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Lyngdoh LAM, Antony S, Basavarajappa C, Kalyanasundaram JR, Ammapattian T. Marriage in persons with severe mental illness: A narrative review-based framework for a supported relationship. J Family Med Prim Care 2023; 12:3033-3041. [PMID: 38361907 PMCID: PMC10866282 DOI: 10.4103/jfmpc.jfmpc_797_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 02/17/2024] Open
Abstract
Background Studies in the past have shown the effect of mental illness on marriage in persons with severe mental illnesses (SMIs). Primary care and family physicians have a major role in addressing marriage-associated dilemmas in their life. Methods The literature search was conducted from databases such as PubMed, ProQuest, EBSCO, Scopus, and Google Scholar for understanding the context and the problem in-depth for bringing out the narrative-review based framework for addressing the dilemmas. Results Marriage rates in persons with SMI are high in Eastern countries. Marriage in persons with SMI enhances social support and prevents the stigma of being unmarried. Disability, unemployment, stigma, and disclosure-related issues are barriers to getting desirable alliances. Evidence based interventions are available to reduce the associated distress to an extent. Conclusion Published peer-reviewed literature has pointed out that marriage plays a significant role in the life of persons with SMI and their families, especially in Asian countries where marriage is an important social institution. It can have a positive impact or can lead to relapse, marital conflicts, and divorce based on contextual and clinical factors. Hence, there is a need to come up with tailor-made interventions to address marriage-related expectations in persons with SMI.
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Affiliation(s)
- Lavinia A. M. Lyngdoh
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro-Sciences, Bengaluru, Karnataka, India
| | - Sojan Antony
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro-Sciences, Bengaluru, Karnataka, India
| | - Chethan Basavarajappa
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bengaluru, Karnataka, India
| | - Janaki Raman Kalyanasundaram
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro-Sciences, Bengaluru, Karnataka, India
| | - Thirumoorthy Ammapattian
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro-Sciences, Bengaluru, Karnataka, India
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Kumar P C P, P J P, Manohar S, M K, Pandey MK. How men with alcohol use disorder perceive communication, couple satisfaction, relational boredom, and quality of life compared to wives: Findings from a hospital-based study. J Ethn Subst Abuse 2023:1-12. [PMID: 37724020 DOI: 10.1080/15332640.2023.2253751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
In India, use of alcohol between 10 and 70 years is increasing significantly as per the Government of India, Ministry of Social Justice & Empowerment. Chronic alcohol use in men can potentially disrupt their relationships with their wives in several ways, leading to poor communication, trust issues, emotional disconnection, physical abuse, financial strain, and neglecting responsibilities. These factors may reduce the quality of life of the couple and negatively impact the couple's overall well-being. This cross-sectional study assesses the communication, couple satisfaction, relational boredom, and quality of life of wives with alcoholic husbands admitted to inpatient psychiatry services (patients: n = 30; wives: n = 30). A social demographic data sheet, self-perceived communication in couples, couple satisfaction, relational boredom scale, and the World Health Organization's quality of life scales were used to collect data. All participants were chronic alcohol users and had used alcohol for over 10 years. The mean scores of couple satisfaction (p < .001) and quality of life were greater among husbands. In contrast, wives scored significantly higher in communication (p < .001) and relational boredom (p < .001) compared to husbands with alcohol use disorder. Furthermore, communication, couple satisfaction, relational boredom, and quality of life domains were negatively correlated (p < .001). In contrast, communication and relational boredom were positively correlated (p < .001). Men with alcohol use disorder perceived a satisfactory relationship and higher quality of life than did their wives.
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Affiliation(s)
- Pradeep Kumar P C
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | | | - Shivanand Manohar
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Kishor M
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Manoj K Pandey
- Clinical Psychology, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
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3
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Straiton M, Reneflot A, Hynek KA, Liefbroer AC, Hauge LJ. Mental disorder and subsequent marital separation among migrant and non-migrant women. Health Care Women Int 2023; 44:1073-1091. [PMID: 35089826 DOI: 10.1080/07399332.2021.2007926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Using national register data between 2006-2014, we investigated the relationship between outpatient mental health service use (a proxy for mental disorder) and subsequent marital separation among women in Norway and whether the strength of the association differed for migrant and non-migrant women. Our sample population included 679,928 married women aged 18-60 years. Service use was strongly associated with marital separation among all women. The relationship was stronger for Filipinas but weaker for Somalis and Russians, compared with non-migrant women. Migration-related factors may influence marital separation among migrant women and barriers to care are likely to exist.
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Affiliation(s)
- Melanie Straiton
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kamila Angelika Hynek
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Nayak G, Ghosal S, Ghosal J, Dutta A. What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years. BMC Public Health 2023; 23:1434. [PMID: 37501082 PMCID: PMC10373271 DOI: 10.1186/s12889-023-16379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/25/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Hypertension, a critical risk factor for cardiovascular diseases, is found to cluster between spouses due to within-couple aggregation of antecedent environmental risk factors, either through assortative mating or cohabitation. However, majority of the evidence of spousal concordance of hypertension is from Caucasoid couples from western societies, whereas marriage, partner selection, and post-marital roles of husband and wives are very different in Indian society. Therefore, we aimed to comprehensively examine the phenomenon of spousal concordance of hypertension in Indian couples. METHOD Couples from Longitudinal Ageing Study in India Wave 1 (n = 10,994) and National Family Health Survey Round 5 (n = 52,026) represented 15 years + Indian spouses. Hypertension was defined when systolic and/or diastolic blood pressure was > 139 and > 89 mmHg respectively, and/or if the individual was previously diagnosed or on anti-hypertensive medication. Odds Ratios (OR) estimated the within-couple concordance of hypertension while adjusting for five environmental risk factors of hypertension: individual-level body mass index, education and caste, and household-level wealth and place of residence. RESULT OR marginally attenuated from 1.84 (95% Confidence Interval: 1.77, 1.92) to 1.75 (1.68, 1.83) after adjustment, signifying negligible explanation by environmental risk factors, and plausibility of "novel" risk factors. Concordance continued to weaken with age (OR: 2.25 (2.02, 2.52) in < 30 versus 1.36 (1.20, 1.53) in ≥ 60 years). CONCLUSION Our study underscores two critical knowledge gaps: first, the identity of "novel" risk factors of hypertension and second, the mechanism behind weakening of concordance with age. Future research should explore these novel risk factors rigorously and try to modify them. Also, primary healthcare policy of the country should focus on couples in addition to individuals for hypertension and cardiovascular disease screening and management.
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Affiliation(s)
| | - Shishirendu Ghosal
- Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Jyoti Ghosal
- Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, Odisha, India
- KIIT School Public Health, KIIT Deemed to Be University, Bhubaneswar, Odisha, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Public Health Foundation of India, Bhubaneswar, Odisha, 751013, India.
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Raghavan R, Brown B, Horne F, Kumar S, Parameswaran U, Ali AB, Raghu A, Wilson A, Svirydzenka N, Venkateswaran C, Kumar M, Kamal SR, Barrett A, Dasan C, Varma A, Banu A. Stigma and mental health problems in an Indian context. Perceptions of people with mental disorders in urban, rural and tribal areas of Kerala. Int J Soc Psychiatry 2023; 69:362-369. [PMID: 35549575 PMCID: PMC9983047 DOI: 10.1177/00207640221091187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The concept of stigma has been widely used to understand patterns of discrimination and negative ideas surrounding people with mental health problems, yet we know little of the specific nuances of how this might operate beyond the 'Global North'. AIM This paper aims to explore the notion of stigma in an Indian context by considering the lived experience of patients, carers and community members. METHODS A sample of 204 participants, representing mental health patients, informal carers and community members was recruited from urban and rural areas in Kerala, India. Participants took part in interviews where they were encouraged to talk about their experiences of mental ill health, attitudes towards these problems, barriers encountered and sources of support. RESULTS Experiences akin to the experience of stigma in Europe and the United States were elicited but there were important local dimensions specific to the Indian context. The difficulties faced by people with diagnoses of mental disorders in finding marriage partners was seen as an important problem, leading to marriage proposals being refused in some cases, and secrecy on the part of those with mental health problems. Rather than the 'self-stigma' identified in the US, participants were more likely to see this as a collective problem in that it could reflect badly on the family group as a whole rather than just the sufferer. CONCLUSIONS In the Indian context, the idioms of stigma emphasised impairments in marriage eligibility and the implications for the family group rather than just the self.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Manoj Kumar
- Mental Health Action Trust, Kozhikode, Kerala, India
| | | | | | | | | | - Asha Banu
- Tata Institute of Social Sciences, Mumbai, India
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Bhutada K, Chakrapani V, Gulfam FR, Ross J, Golub SA, Safren SA, Prasad R, Patel VV. Pathways Between Intersectional Stigma and HIV Treatment Engagement Among Men Who Have Sex with Men (MSM) in India. J Int Assoc Provid AIDS Care 2023; 22:23259582231199398. [PMID: 37701971 PMCID: PMC10501078 DOI: 10.1177/23259582231199398] [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: 03/21/2023] [Revised: 06/13/2023] [Accepted: 08/18/2023] [Indexed: 09/14/2023] Open
Abstract
In India and other low-and-middle-income countries, little is known about how intersectional stigma affects MSM engagement in ART. Informed by the Health Stigma and Discrimination Framework, we qualitatively examined how multiple stigmas influence ART engagement among Indian MSM. We conducted 3 focus groups (N = 22) with MSM living with HIV, aged 21-58 years, in Delhi and Hyderabad to identify potential intervention targets and solutions to improve treatment outcomes. Framework analysis and techniques were used to code and analyze translated audio-recordings. Findings revealed enacted stigma, associated with HIV and MSM identity, manifested as familial shame and healthcare discrimination, inhibiting access to support, and decreasing HIV care engagement. Anticipated stigma led to worry about disclosure and societal repercussions. Community-Based-Organizations, ART centers, and family members were primary sources of support, leading to increased ART initiation and retention. Potential solutions included using MSM peer-counselors, increasing social support, and providing HIV education to the general community.
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Affiliation(s)
- Kiran Bhutada
- Albert Einstein College of Medicine, Montefiore Health System Bronx, NY, USA
| | - Venkatesan Chakrapani
- Centre for Sexuality and Health Research and Policy (C-SHaRP), C-ShaRP, Chennai, India Chennai, India
| | | | - Jonathan Ross
- Albert Einstein College of Medicine, Montefiore Health System Bronx, NY, USA
| | | | | | | | - Viraj V Patel
- Albert Einstein College of Medicine, Montefiore Health System Bronx, NY, USA
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Sabri B, Rai A, Rameshkumar A. Violence Against Women in India: An Analysis of Correlates of Domestic Violence and Barriers and Facilitators of Access to Resources for Support. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2022; 19:700-729. [PMID: 36530195 PMCID: PMC9756932 DOI: 10.1080/26408066.2022.2105671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Purpose Domestic violence (DV) is a significant public health problem in India, with women disproportionately impacted. This study a) identified risk and protective correlates of DV and, b) barriers and facilitators for seeking and receiving help for DV among women in India. Methods A systematic search of 5 databases was performed to identify correlates of DV in the quantitative literature. The search resulted in inclusion of 68 studies for synthesis. For qualitative exploration, data were collected from 27 women in India. Results While factors such as social norms and attitudes supportive of DV were both risk correlates and barriers to addressing DV, omen's empowerment, financial independence and informal sources of support were both protective correlates of DV as well as facilitators in addressing DV. Conclusions Strong efforts in India are needed to reduce DV-related risk factors and strengthen protective factors and enhance access to care for women in abusive relationships.
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Affiliation(s)
- Bushra Sabri
- John Hopkins University School of Nursing, Baltimore, MD
| | - Abha Rai
- School of Social Work, Loyola University, Chicago, IL
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8
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Attitude towards negotiating safer sexual relations: Exploring power dynamics among married couples in India. J Biosoc Sci 2022; 55:495-508. [PMID: 35582994 DOI: 10.1017/s0021932022000220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The study primarily focuses on analyzing married women's attitudes towards negotiating safer sex in two contexts. The first context is when a woman refuses to have sex with husband if she knows her husband has a sexually transmitted disease (STD) and the second is when she does so if she knows he has sex with other women. The study examined predictors of Indian women's attitude towards negotiating safer-sex using data on 92,306 ever married women from the state module of the 2015-16, National Family Health Survey 4. Descriptive and multilevel logistic regression was used to understand the interplay between the attitude towards negotiation of safer sexual relationships with husband and the selected background characteristics with a primary focus on controlling behaviour and power relations. About 17% of women did not believe in negotiating safer sexual relations with the husband. An approximately equal proportion of ever-married women (79% each) believed in doing so under the two specific conditions, that is, if they knew the husband had an STD and they knew he had sex with other women. Multilevel regression analysis showed that women who had household decision-making power [AOR=0.71; p<0.01] and those whose husbands displayed low control towards them [AOR=0.91; p<0.05] were more likely to believe in negotiating safer-sex. Our findings suggest that women who have controlling partners or those who live under the umbrella of the husband's authority lack the power to negotiate for safer sex. Interventions promoting sexual well-being must deal with negative male perceptions and expectations that perpetuate unhealthy sexual habits and marriage ties.
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9
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Straiton M, Hynek KA, Reneflot A, Hauge LJ. Mental disorder and first-time marriage formation among non-Western migrant women: A national register study. SSM Popul Health 2022; 17:101022. [PMID: 35059491 PMCID: PMC8760389 DOI: 10.1016/j.ssmph.2022.101022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/22/2021] [Accepted: 01/04/2022] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Studies show that there is a mental health selection into marriage among the general population. This study explored the association between mental disorder and marriage formation among non-Western migrant women living in Norway, and whether the association varied with region of origin, income, education and having a dependent child. METHODS Using linked national register data, we followed 49,329 non-Western never married migrant women aged 18-60 living in Norway between 2006 and 2014. As a proxy for mental disorders, we investigated whether outpatient mental health service use was associated with marital formation using discrete time logistic regression analyses. RESULT Overall, outpatient mental health service use was associated with lower odds of marital formation, even after controlling for sociodemographic factors. Interaction analyses suggested that the relationship was weaker for South Asian women, who had the highest odds of marriage formation, compared with Sub-Saharan African women, who had the lowest. The relationship was also stronger for women with children and women with low incomes. CONCLUSION Mental health selection effects may depend on the universality of marriage. Since marriage may be associated with psychosocial and economic benefits, it is important to identify and treat mental disorder among non-Western migrant women, particularly those with childcare responsibilities and low income.
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Affiliation(s)
- Melanie Straiton
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213, Oslo, Norway
| | - Kamila Angelika Hynek
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213, Oslo, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213, Oslo, Norway
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Patil VP, Luck J, Yoon J, Khanna S. Domestic Violence and Sterilization Skew in India: An Instrumental Variable Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1544-NP1565. [PMID: 32532164 DOI: 10.1177/0886260520933044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this study was to assess the prevalence of domestic violence in ever-married women in India and analyze the relationship between domestic violence and use of female sterilization as contraception. We analyzed data from the National Family Health Survey 2005-2006 (NFHS3). The Domestic Violence Module of the survey included abuse experiences and reproductive health outcomes of ever-married women aged 15 to 49 years (n = 69,704). The main outcome of interest was female sterilization and domestic violence experience was the main independent variable. Covariates in our multivariate regression models were guided by the socioecological model for domestic abuse. We estimated a reference linear probability model for the dichotomous outcome. We also employed an instrumental variables procedure to strengthen causal inference under such potential sources of bias as measurement error in reporting domestic violence and omitted variables. The reference model showed an increase of 2.1 percentage points (p < .001) in the probability of female sterilization associated with exposure to domestic violence. After correcting the estimate for the measurement error and omitted variable bias, we found that domestic violence was associated with an increase in female sterilization by 6.4 percentage points (p < .001), which is 18% higher than the rate of sterilization among non-victims. In conclusion, our findings imply that domestic violence may lead abuse victims to opt for female sterilization as contraception. Domestic violence is a significant obstacle to efficient contraceptive use. Programs directed toward violence prevention should work conjointly with family planning programs in India.
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Affiliation(s)
| | - Jeff Luck
- Oregon State University, Corvallis, USA
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Nishat JF, Shovo TEA, Ahammed B, Islam MA, Rahman MM, Hossain MT. Mental health status of early married girls during the COVID-19 pandemic: A study in the southwestern region of Bangladesh. Front Psychiatry 2022; 13:1074208. [PMID: 36683997 PMCID: PMC9849885 DOI: 10.3389/fpsyt.2022.1074208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Due to unemployment, the prolonged lockdown during the COVID-19 pandemic caused panic and deepened poverty, especially among lower-class and marginal people. The related financial crises led to harmful practices such as the early marriage of adolescent girls, which deteriorated these girl's mental state. AIMS This study attempted to assess the prevalence of mental health problems among early married girls and determine the associated predictors of the growing mental health burden. METHODS This cross-sectional survey was conducted during the third wave of the COVID-19 pandemic in Dumuria Upazila in the Khulna district of Bangladesh. Data were collected purposively from 304 girls who were married off during the COVID-19 pandemic, this was carried out between 22 July and 31 August 2022 by administering a semi-structured interview schedule, with mental health measured by the depression, anxiety, and stress scale 21 (DASS 21). The data were analyzed using IBM SPSS Statistics (version 25), and multiple linear regression was executed in order to predict mental health problems among early married girls. RESULTS The findings show that the overall prevalence of depression, anxiety, and stress among early married girls during the COVID-19 pandemic in Bangladesh was 60.9% (95% CI: 0.554-0.663), 74.7% (95% CI: 0.698-0.796), and 23.7% (95% CI: 0.189-0.285). The prevalence was relatively higher among girls from the Sanatan (Hindu) religion and younger girls than among Muslim and older girls, respectively. The multiple linear regressions indicate that age, age at marriage, duration of the marriage, spousal occupation, intimate partner violence (IPV), and subjective happiness were the critical predictors of mental health problems among early married girls. CONCLUSION Early marriage, along with various adverse outcomes, i.e., IPV, maladjustment, and poor subjective happiness, has resulted in heightened mental health problems for young girls. Policymakers should implement coercive measures to prevent early marriage, especially during social, economic, political, and health crises; in addition, more research is recommended in order to explore the mechanisms that make early married girls psychologically vulnerable and thus formulate protective and preventive programs for addressing such vulnerabilities.
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Affiliation(s)
| | - Taufiq-E-Ahmed Shovo
- Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Benojir Ahammed
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, Bangladesh
| | - Md Akhtarul Islam
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, Bangladesh
| | | | - Md Tanvir Hossain
- Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh
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12
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Manjula V., Munivenkatappa M, Navaneetham J, Philip M. Quality of Marital Relationship and Sexual Interaction in Couples With Sexual Dysfunction: An Exploratory Study From India. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/26318318211047547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Sexual dysfunction and marital intimacy and quality are found to have a reciprocal relationship. Examining this relationship in couples seeking help for sexual dysfunctions in the cultural context of India is worthwhile. Aim: This study aims to explore the nature of sexual functioning, sexual interaction, sexual communication, and marital intimacy and quality in couples with sexual dysfunction. Further, relationship between the above variables is also examined. Methods: A cross-sectional, single-group exploratory design was adopted. A sample of 155 married heterosexual individuals, with a clinical diagnosis of sexual dysfunction in either of the spouses, was included in the study. The tools used included MINI neuropsychiatric interview, Marital Quality Scale, Marital Intimacy Questionnaire, Dyadic Sexual Communication Scale, and Sexual Interaction Inventory. Results: Erectile dysfunction and premature ejaculation in men and hypoactive sexual desire disorder in women were the most common sexual dysfunctions. Majority of the sample were young adults. About 82% of the sample had moderate-to-severe levels of marital distress. Mood disorder was the most common psychiatric disorder reported in the sample. High levels of intimacy problems were seen with no significant gender differences in the overall marital quality or intimacy. Difficulty in the overall sexual interactions was found; however, higher levels of dissatisfaction with the frequency of sex and lower self-acceptance was reported by men compared to women. Significant interrelationships were found between marital quality and intimacy, sexual interaction, and sexual communication. Conclusions: Sexual dysfunctions and marital distress are closely related. Sexual interaction and sexual communication play a significant role in marital quality and intimacy.
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Affiliation(s)
- Manjula V.
- Department of Psychology, Christ (deemed to be) University, Bangalore, Karnataka, India
| | - Manjula Munivenkatappa
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mariamma Philip
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Narayan CL, Narayan M, Deepanshu M. Live-In Relationships in India—Legal and Psychological Implications. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/2631831820974585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Live-in relationship, that is, living together as couple without being married to each other in a legally accepted way, is considered a taboo in India. But recently, such relationships are being increasingly common due to a variety of reasons. In absence of any specific legislation, rules, or customs on the subject, the Supreme Court has issued certain guidelines in its judgment for regulating such relationships. This article tries to figure out the current legal positions governing the live-in relationships in India after making a systemic assessment of these judgments. Live-in relationship between two consenting adults is not considered illegal and if the couple present themselves to the society as husband and wife and live together for a significant period of time, the relationship is considered to be a relationship “in the nature of marriage” under the Prevention of Domestic Violence Act, 2005. Consequently, the female partner is entitled to claim alimony under its provisions. Children born out of such relationships are considered legitimate and entitled to get share in the self-acquired property of their parents, though they are not entitled for a coparcenary share in the Hindu undivided family property. Live-in relationships may enable the couple to know each other better, but such no-strings-attached relationship has its disadvantages as well. The couple faces multiple social and logistics problems in day-to-day living. From mental health point of view, it is considered better to be engaged in a good-quality relationship than living alone and having no relation at all.
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Rabha A, Padhy SK, Grover S. Parenting skills of patients with chronic schizophrenia. Indian J Psychiatry 2021; 63:58-65. [PMID: 34083821 PMCID: PMC8106422 DOI: 10.4103/psychiatry.indianjpsychiatry_107_20] [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: 02/09/2020] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 11/14/2022] Open
Abstract
AIM OF THE STUDY This study aims to evaluate the parenting skills of patients with schizophrenia as perceived by themselves and their children and compare the same with a matched healthy control group of parents and their children. MATERIALS AND METHODS Fifty-one patients with schizophrenia and their 51 children were assessed on the Alabama Parenting Scale. A healthy control group of 51 parents and their children were also assessed for parenting. RESULTS The mean age of parents with schizophrenia was 45.23 years. Compared to the parents in the healthy control group, patients with schizophrenia reported deficits in the domains of positive involvement, positive parenting; more often report poor monitoring/supervision, and inconsistent discipline. When the children of patients with schizophrenia and children of healthy parents were compared, children of healthy control parents reported higher positive involvement, positive parenting; and lower corporal punishment and inconsistent discipline. Except for few associations, parenting was not affected by demographic and clinical profile of the patients with schizophrenia. CONCLUSION The present study suggests that patients with schizophrenia have deficits in parenting and there is a need to improve the parenting skills of the patients with schizophrenia.
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Affiliation(s)
- Anjumoni Rabha
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Susanta Kumar Padhy
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Moorkath F, Vranda MN, Naveenkumar C. Profile of Women with Mental Illness Admitted in Shelter Care Homes; A Co-relational Description of Changing Sociocultural Scenario in India. Indian J Community Med 2020; 45:287-290. [PMID: 33354003 PMCID: PMC7745805 DOI: 10.4103/ijcm.ijcm_119_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 02/11/2020] [Indexed: 11/04/2022] Open
Abstract
Background: The prevalent explanations of gender and mental illness in the Indian social structure often highlighted in terms of traditions and gender-colored norms which is confirmed with the patriarchal framework. The combination of women and diagnosis of mental illness disturbs the prescribed gender expectations which accelerate the family abandonment, and many women lead their life in shelter care homes after psychiatric hospitalization. The aim of the study is to assess the sociodemographic characteristics of the residents admitted in shelter care homes and understand the co-relational aspects of changing sociocultural scenario. Subjects and Methods: Recruited 50 women residents living in 14 centers both the governmental and nongovernmental shelter care homes in Bengaluru, Karnataka. Utilized sociodemographic datasheet to assess the sociodemographic variables and retrospective file review to elicit commonalities among the sample. Results: The current study reveals that majority (74%) belongs to the nuclear family, lived in a rented house before institutionalization (46%). The reason for stay in shelter care home reported to be family abandonment and rejection (72%) and majority of the residents experiencing chronic homelessness (92%) are unmarried/separated (82%) and majority revealed none of the family members ever visited them in shelter care homes (66%). Conclusion: It is imperative to understand the connection between sociodemographic details of the women admitted in shelter care homes and the rapid changes occurring in the sociocultural structure for comprehensive understanding of mental illness-homelessness-institutionalization nexus.
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Affiliation(s)
- Febna Moorkath
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Mysore Narasimha Vranda
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Kumar P, Sharma N, Ghai S, Grover S. Perception about Marriage among Caregivers of Patients with Schizophrenia and Bipolar Disorder. Indian J Psychol Med 2019; 41:440-447. [PMID: 31548767 PMCID: PMC6753718 DOI: 10.4103/ijpsym.ijpsym_18_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 06/16/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Marriage has a complex relationship with mental illness. The marriage of a person with mental illness (PMI) is a controversial issue with varied opinions. There is a dearth of studies exploring perception about marriage among caregivers of patients with severe mental disorders. MATERIALS AND METHODS Thirty caregivers were interviewed in depth using a semi-structured interview schedule. Quantitative data were analyzed using MS Excel, while qualitative data were interpreted based on Colaizzi's framework. RESULTS About half (53%) of the caregivers believed that PMI should marry, and 46% of caregivers believed that marriage could worsen the mental illness of their patient. The qualitative analysis showed that factors that affect the decision among caregivers to get their mentally ill wards married include shovelling off the stigma of keeping the unmarried ward at home and to have somebody to take care of the unmarried ward after their death. Many caregivers believe that marriage and/or sexual intercourse can be a cure/treatment for various mental disorders. CONCLUSION Caregivers of patients with severe mental illness have many misconceptions about the association of marriage and outcome of mental illnesses.
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Affiliation(s)
- Pramod Kumar
- National Institute of Nursing Education, Chandigarh, India
| | - Nitasha Sharma
- National Institute of Nursing Education, Chandigarh, India
| | - Sandhya Ghai
- National Institute of Nursing Education, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Ayesa-Arriola R, Pelayo Terán JM, Setién-Suero E, Neergaard K, Ochoa S, Ramírez-Bonilla M, Pérez-Iglesias R, Crespo-Facorro B. Patterns of recovery course in early intervention for FIRST episode non-affective psychosis patients: The role of timing. Schizophr Res 2019; 209:245-254. [PMID: 30772066 DOI: 10.1016/j.schres.2019.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/07/2019] [Accepted: 01/19/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prevention of symptom relapse and promotion of functional recovery are the two main goals of early intervention following a first episode of non-affective psychosis (FEP). The identification of patterns of recovery is important in developing and implementing recovery focused interventions at set time interval. METHOD Patterns of recovery course, in terms of symptomatic and functional remission, were explored at 1 and 3-year follow-up in a sample of 373 consecutive FEP patients. Relapses during this period were considered. RESULTS Four patterns of recovery course were defined: good stable (26%), good unstable (21%), poor unstable (10%), poor stable (43%). Those who met criteria for good stable recovery were more likely have less severe baseline negative symptoms (OR = 2.092; 95% CI = 0.99-4.419) and to not be diagnosed with schizophrenia (OR = 2.242; 95% CI = 1.015-4.954). Short DUP (OR = 2.152; 95% CI = 0.879-5.27) and low premorbid IQ (OR = 2.281; 95% CI = 0.954-5.457) increased the likelihood of good unstable recovery. Less severe baseline negative symptoms (OR = 3.851; 95% CI = 1.422-10.435) and single status (OR = 4.307; 95% CI = 1.014-18.293) increased the likelihood of a poor unstable recovery. Poor unstable pattern was significantly associated with a high relapse rate (73%). CONCLUSIONS Our results shed light on identifying different recovery patterns in FEP. Despite evidence for early intervention effectiveness, we should explore ways to prevent relapse and improve long-term recovery, particularly in reference to the role of timing in the design of interventions.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain.
| | - Jose María Pelayo Terán
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Unidad de Gestión Clínica de Psiquiatría y Salud Mental, Gerencia de Asistencia Sanitaria de El Bierzo, Servicio de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
| | - Karl Neergaard
- Laboratoire Parole et Langage, Aix-Marseille University, Aix-en-Provence, France
| | - Susana Ochoa
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Mariluz Ramírez-Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rocío Pérez-Iglesias
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychosis Studies, Institute of Psychiatry, King's College London, London
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
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Moorkath F, Vranda MN, Naveenkumar C. Women with Mental Illness - An Overview of Sociocultural Factors Influencing Family Rejection and Subsequent Institutionalization in India. Indian J Psychol Med 2019; 41:306-310. [PMID: 31391661 PMCID: PMC6657485 DOI: 10.4103/ijpsym.ijpsym_123_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/18/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Family abandonment and rejection resulting in homelessness are detrimental to women diagnosed with mental illness in India. A majority of the literature related to homelessness holds a western background, and women's homelessness in relation to mental illness is relatively unexplored in the Indian context. This review was conducted to understand the sociocultural factors influencing family rejection and to synthesize the living situation of institutionalized women with mental illness in India. METHODS Literature search in electronic databases (PubMed, Google Scholar), carried out using appropriate keywords, and a manual search in the library catalog. RESULTS As per the selection criteria, 19 reports, including original research articles and conceptual papers, were included and reviewed. CONCLUSION There is a shortage of methodologically sound research in understanding the connection of mental illness-women homelessness-and the institutionalization scenario. This review highlights the necessity of shifting focus from institutionalization to innovative psychiatric rehabilitation strategies using the Mental Healthcare Act, 2017.
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Affiliation(s)
- Febna Moorkath
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
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19
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Sharma Gautam D, Hearn G. No time, no money, no luck: Barriers to prenatal care among dalit women in rural Nepal. Health Care Women Int 2019; 40:914-930. [PMID: 30990774 DOI: 10.1080/07399332.2019.1597366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In Nepal, a large gap exists between non-dalit and dalit women in regard to maternal mortality and prenatal care. Especially rural Dalits are far behind non-dalits in utilizing prenatal care. We explored rural dalit women's prenatal practices and barriers to accessing prenatal care. Interviews revealed that lack of cultural and economic capital, unequal domestic and economic burden, and gender and caste discrimination impact the use of prenatal care. The use of prenatal care might be improved by informing women about free services and incentives, better access and transportation, and heightened sensitivity to the situation of these women.
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Affiliation(s)
- Dipa Sharma Gautam
- Department of Sociology Social Work and Criminology, Idaho State University , Pocatello , Idaho , USA
| | - Gesine Hearn
- Department of Sociology Social Work and Criminology, Idaho State University , Pocatello , Idaho , USA
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20
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Sharma PK, Natrajan-Tyagi R. South Asian American Daughter–Father Relationships in the Aftermath of Maternal Loss. WOMEN & THERAPY 2018. [DOI: 10.1080/02703149.2018.1430395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Pooja Khosla Sharma
- Couple and Family Therapy (CFT) Program, California School of Professional Psychology, Alliant International University, Irvine, California
| | - Rajeswari Natrajan-Tyagi
- Couple and Family Therapy (CFT) Program, California School of Professional Psychology, Alliant International University, Irvine, California
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21
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Relationship Quality as Mediator of Forgiveness and Psychological Well-being among Transgressors in Romantic Relationships. PSYCHOLOGICAL STUDIES 2017. [DOI: 10.1007/s12646-017-0406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Nair AG, Jain P, Agarwal A, Jain V. Work satisfaction, burnout and gender-based inequalities among ophthalmologists in India: A survey. Work 2017; 56:221-228. [DOI: 10.3233/wor-172488] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Pooja Jain
- Advanced Eye Hospital & Institute, Navi Mumbai, Maharashtra, India
| | - Aniruddha Agarwal
- Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Vandana Jain
- Advanced Eye Hospital & Institute, Navi Mumbai, Maharashtra, India
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23
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Ram D, Siddappa AL, Raman R, Hattur BG. Explanatory Models and Medication Adherence in Patients with Depression in South India. J Clin Diagn Res 2017; 11:VC01-VC04. [PMID: 28274025 PMCID: PMC5324470 DOI: 10.7860/jcdr/2017/23954.9170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 10/29/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Conceptualization of depression may have bearing on treatment seeking. It may affect adherence behaviour of the patients. AIM To find out the explanatory models and their relationship with socio-demographic variables and medication adherence in patients with depression. MATERIALS AND METHODS Fifty-eight consecutive patients with depression in remission were recruited as per selection criteria. Socio-demographic details were collected. Patients were assessed using Mental Distress Explanatory Model Questionnaire (MDEMQ) and Morisky Medication Adherence Scale (MMAS). RESULTS Significant scores were observed in all dimensions of explanatory models. In the Mann-Whitney U test the patient's marital status (MU=113.500, p=0.05, sig≤0.05, 2-tailed), and family history of mental illness (MU=165.5, p=0.03, sig≤0.05, 2-tailed) had a statistically significant group difference in the score of MDEMQ. In linear regression analysis, four predictors (MDEMQ subscales Stress, Western physiology, Non-Western physiology and Supernatural) had significantly predicted the value of MMAS (R2=0.937, f=153.558, p<0.001). CONCLUSION Findings of this study suggested that patients with depression harbor multidimensional explanatory model. The levels of explanatory models are inversely associated with levels of medication adherence.
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Affiliation(s)
- Dushad Ram
- Associate Professor, Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Adarsh Lakkur Siddappa
- Assistant Professor, Department of Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Rajesh Raman
- Professor, Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
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24
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Panigrahi A, Panigrahi M, Padhy AP, Das SC. Common mental disorder and its socio-demographic correlates among married women residing in slum areas of Bhubaneswar, India. Women Health 2016; 57:521-533. [PMID: 27105141 DOI: 10.1080/03630242.2016.1181137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The mental health of women residing in slum areas is a neglected and important public health concern. The present cross-sectional study was undertaken during 2012-2013 to assess frequently occurring mental disorders and associated factors among married women 15-45 years of age, residing in slum areas of Bhubaneswar, India. A multistage, cluster, random sampling design was applied to select the study areas. The presence of a mental disorder was determined using a validated, self-reported questionnaire, developed by the World Health Organization. Using a predesigned, pretested schedule, relevant data were collected from 362 eligible, willing women respondents. Eighty women (22.1%) had a mental disorder, 56 (70.0%) of whom never consulted a health-care provider. Results of multiple logistic regression indicated that presence of a mental disorder was positively associated with not being satisfied with managing household financial affairs, not having time to attend social obligations, attending religious services less than four times per month, addiction of a family member to alcohol or drugs, and misunderstandings or quarrels in the family. Policy makers should be encouraged to incorporate such determinants in schemes or programs intended to promote the mental health of married slum women.
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Affiliation(s)
- Ansuman Panigrahi
- a Department of Community Medicine, Kalinga Institute of Medical Sciences , KIIT University , Bhubaneswar , Odisha , India
| | - Madhulita Panigrahi
- a Department of Community Medicine, Kalinga Institute of Medical Sciences , KIIT University , Bhubaneswar , Odisha , India
| | - Aditya Prasad Padhy
- a Department of Community Medicine, Kalinga Institute of Medical Sciences , KIIT University , Bhubaneswar , Odisha , India
| | - Sai Chandan Das
- a Department of Community Medicine, Kalinga Institute of Medical Sciences , KIIT University , Bhubaneswar , Odisha , India
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25
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Narayan CL, Narayan M, Shikha D, Shekhar S. Indian marriage laws and mental disorders: Is it necessary to amend the legal provisions? Indian J Psychiatry 2015; 57:341-4. [PMID: 26816420 PMCID: PMC4711231 DOI: 10.4103/0019-5545.171836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Mridula Narayan
- Clinical Psychologist, Akanksha - An Institute of Mentally Challenged, Bodhgaya, Bihar, India
| | - Deep Shikha
- Department of Psychiatry, AN Magadh Medical College, Gaya, Bihar, India
| | - Shivendra Shekhar
- Department of Psychiatry, AN Magadh Medical College, Gaya, Bihar, India
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26
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Routray P, Schmidt WP, Boisson S, Clasen T, Jenkins MW. Socio-cultural and behavioural factors constraining latrine adoption in rural coastal Odisha: an exploratory qualitative study. BMC Public Health 2015; 15:880. [PMID: 26357958 PMCID: PMC4566293 DOI: 10.1186/s12889-015-2206-3] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 09/02/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Open defecation is widely practiced in India. To improve sanitation and promote better health, the Government of India (GOI) has instituted large scale sanitation programmes supporting construction of public and institutional toilets and extending financial subsidies for poor families in rural areas for building individual household latrines. Nevertheless, many household latrines in rural India, built with government subsidies and the facilitation and support of non-government organizations (NGO), remain unused. Literature on social, cultural and behavioural aspects that constrain latrine adoption and use in rural India is limited. This paper examines defecation patterns of different groups of people in rural areas of Odisha state in India to identify causes and determinants of latrine non-use, with a special focus on government-subsidized latrine owners, and shortcomings in household sanitation infrastructure built with government subsidies. METHODS An exploratory study using qualitative methods was conducted in rural communities in Odisha state. Methods used were focus group discussions (FGDs), and observations of latrines and interviews with their owners. FGDs were held with frontline NGO sanitation program staff, and with community members, separately by caste, gender, latrine type, and age group. Data were analysed using a thematic framework and approach. RESULTS Government subsidized latrines were mostly found unfinished. Many counted as complete per government standards for disbursement of financial subsidies to contracted NGOs were not accepted by their owners and termed as 'incomplete'. These latrines lacked a roof, door, adequate walls and any provision for water supply in or near the cabin, whereas rural people had elaborate processes of cleansing with water post defecation, making presence of a nearby water source important. Habits, socialising, sanitation rituals and daily routines varying with caste, gender, marital status, age and lifestyle, also hindered the adoption of latrines. Interest in constructing latrines was observed among male heads for their female members especially a newlywed daughter-in-law, reflecting concerns for their privacy, security, and convenience. This paper elaborates on these different factors. CONCLUSIONS Findings show that providing infrastructure does not ensure use when there are significant and culturally engrained behavioural barriers to using latrines. Future sanitation programmes in rural India need to focus on understanding and addressing these behavioural barriers.
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Affiliation(s)
- Parimita Routray
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Wolf-Peter Schmidt
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Sophie Boisson
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Thomas Clasen
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Marion W Jenkins
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Department of Civil and Environmental Engineering, University of California Davis, One Shields Ave., Davis, CA, 95616, USA.
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Abstract
Marriage is a social institution that formalizes and stabilizes the union between a man and wife. At times, either of the parties undergoing the contract of marriage may ask it be declared null and void. Psychiatrists and legal experts may be called in to provide opinion whether such a marriage should be annulled. Some laws in India do state unsoundness of mind as a valid reason for nullity of marriage. However, determining unsoundness of mind can be a difficult issue, especially when made in retrospect. This paper highlights some cases where nullity of marriage was contested in view of unsoundness of mind. Furthermore, some issues encountered by psychiatrists pertaining to nullity of marriage are discussed. Though psychiatrists and legal experts may have different ways of approaching the issue of nullity on the basis of psychiatric disorder, the overall aim of both remains the same of avoiding broken homes, upholding the dignity of the individual and legal framework.
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Affiliation(s)
- Siva Nambi
- Department of Psychiatry, Sree Balaji Medical College and Hospital, Chromepet, Chennai, Tamil Nadu, India
| | - Siddharth Sarkar
- Department of Psychiatry, Sree Balaji Medical College and Hospital, Chromepet, Chennai, Tamil Nadu, India
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28
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Affiliation(s)
- Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Abhishek Pathak
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Sharma I, Tripathi CB, Pathak A. Social and legal aspects of marriage in women with mental illness in India. Indian J Psychiatry 2015; 57:S324-32. [PMID: 26330650 PMCID: PMC4539877 DOI: 10.4103/0019-5545.161499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The institution of marriage in Hindus is regulated by the prevailing social norms and the Hindu Marriage Act (HMA), 1955. Married women with mental illness are heavily discriminated. This paper examines the social and legal aspects of Hindu marriage in women with mental illness. The HMA, 1955 lays down the conditions for a Hindu marriage and also provides matrimonial reliefs: Nullity of marriage, restitution of conjugal rights, judicial separation and divorce. The application of the provisions of HMA in the setting mental illness is difficult and challenging. There is a wide gap between the legislative provisions of HMA, and societal value systems and attitudes towards marriage in Indian society. Societal norms are powerful and often override the legal provisions. The disparities are most glaring in the setting of mental illness in women. This is a reflection of social stigma for mental illness and patriarchal attitude towards women. Concerted efforts are needed to bridge the gap between the legislative provisions of HMA and societal value systems and attitudes toward marriage. Awareness programs regarding the nature and types of mental illness, advances in treatment and information about good outcome of severe mental illness will be helpful. Improvement in moral and religious values will overcome to some extent the negative attitudes and patriarchal mind set toward married women with mental illness.
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Affiliation(s)
- Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - C B Tripathi
- Department of Forensic Medicine, Narain Medical College, Sasaram, Bihar, India
| | - Abhishek Pathak
- Department of Psychiatry, National Institute of Mental Health and Neuroscience, Bengaluru, Karnataka, India
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30
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Abstract
The Special Marriage Act (SMA), 1954 and the Hindu Marriage Act (HMA), 1955 have put restrictions on the marriage of persons with mental illness, which are proving to be detrimental to patients and their families. There is an urgent need to address this problem. The deficiencies in the existing legislation have been projected and constructive suggestions have been put forward.
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Affiliation(s)
- Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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31
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Bohra N, Sharma I, Srivastava S, Bhatia MS, Chaudhuri U, Parial S, Sharma A, Kataria D. Violence against women. Indian J Psychiatry 2015; 57:S333-8. [PMID: 26330651 PMCID: PMC4539878 DOI: 10.4103/0019-5545.161500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Violence against women (VAW) is a major public health problem in the country. The problem is grossly under-reported. A number of factors have been blamed for crimes against women. An inefficient law enforcing machinery has often been targeted for the increasing number of cases being reported. There is little recognition that psychiatric morbidity can perpetuate such crimes. Of late, there appears to a continuous increase in the number of crimes committed against women; especially the very serious ones like gang rapes. The latter have shaken the very conscience of people. Even harsher legislation does not seem to have made any effect. One wonders how this could be possible in a society heading toward high education, economic and technological development. Media has played a pivotal role by highlighting the problem to the masses. The need for the hour is for mental health professionals to take the challenge and present a comprehensive proposal for definite action to prevent all forms of VAW.
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Affiliation(s)
| | - Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Shruti Srivastava
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Shahdara, New Delhi, India
| | - M S Bhatia
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Shahdara, New Delhi, India
| | - Uday Chaudhuri
- Department of Medicine, Vivekanand Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Sonia Parial
- Dhanwantri Hospital, Old Dhamteri Road, Raipur, Chhattisgarh, India
| | - Avdesh Sharma
- Department of Psychiatry, Mind Vision Centre for Mental Health, New Delhi, India
| | - Dinesh Kataria
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
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Affiliation(s)
- Indira Sharma
- Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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