Department of Anthropology, University of Calcutta, Kolkata, West Bengal, India.
Indian Council of Medical Research, Hyderabad, India.
PLoS One. 2024 Jul 2;19(7):e0306071. doi: 10.1371/journal.pone.0306071. eCollection 2024.
Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India.
Data from "Understanding the Lives of Adolescents and Young Adults" (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis.
The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence <10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (>25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws' to conceive (for young married women only) were associated with MDD.
For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes.
抑郁症是一种普遍存在且使人虚弱的精神疾病，影响着全球的年轻女性。本研究旨在确定印度比哈尔邦和北方邦年轻女性中重度抑郁症（MDD）的社会心理决定因素。
本研究使用了“了解青少年和年轻人的生活”（UDAYA）研究（2018-19 年）的数据，该研究对象为 12-23 岁的已婚和未婚年轻女性。使用患者健康问卷 PHQ-9 评估 MDD，得分≤10 为阳性。通过多水平二元逻辑回归分析确定 MDD 的决定因素。
MDD 的患病率分别为已婚年轻女性为 13.6%（95%置信区间 12.2-15.2）和未婚女孩为 5.1%（95%置信区间 4.2-6.1）。在已婚年轻女性中，社区层面的变量，如嫁妆相关的羞辱（1.74，95%置信区间 1.15-2.64）和性侵犯（2.15，95%置信区间 1.24-3.73）与 MDD 显著相关。对于未婚女孩，报告的家庭暴力发生率<10%的参与者（0.45，95%置信区间 0.24-0.85）、家庭暴力（≥10%的参与者）%（0.35，95%置信区间 0.19-0.68）和伴侣间暴力（>25%的参与者）（0.42；95%置信区间 0.23-0.74）仍然是 MDD 的显著预测因素。在个体层面，对于两个群体，年龄、参与教育决策、社会资本（目前在校/接受教育课程和朋友数量）、自我效能感、电话骚扰和体育活动均与 MDD 相关。财富指数、求职、参与健康决策（对于未婚女孩）、父母互动和身体虐待（仅对于未婚女孩）以及教育、最近一次性交、来自姻亲的怀孕压力（仅对于已婚年轻女性）与 MDD 相关。
对于已婚年轻女性，社区层面的靶向干预应侧重于社会生态系统，以培养安全的社区环境意识。对于未婚女孩，此外，干预措施还应旨在优化其家庭环境，以获得有效的心理健康结果。
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