Common mental disorder and associated factors amongst women with young infants in rural Malawi
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Common mental disorder (CMD) affecting women during the childbearing years is an important health problem in low and middle income countries. This study investigates CMD and associated factors amongst women with young infants in rural Malawi.
In this cross-sectional study, mothers of infants due for measles vaccination were recruited from a district hospital child health clinic. Maternal CMD was measured using a Chichewa version of the Self-Reporting Questionnaire (SRQ). DSM-IV diagnoses of major and minor depressive disorder were made using the structured clinical interview for DSM-IV (SCID). Socio-demographic, maternal and infant variables were measured and associations with CMD were determined.
Of 519 eligible women, 501 were included in the analysis. Mean age was 24.4 years and median infant age was 9.9 months. The weighted prevalence of any current depressive episode (minor or major) was 30.4% (95% CI 22.8–38.1%). The weighted prevalence of current major depressive episode was 13.9% (95% CI 8.2–19.5%). Mean SRQ score for the total sample was 5.71 (SD 4.42). On multivariate analysis, SRQ score was significantly associated with lower socioeconomic status, lack of a confiding relationship with partner or relative, and recent infant illness. Amongst the women who knew their HIV status (n = 314), SRQ score was also associated with HIV infection.
This study demonstrates that CMD is a significant health burden among women with infants in rural Malawi, and is associated with poverty, relationship difficulties, HIV infection and infant health problems.
KeywordsCommon mental disorder Depression Maternal Developing countries Risk factors
The authors would like to thank the fieldworkers Mrs. Doreen Nkhulanze and Mrs. Sophie Nkhwazi, the staff at Thyolo District Hospital and the participating mothers. They wish to send thanks to all those who contributed to the funding of this study, and to Professor Peter Winstanley for his support. Astra Zeneca Pharmaceuticals contributed to the funding of the study through an unrestricted educational grant to Dr. Stewart of £2000.
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