with mental distress; namely, an increase in women's agency regarding her attitudes about gender norms corresponded to a reduction in mental distress, whereas an increase in women's agency regarding speaking up in public corresponded to an increase in mental distress. Our research demonstrates that agency may be a determinant of mental health and that comprehensive measurement can reveal nuanced relationships.
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Affiliation(s)
| | - Sam Harper
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Lisa M Bates
- Department of Epidemiology, Columbia University, New York, USA
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; Institute for Health and Social Policy, McGill University, Montreal, Canada
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Chander KR, Manjunatha N, Binukumar B, Kumar CN, Bada Math S, Janardhan Reddy YC. The prevalence and its correlates of somatization disorder at a quaternary mental health centre. Asian J Psychiatr 2019; 42:24-27. [PMID: 30947092 DOI: 10.1016/j.ajp.2019.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Somatization Disorder (SD) is known to cause disability and impact the quality of life due to psychological and somatic distress. Though it is a Common Mental Disorder (CMD), the disorder tends to visit all levels of health care, among which prevalence of SD at tertiary care is 10.1%. AIMS To estimate current prevalence and its correlates of socio-clinical factors in SD at a quaternary mental health centre (QMHC). METHODS Total of 422 adult subjects were selected through systematic random sampling at first contact psychiatry outpatient clinic. Subjects were interviewed with Mini International Neuropsychiatric Interview Plus version 5.0.0, Clinical Global Impression Severity Scale and Sheehan Disability Scale. RESULTS Current prevalence of SD was 5%. Significant correlates are observed with median age of 40.5 years, female, married, <5 years of education, monthly income of <₹ 10,357(85.5%) and lower socioeconomic status (75%). DISCUSSION There is high prevalence of SD even at QMHC. The higher prevalence among adult population in this setup reflect the impairment of working population which invariably impact on national economy. CONCLUSION Poverty continues to be a major contributing factor to SD causing double impact on the economy by affecting the working population the most.
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Affiliation(s)
- Kalaivanan Rakesh Chander
- Departments of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India
| | - Narayana Manjunatha
- Departments of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India.
| | - B Binukumar
- Departments of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India
| | - Channaveerachari Naveen Kumar
- Departments of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India
| | - Suresh Bada Math
- Departments of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India
| | - Y C Janardhan Reddy
- Departments of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bengaluru, India
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Mathias K, Kermode M, San Sebastian M, Davar B, Goicolea I. An asymmetric burden: Experiences of men and women as caregivers of people with psycho-social disabilities in rural North India. Transcult Psychiatry 2019; 56:76-102. [PMID: 30141376 DOI: 10.1177/1363461518792728] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Caring for a family member with a psycho-social disability can be both rewarding and burdensome. This study analyses the experiences of caregivers of people with psychosocial disabilities (PPSDs) in rural communities in North India using relational gender theory. In-depth interviews with 18 female and male caregivers of PPSDs probed the social, emotional and health impacts of their caregiving role. Nine themes were identified that were grouped under three meta-themes: intra-personal, inter-personal and institutional impacts. Under the intra-personal meta-theme, all caregivers experienced high tension, with women describing almost overwhelming stress. Women minimised their role as caregivers, and felt negative and hopeless about their futures, while men had a more positive view of the future and themselves. Embodied experiences of psychological and social distress were consistently described by women, but not by men. Within the interpersonal meta-theme, men experienced opportunity for social connection and social support that was seldom available to women. Interpersonal violence with other household members was described by both men and women. Within the institutional meta-theme, both men and women described strength in unity, and gestures leading to the reordering of gender relations. These findings underline the significant and diffuse impacts of a gender order that values males and disadvantages females as caregivers of PPSDs, with the asymmetry of a greater burden for women. The findings point to the urgent need for global mental health policies that support and empower caregivers and that strengthen gender equality.
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Joe W, Perkins JM, Subramanian SV. Community involvement, trust, and health-related outcomes among older adults in India: a population-based, multilevel, cross-sectional study. Age Ageing 2019; 48:87-93. [PMID: 30379981 PMCID: PMC6322503 DOI: 10.1093/ageing/afy154] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/30/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives this study examined whether individual and contextual measures of structural and cognitive social capital were associated with six health-related outcomes across older adults in India. Methods data were collected from a representative sample of adults aged 60 and above across India in 2011-12 (n = 9,174). Personal community involvement and having someone to trust represented individual measures of structural and cognitive social capital. These measures were then aggregated to represent contextual measures of social capital, that is, the mean village level of community involvement and the village proportion having someone to trust. To examine associations between all four social capital indicators and six outcomes including self-rated health, psychological well-being, subjective well-being, memory, activities of daily living (ADL), and instrumental activities of daily living, we fit pooled, sex-stratified, and place-stratified multilevel regression models and adjusted for demographic and socio-economic factors. Results personal community involvement was positively associated with all outcomes among the full sample. Adjusted odds ratios ranged from 1.05 (95% CI 1.02; 1.08) for good self-rated health to 1.42 (95% CI 1.33; 1.53) for high-ADL function. Personally having someone to trust was associated with four outcomes. Village-level social capital measures were less frequently associated with outcomes than personal social capital measures. Association strength between six health-related outcomes and individual and contextual measures of structural and cognitive social capital varied, however, among older people in India by sex, place and outcome. Discussion interventions to promote healthy ageing by increasing community involvement and trust may need to be tailored to population subgroups.
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Affiliation(s)
- William Joe
- Population Research Centre, Institute of Economic Growth, Delhi, India; Department of Social and Behavioral Science, Harvard School of Public Health, Boston, MA, USA
| | - Jessica M Perkins
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA; Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S V Subramanian
- Department of Social and Behavioral Science, Harvard School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Richardson RA, Harper S, Schmitz N, Nandi A. The effect of affordable daycare on women's mental health: Evidence from a cluster randomized trial in rural India. Soc Sci Med 2018; 217:32-41. [PMID: 30292875 DOI: 10.1016/j.socscimed.2018.09.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/17/2018] [Accepted: 09/29/2018] [Indexed: 11/30/2022]
Abstract
Access to affordable daycare might improve population mental health. However, evidence is sparse and restricted to middle- and high-income country settings. We conducted a cluster-randomized controlled trial in one low-income setting, rural Rajasthan, India. Communities lacking daycare facilities were identified (n = 160) and randomly selected for assistance in setting up a community-based daycare program (n = 80) or not (n = 80). Women eligible for the daycare program living in these communities completed structured interviews before the intervention (participation rate = 89%) and approximately one year after rollout of the intervention (participation rate = 96%), resulting in a final analytic sample of 3041. Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire (score range: 0-12). We modeled the relation between access to daycare and number of mental distress symptoms (GHQ-12 score) with negative binomial regression using an intention-to-treat approach, which groups women according to if they lived in communities randomized to affordable daycare. We also evaluated the effect of access to daycare on secondary outcomes that may be related to mental distress, including women's work burden, agency, and intimate partner violence (IPV). We found that access to daycare resulted in modest reductions in symptoms of mental distress (mean difference = 0.21, 95% CI: -0.43, 0.02). We found some evidence that daycare reduced IPV, but virtually no change in women's work burden or agency. Our results provide some indication that access to affordable daycare might be one policy lever to improve population mental health.
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Affiliation(s)
- Robin A Richardson
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
| | - Sam Harper
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada; Institute for Health and Social Policy, McGill University, 1130 Pine Avenue West, Montreal, QC, H3A 1A3, Canada
| | - Norbert Schmitz
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada; Department of Psychiatry, Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4A 1R3, Canada
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada; Institute for Health and Social Policy, McGill University, 1130 Pine Avenue West, Montreal, QC, H3A 1A3, Canada
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Tomori C, Srikrishnan AK, Mehta SH, Nimmagadda N, Anand S, Vasudevan CK, Celentano DD, Solomon SS. HIV risks among women who are married to men who have sex with men in India: a qualitative investigation. CULTURE, HEALTH & SEXUALITY 2018; 20:873-887. [PMID: 29125041 PMCID: PMC5945330 DOI: 10.1080/13691058.2017.1390161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In countries such as India, men who have same-sex partnerships may marry women due to cultural pressures regardless of their sexual desires and preferences. The wives of such men may be at risk for HIV but limited existing research addresses this issue. This qualitative study used in-depth interviews to investigate HIV-related risk among married men who have sex with men (n = 34) and women who were aware of their husband's same-sex behaviour (n = 13) from six research sites in five states and a Union Territory in India: Delhi (Delhi), Visakhapatnam (Andhra Pradesh), Hyderabad (Telangana), Bengaluru (Karnataka), Chennai and Madurai (Tamil Nadu). Thematic analysis revealed that wives of men who have sex with men were at risk for HIV from their husbands' sexual practices, which are often hidden to avoid the potential consequences of stigmatisation, as well as from gender-based inequities that make husbands the primary decision-makers about sex and condom use, even when wives are aware of their husband's same-sex behaviour. Innovative interventions are needed to address HIV-related risk in couples where wives remain unaware of their husband's same-sex behaviour, and for wives who are aware but remain within these marriages.
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Affiliation(s)
- Cecilia Tomori
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Santhanam Anand
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
| | | | - David D. Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sunil S. Solomon
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M. Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia. BMC Psychiatry 2018; 18:195. [PMID: 29902985 PMCID: PMC6002988 DOI: 10.1186/s12888-018-1781-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers. METHODS We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS). RESULTS Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers. CONCLUSION Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
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Affiliation(s)
- Hashima E. Nasreen
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Jamalludin Ab Rahman
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Razman Mohd Rus
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Mira Kartiwi
- Faculty of Information and Communication Technology, International Islamic University Malaysia, Jalan Gombak, 53100 Kuala Lumpur, Malaysia
| | - Rosnah Sutan
- Community Health Department, Universiti Kebangsaan Malaysia, Bandar Tun Razak Cheras, 56000 Kuala Lumpur, Malaysia
| | - Maigun Edhborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, SE-141 83 Huddinge, Stockholm, Sweden
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Fahey N, Soni A, Allison J, Vankar J, Prabhakaran A, Moore Simas TA, Byatt N, Phatak A, O'Keefe E, Nimbalkar S. Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women. Ann Glob Health 2018; 82:779-787. [PMID: 28283129 PMCID: PMC5485235 DOI: 10.1016/j.aogh.2016.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics. OBJECTIVES To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics. METHODS Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities. FINDINGS The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD. CONCLUSIONS Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome challenging life events and stressors, thereby reducing the risk of CMD.
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Affiliation(s)
| | - Apurv Soni
- University of Massachusetts, Worcester, MA.
| | | | | | | | | | | | - Ajay Phatak
- Pramukhswami Medical College, Gujarat, India
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Sithey G, Li M, Wen LM, Kelly PJ, Clarke K. Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan's Gross National Happiness Study, 2015. BMJ Open 2018; 8:e018202. [PMID: 29453295 PMCID: PMC5857675 DOI: 10.1136/bmjopen-2017-018202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Common mental disorders (CMDs) are a major cause of the global burden of disease. Bhutan was the first country in the world to focus on happiness as a state policy; however, little is known about the prevalence and risk factors of CMDs in this setting. We aim to identify socioeconomic, religious, spiritual and health factors associated with symptoms of CMDs. DESIGN AND SETTING We used data from Bhutan's 2015 Gross National Happiness (GNH) Survey, a multistage, cross-sectional nationwide household survey. Data were analysed using a hierarchical analytical framework and generalised estimating equations. PARTICIPANTS The GNH Survey included 7041 male and female respondents aged 15 years and above. MEASURES The 12-item General Health Questionnaire was used to measure symptoms of CMDs. We estimated the prevalence of CMDs using a threshold score of ≥12. RESULTS The prevalence of CMDs was 29.3% (95% CI 26.8% to 31.8%). Factors associated with symptoms of CMDs were: older age (65+) (β=1.29, 95% CI 0.57 to 2.00), being female (β=0.70, 95% CI 0.45 to 0.95), being divorced or widowed (β=1.55, 95% CI 1.08 to 2.02), illiteracy (β=0.48, 95% CI 0.21 to 0.74), low income (β=0.37, 95% CI 0.15 to 0.59), being moderately spiritual (β=0.61, 95% CI 0.34 to 0.88) or somewhat or not spiritual (β=0.76, 95% CI 0.28 to 1.23), occasionally considering karma in daily life (β=0.53, 95% CI 0.29 to 0.77) or never considering karma (β=0.80, 95% CI 0.26 to 1.34), having poor self-reported health (β=2.59, 95% CI 2.13 to 3.06) and having a disability (β=1.01, 95% CI 0.63 to 1.40). CONCLUSIONS CMDs affect a substantial proportion of the Bhutanese population. Our findings confirm the importance of established socioeconomic risk factors for CMDs, and suggest a potential link between spiritualism and mental health in this setting.
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Affiliation(s)
- Gyambo Sithey
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mu Li
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Li Ming Wen
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Health Promotion Unit, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Patrick J Kelly
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kelly Clarke
- Institute for Global Health, University College London, London, UK
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Dinos S, Ascoli M, Owiti JA, Bhui K. Assessing explanatory models and health beliefs: An essential but overlooked competency for clinicians. BJPSYCH ADVANCES 2018. [DOI: 10.1192/apt.bp.114.013680] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
SummaryExplanatory models of illness – the way people perceive, interpret and respond to it – are mediated not only by the illness itself, but also by cultural and social contexts. This article discusses recent evidence showing how the exploration of explanatory models can help to shape treatment and outcomes for some of the most common categories of mental illness, and presents case studies illustrating dilemmas clinicians face when their explanatory models differ from those of their patients. It concludes with recommendations on how a culturally sensitive clinical approach based on the exploration of explanatory models during assessment and treatment can be used as an effective way of dealing with the complexity of patients' and families' needs.Learning Objectives• Appreciate the use of explanatory models in clinical practice• Understand the relevance of explanatory models in relation to specific diagnostic categories of mental illness• Recognise that dilemmas may arise if the explanatory models of the clinician and the patient differ, and be able to manage this tension
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Richardson RA, Nandi A, Jaswal S, Harper S. Are work demands associated with mental distress? Evidence from women in rural India. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1501-1511. [PMID: 29058017 DOI: 10.1007/s00127-017-1448-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE High work demands might be a determinant of poor mental health among women in low- and middle-income countries, especially in rural settings where women experience greater amounts of labor-intensive unpaid work. Research originating from such settings is lacking. METHODS We estimated the cross-sectional association between work demands and mental distress among 3177 women living in 160 predominantly tribal communities in southern Rajasthan, India. A structured questionnaire captured the number of minutes women spent on various activities in the last 24 h, and we used this information to measure women's work demands, including the total work amount, nature of work (e.g., housework), and type of work (e.g., cooking). Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire. We used negative binomial regression models to estimate the association between work demands (amount, nature, and type) and mental distress. RESULTS On average, women spent more than 9.5 h a day on work activities. The most time, intensive work activity was caring for children, the elderly, or disabled (149 min). In adjusted models, we found a U-shaped association between work amount and mental distress. High amounts of housework were associated with higher distress, whereas paid work and farmwork amount were not. Certain types of housework, including collecting water and cleaning, were associated with increased distress scores. CONCLUSIONS We found an association between aspects of work demands and mental distress. Research in other contexts where women perform high amounts of unpaid work, particularly within the home or farm, is warranted.
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Affiliation(s)
- Robin A Richardson
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, H3A 1A2, Canada.
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, H3A 1A2, Canada.,Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Surinder Jaswal
- Centre for Health and Mental Health, Tata Institute of Social Sciences, Mumbai, India
| | - Sam Harper
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, H3A 1A2, Canada.,Institute for Health and Social Policy, McGill University, Montreal, Canada
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