Social factors associated with chronic depression among a population-based sample of women in rural Pakistan
Social factors associated with chronic depression among a population-based sample of women in rural Pakistan
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DOI：
10.1007/s00127-004-0781-1
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发表时间：
2004-08-01
影响因子：
4.4
通讯作者：
Creed, F
中科院分区：
文献类型：
--
作者：
Husain, N;Gater, R;Creed, F
客观的。此前的研究报告称，巴基斯坦女性抑郁症患病率很高。本文调查了在西方国家进行的研究中确定的慢性抑郁症的危险因素是否可以解释这种高患病率。方法。使用常见精神障碍自评问卷（SRQ）和精神病学评估表对巴基斯坦农村地区的一般人群样本进行了两阶段调查。人口统计数据以及生活事件和困难表的结果与 SRQ 评分和精神障碍进行了分析。结果。共有 145 名女性接受了筛查。 SRQ 得分高与教育程度低、没有知己、有四个或更多孩子、年龄较大、未婚以及住在每间房超过三人的房子有关。回归分析表明，前三个独立地影响 SRQ 分数。在受访样本（74 名女性）中，只有教育水平独立地导致抑郁症的存在。此外，受教育程度最低的群体经历的显着困难最多：其中 67% 的人经历过显着的住房和经济困难，而其他教育群体的这一比例为 28% 和 25% (p = 0.005)。经历住房和经济困难是受过中等教育的女性患抑郁症的一个重要危险因素，但对于没有受过中等教育的女性则不然。结论。这项研究表明，高度的社会逆境和低教育水平与巴基斯坦女性的抑郁症密切相关。在西方发现的其他脆弱因素（例如缺乏知己、家里有三个或更多幼儿、或童年时期失去母亲）在这一人群中可能不太重要。
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.