Social factors associated with chronic depression among a population-based sample of women in rural Pakistan |
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Authors: | Husain N Gater R Tomenson B Creed F |
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Institution: | (1) Institute of Psychiatry, Rawalpindi General Hospital, Rawalpindi, Pakistan;(2) School of Psychiatry & Behavioural Sciences, Rawnsley Building Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK;(3) School of Psychiatry & Behavioural Sciences, University of Manchester, Manchester, UK |
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Abstract: | Abstract
Objective
Previous studies have reported a
high prevalence of depression in women in Pakistan.
This paper investigates whether risk factors for chronic
depression established in studies performed in Western
countries can explain this high prevalence.
Method
A
two–phase survey using the self–rating questionnaire
(SRQ) for common mental disorders and the Psychiatric
Assessment Schedule was performed on a general population
sample in rural Pakistan. Demographic data and
results of the Life Events and Difficulties Schedule were
analysed in relation to SRQ score and psychiatric disorder.
Results
A total of 145 women were screened. High
SRQ score was associated with low educational status,
not having a confidant, having four or more children, being
older, not being married and living in a house with
more than three people per room. Regression analysis
demonstrated that the first three of these independently
contributed to SRQ score. In the interviewed sample (74
women), only educational level independently contributed
to the presence of depression. In addition, the
least educated group experienced the greatest number
of marked difficulties: 67% of them had experienced
both marked housing and financial difficulties compared
to 28% and 25% of the other educational groups
(p = 0.005). Experiencing both housing and financial
difficulties was a significant risk factor for depression in
women with secondary education, but not for those
without secondary education.
Conclusions
This study
suggests that high levels of social adversity and low levels
of education are strongly associated with depression
in women in Pakistan. The other vulnerability factors
found in the West (such as lack of a confidant, the presence
of three or more young children at home, or loss of
mother during childhood) may be of lesser importance
in this population. |
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Keywords: | prevalence women depression social
difficulties developing country |
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