教育缓解了农村印度女性压力与精神障碍之间的关系。
Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women.
机构信息
Des Moines University, Des Moines, IA.
University of Massachusetts, Worcester, MA.
出版信息
Ann Glob Health. 2016 Sep-Oct;82(5):779-787. doi: 10.1016/j.aogh.2016.04.001.
BACKGROUND
Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.
OBJECTIVES
To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.
METHODS
Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities.
FINDINGS
The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD.
CONCLUSIONS
Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome challenging life events and stressors, thereby reducing the risk of CMD.
背景
常见精神障碍（CMD）是一组心理健康状况，包括抑郁、焦虑和其他相关非精神病性情感障碍。印度生殖年龄段妇女心理健康的定性解释模型表明，痛苦与 CMD 密切相关。感知压力与 CMD 之间的关系可能会因个体的社会人口统计学特征而减弱或加剧。
目的
在印度西部农村地区筛查生殖年龄段妇女的常见精神障碍（CMD），并探讨感知压力与 CMD 筛查状况之间的关系如何因社会人口统计学特征而变化。
方法
对印度古吉拉特邦农村地区的 700 名妇女进行横断面调查。使用自我报告问卷 20（SRQ-20）进行 CMD 筛查状况评估。使用多变量逻辑回归评估与 CMD 筛查状况相关的因素。使用交互项评估感知压力与 CMD 筛查状况之间关系的效应修饰，并根据预测概率进行解释。
发现
分析队列包括 663 名妇女，约有 1/4 的妇女（157 名，23.7%）CMD 筛查阳性。收入低、教育程度低、食物不安全和创伤后反复思考与 CMD 阳性筛查风险增加有关。感知压力与 CMD 筛查状况密切相关。较高的教育水平减弱了高水平压力与 CMD 筛查状况之间的关系（82.3%、88.8%、32.9%；趋势检验 P 值：0.03）。增加收入和年龄减弱了中度压力与 CMD 之间的联系。
结论
我们的研究结果表明，印度西部农村地区生殖年龄段妇女可能存在较高的 CMD 负担。较高的教育水平可能会减轻压力与 CMD 之间的关联。未来改善印度农村地区心理健康的努力应侧重于通过增强农村妇女的自我效能感和解决问题的能力来预防 CMD，以克服具有挑战性的生活事件和压力源，从而降低 CMD 的风险。
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