Predictors of psychological distress among postnatal mothers in rural Nepal: A cross-sectional community-based study

JOURNAL OF AFFECTIVE DISORDERS

卷:156

Article

Clarke, Kelly¹  Saville, Naomi¹  Shrestha, Bhim²  Costello, Anthony¹  King, Michael³  Manandhar, Dharma²  Osrin, David¹  Prost, Audrey¹ 

[1] UCL, Inst Global Hlth, London WC1N 1EH, England

[2] MIRA, Kathmandu, Nepal

[3] UCL, Mental Hlth Sci Unit, London WC1E 6BT, England

关键词: Postnatal psychological distress;    Postnatal depression;    Common mental disorder;    Nepal;    Maternal mental health;    Rural health;   

DOI  :  10.1016/j.jad.2013.11.018

来源: Elsevier

【 摘 要 】

Background: Perinatal common mental disorders are a major cause of disability among women and have consequences for children's growth and development. We aimed to identify factors associated with psychological distress, a proxy for common mental disorders, among mothers in rural Dhanusha, Nepal. Methods: We used data from 9078 mothers who were screened for distress using the 12 item General Health Questionnaire (GHQ-12) around six weeks after delivery. We assessed the association between GHQ-12 score and socioeconomic, gender based, cultural and reproductive health factors using a hierarchical analytical framework and multilevel linear regression models. Results: Using a threshold GHQ 12 score of >6 to indicate caseness, the prevalence of distress was 9.8% (886/9078). Factors that predicted distress were severe food insecurity (L) 2.21 (95% confidence interval 143, 3.40)), having a multiple birth (2.28 (1.27, 4.10)), caesarean section (1.70 (0.29, 2.24)), perinatal health problems (1.58 (1.23, 2.02)), no schooling (1.37 (1.08, 1.73)), fevver assets (1.33 (1.10, 1.60)), five or more children (1.33 (1.09,1.61)), poor or no antenatal care (1.31 (1.15, 1.48)p <0001), having never had a son (1.31 (1.14, 149)), not staying in the parental home in the postnatal period (1.15 (1.02,1.30)), having a husband with 110 schooling (1.17 (0.96, 1.43)) and lower maternal age (0.99 (0.97, 1.00)). Limitations: The study was cross-sectional and we were therefore unable to infer causality. Because data were not collected for some established predictors, including infant death, domestic violence and history of mental illness, we could not assess their associations with distress. Conclusions: Socioeconomic disadvantage, gender inequality and poor reproductive health predict distress among mothers in Dhanusha. Maternal and child health programmes, as well as povertyalleviation and educational interventions, may be beneficial for maternal mental health. (C) 2013 The Authors. Published by Elsevier EN. All rights reserved.

【 授权许可】

Free