Women’s reproductive health and depression
- First Online:
- 264 Downloads
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.
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.
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.
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.
Key wordsdepression common mental disorders (CMD) Africa reproductive health
- 1.Desjarlais R, Eisenberg L, Good B (1995) In world mental health. Problems and priorities in low-income countries. Oxford University Press, LondonGoogle Scholar
- 2.Abas M, Broadhead J (1994) Mental disorders in the developing world. Br Med J 308:1052Google Scholar
- 6.Hobfall S (1998) Stress, culture and community. In: The psychology and philosophy of stress. Plenum Press, New YorkGoogle Scholar
- 14.Harris B, Huckle P, Thomas R, Johns S, Fung H (1989) The use of rating scales to identify postnatal depression. Br J Psych 154:813–817Google Scholar
- 15.Wing J, Cooper J, Sartorius N (1974) Measurement and classification of psychiatric symptoms. Cambridge University Press, pp 190–229Google Scholar
- 16.World Health Organisation (1993) The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. WM 15 World Health Organisation. Geneva and Oxford University Press, OxfordGoogle Scholar
- 17.Diagnostic, Management Guidelines for Mental Disorders (1996) In primary care: ICD10 Chapter V Primary care version. WHO/Hogrefe & Huber Publishers, Gőttingen, Germany Google Scholar
- 19.Sartorius N, Űstűn T, Lecrubier Y, Wittchen H-U (1996) Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. Br J Psychiatry 168(suppl 30):38–43Google Scholar
- 20.Orley J, Wing J (1979) Psychiatric disorders in two African villages. Arch Gen Psych 36:513–520Google Scholar
- 23.Cox J (1979) Psychiatric morbidity and pregnancy: a controlled study of 263 semi-rural Ugandan women. Psychiatry 134:401–405Google Scholar
- 27.Nhiwatiwa S, Patel V, Acunda W (1998) Predicting postnatal mental disorder with a screening questionnaire: a prospective cohort study from Zimbabwe. J Epid Comm Health 52:262–266Google Scholar
- 29.Singhateh SK (1985) Female circumcision, the Gambian experience: a study on the social, economic and health implications. The Gambia Women’s Bureau, Banjul, The GambiaGoogle Scholar