Women's reproductive health and depression - A community survey in the Gambia, West Africa
Women's reproductive health and depression - A community survey in the Gambia, West Africa
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DOI：
10.1007/s00127-006-0085-8
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发表时间：
2006-09-01
影响因子：
4.4
通讯作者：
Walraven, Gijs
中科院分区：
文献类型：
--
作者：
Coleman, Rosalind;Morison, Linda;Walraven, Gijs
背景：抑郁症是发展中国家最常见的精神疾病，贫困妇女面临的风险最大。在这些情况下，正规的精神卫生服务很少。抑郁症通常与身体症状共同出现，或者不引人注目，所以这种情况经常被忽视。为了加强抑郁症的预防和管理，需要了解容易识别的抑郁症相关因素。本研究探讨了非洲农村育龄妇女抑郁与生殖健康状况之间的关系。方法：对西非冈比亚15-54岁农村妇女进行社区生殖健康调查，包括使用改进的爱丁堡抑郁量表（EDS）、生殖健康问卷和妇科检查进行筛查。然后对抑郁症进行临床评估，并使用565名妇女的数据来估计抑郁症的患病率，并检查与生殖健康状况和人口因素的关系。结果：抑郁症的加权患病率为10.3% （95% CI 8.3-12.7）。抑郁与丧偶或离婚（调整比值比为8.42,2.77-25.57）、不孕症（3.69,1.42-9.65）和严重月经疼痛（3.94,1.52-10.27）的关系最为显著。族群间存在显著差异。处于产后阶段与抑郁的可能性增加无关。结论：本研究指出了生殖潜力和生殖健康在维持农村和资源贫乏社会不同阶层妇女心理健康方面的重要性。它可以为女性抑郁症患者的管理提供一个初步的重点，并指导未来在生殖健康和精神病学方面的研究。
Background: Depression is the commonest mental illness in developing countries and impoverished women are most at risk. Formal mental health services in these situations are rare. Depression commonly co-presents with physical symptoms or else is unspectacular, so the condition often goes unrecognised. To strengthen the prevention and management of depression, information is required on easily recognisable correlates of depression. This study explored associations between depression and reproductive health conditions in rural African women of reproductive age. Methods: A community-based reproductive health survey among rural women aged 15-54 years in The Gambia, West Africa, included screening with a modified Edinburgh Depression Scale (EDS), a reproductive health questionnaire and a gynaecological examination. Depression was then assessed clinically and data for 565 women were used to estimate the prevalence of depression and examine associations with reproductive health conditions and demographic factors. Results: The weighted prevalence of depression was 10.3% (95% CI 8.3-12.7). Being depressed was most significantly associated with widowhood or divorce (adjusted Odds Ratio (aOR) 8.42, 2.77-25.57), infertility (3.69, 1.42-9.65) and severe menstrual pain (3.94, 1.52-10.27). There were significant differences between ethnic groups. Being in the postpartum period was not associated with an increased likelihood of depression. Conclusion: This study points to the importance of reproductive potential and reproductive health in maintaining women's mental well-being across different strata of a rural and resource-poor society. It could provide an initial focus for the management of women with depression as well as directing future research in reproductive health and psychiatry.