Predictors of maternal psychological distress in rural India: A cross-sectional community-based study


Prost, A; Lakshminarayana, R; Nair, N; Tripathy, P; Copas, A; Mahapatra, R; Rath, S; Gope, RK; Bajpai, A; Patel, V; Costello, A; (2012) Predictors of maternal psychological distress in rural India: A cross-sectional community-based study. Journal of affective disorders, 138 (3). pp. 277-286. ISSN 0165-0327 DOI: https://doi.org/10.1016/j.jad.2012.01.029

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Abstract

Background: Maternal common mental disorders are prevalent in low-resource settings and have far-reaching consequences for maternal and child health. We assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among mothers in rural Jharkhand and Orissa, eastern India, where over 40% of the population live below the poverty line and access to reproductive and mental health services is low. Method: We screened 5801 mothers around 6 weeks after delivery using the Kessler-10 item scale, and identified predictors of distress using multiple hierarchical logistic regression. Results: 11.5% (95% Cl: 10.7-12.3) of mothers had symptoms of distress (K10 score >15). High maternal age, low asset ownership, health problems in the antepartum, delivery or postpartum periods, caesarean section, an unwanted pregnancy for the mother, small perceived infant size and a stillbirth or neonatal death were all independently associated with an increased risk of distress. The loss of an infant or an unwanted pregnancy increased the risk of distress considerably (AORs: 7.06 95% CI: 5.51-9.04 and 1.49, 95% CI: 1.12-1.97, respectively). Limitations: We did not collect data on antepartum depression, domestic violence or a mother's past birth history, and were therefore unable to examine the importance of these factors as predictors of psychological distress. Conclusions: Mothers living in underserved areas of India who experience infant loss, an unwanted pregnancy, health problems in the perinatal and postpartum periods and socioeconomic disadvantage are at increased risk of distress and require access to reproductive healthcare with integrated mental health interventions. (C) 2012 Elsevier B.V. All rights reserved.

Item Type: Article
Keywords: Common mental disorder, Maternal depression, India, Rural health, randomized controlled-trial, common mental-disorders, low-income, countries, infant growth, postnatal depression, primary-care, health, intervention, cohort, women
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Mental Health
Centre for Maternal, Reproductive and Child Health (MARCH)
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 22342117
Web of Science ID: 302663900009
URI: http://researchonline.lshtm.ac.uk/id/eprint/27858

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