Food insecurity, morbidity, and susto: Factors associated with depression severity in Guatemala measured with the Personal Health Questionnaire 9

2021 ◽  
pp. 002076402110478
Author(s):  
Jonathan Maupin ◽  
Joseph Hackman

Background: Depression is the largest contributor to non-fatal health loss globally and the majority of this burden occurs in low- and middle-income countries. Yet, estimates of prevalence rates and severity in these contexts may be uncertain due to limited screening, lack of mental health providers, and stigma around mental disorders which may prevent individuals from seeking care. In Guatemala, estimates of depression vary, due in part to the range of screening and diagnostic instruments used and diversity of sample populations. Most studies emphasize personal experiences with violence as a predictor of depression in Guatemala, although high rates of inequality, discrimination, and resource scarcity in the country potentially play a role. Aims: In this study, we examine factors associated with depression severity categories measured with the Personal Health Questionnaire 9 (PHQ-9) among a random sample of women in a small urban community in the Central Highlands of Guatemala. Methods: Participants were recruited through a randomized sample of households in a small urban community. Participants completed a questionnaire which included questions on demographics, illness history, food insecurity, and the PHQ-9. In total, 101 women were included in the analysis. Results: Food insecurity, 2-week symptom reporting, and experiencing susto are associated with higher depression severity categories. Conclusion: This research highlights need for more research on factors related to the prevalence and severity of mental disorders, and the relationship between mental disorders and cultural constructs of distress, particularly in areas like Guatemala with limited mental health services.

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund

Abstract Background Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with poverty, food insecurity and domestic violence. We used data collected from perinatal women at two time-points during the COVID-19 pandemic to test the hypotheses that (1) socio-economic adversities at baseline would be associated with higher CMD prevalence at follow-up and (2) worse mental health at baseline would be associated with higher food insecurity prevalence at follow-up. Methods Telephonic interviews were conducted with perinatal women attending healthcare facilities in Cape Town, South Africa. Multivariable logistic regression analysis was used to model the associations of baseline risk factors with the prevalence of household food insecurity and CMD at 3 months follow-up. Results At baseline 859 women were recruited, of whom 217 (25%) were pregnant, 106 (12%) had probable CMD, and 375 (44%) were severely food insecure. At follow-up (n=634), 22 (4%) were still pregnant, 44 (7%) had probable CMD, and 207 (33%) were severely food insecure. In the multivariable regression model, after controlling for confounders, the odds of being food insecure at follow-up were greater in women who were unemployed [OR=2.05 (1.46-2.87); p<0.001] or had probable CMD [OR=2.37 (1.35-4.18); p=0.003] at baseline; and the odds of probable CMD at follow-up were greater in women with psychological distress [OR=2.81 (1.47-5.39); p=0.002] and abuse [OR=2.47 (1.47-4.39); p=0.007] at baseline. Conclusions This study highlights the complex bidirectional relationship between mental health and socioeconomic adversity among perinatal women during the COVID-19 pandemic.


2007 ◽  
Vol 10 (6) ◽  
pp. 574-581 ◽  
Author(s):  
Lucia Kaiser ◽  
Nikki Baumrind ◽  
Sheila Dumbauld

AbstractObjectiveTo identify factors associated with food insecurity in California women.DesignThe California Women's Health Survey is an ongoing annual telephone survey that collects data about health-related attitudes and behaviours from a randomly selected sample of women. Food insecurity of the women was measured by a 6-item subset of the Food Security Module. Statistical procedures included chi-square tests, t-tests, logistic regression analysis and analysis of covariance.SettingCalifornia, USA.SubjectsFour thousand and thirty-seven women (18 years or older).ResultsPrevalence of food insecurity was 25.7%. After controlling for income, factors associated with greater food insecurity were Hispanic or Black race/ethnicity; less than a 12th grade education; being unmarried; less than 55 years old; being Spanish-speaking; having spent less than half of one's life in the USA; sadness/depression; feeling overwhelmed; poor physical/mental health interfering with activities; and fair to poor general health. Among Food Stamp Program (FSP) participants, 71% were food-insecure. Among FSP-eligible women who had not applied for the programme, the prevalence of food insecurity was lower among women responding that they did not need food stamps than in women giving other reasons for not applying (23.9% vs. 66.9%, P < 0.001). Factors associated with food insecurity in FSP recipients included being unable to make food stamps last for 30 days, feeling overwhelmed, and having a birthplace in Mexico or Central America.ConclusionsAlong with several socio-economic variables, poor physical and mental health is associated with food insecurity. Whether food insecurity is a cause or effect of poor health remains in question.


2015 ◽  
Vol 206 (2) ◽  
pp. 110-115 ◽  
Author(s):  
Trang Thu Nguyen ◽  
Thach Duc Tran ◽  
Tuan Tran ◽  
Buoi La ◽  
Hau Nguyen ◽  
...  

BackgroundIn low- and middle-income countries little is known about changes in women's mental health status from the perinatal period to 15 months postpartum or the factors associated with different trajectories.AimsTo determine the incidence and rates of recovery from common mental disorders (CMD) among rural Vietnamese women and the risk and protective factors associated with these outcomes from the perinatal period to 15 months after giving birth.MethodIn a population-based prospective study, a systematically recruited cohort of women completed baseline assessments in either the last trimester of pregnancy or 4–6 weeks after giving birth and were followed up 15 months later. The common mental disorders of major depression, generalised anxiety and panic disorder were assessed by psychiatrist-administered Structured Clinical Interview for DSM-IV Disorders at both baseline and follow-up.ResultsA total of 211 women provided complete data in this study. The incidence rate of CMD in the first postpartum year was 13% (95% CI 8–19), and 70% (95% CI 59–80) of women who had perinatal CMD recovered within the first postpartum year. Incidence was associated with having experienced childhood maltreatment, experiencing the intimate partner as providing little care, sensitivity, kindness or affection, and the chronic stress of household poverty. Recovery was associated with higher quality of a woman's relationships with her intimate partner and her own mother, longer period of mandated rest following birth, and sharing of domestic tasks and infant care.ConclusionsModifiable social factors, in particular the quality of a woman's closest relationships with her partner and her own mother, and participation by family members in domestic work and infant care, are closely related to women's mental health in the first year after giving birth in resource-constrained settings.


2020 ◽  
pp. 107755872094270
Author(s):  
Priyanka Anand ◽  
Yonatan Ben-Shalom ◽  
Eric Schone

We use data from the 2012-2015 TRICARE Standard Survey to examine factors that affect civilian health care providers’ acceptance of patients covered by the U.S. Department of Defense’s TRICARE insurance program and Medicare. We find that 74% of physicians report that they accept new TRICARE patients compared with 83% accepting new Medicare patients; in contrast, only 36% of mental health providers report that they accept new Medicare and/or TRICARE patients. Among the most common reasons provided by both physicians and mental health providers for not accepting either insurance type are insufficient reimbursement or their specialty not being covered; lack of awareness of TRICARE is also frequently cited, particularly among mental health providers. These findings suggest that successful strategies to increase provider acceptance of TRICARE and Medicare may include improving reimbursement rates and specialty coverage and increasing provider awareness of TRICARE through outreach programs.


2020 ◽  
Vol 4 (2) ◽  
pp. 22-28
Author(s):  
M. M. Haddad ◽  
A. I. Ojukwu ◽  
B. Y. Mansur ◽  
U. Yunusa ◽  
B. L. Umar ◽  
...  

The study was conducted to evaluate the factors associated with common mental disorders among women of reproductive age in Sumaila Local Government Area of Kano state. Cross-sectional descriptive design was used. A total of 163 women were recruited for the study using multi-stage sampling technique. A close-ended structured questionnaire was used for data collection. Data collected were organized and analyzed with Statistical Package for the Social Sciences (SPSS) version 20.0 and results were presented using frequency distribution and percentages, and mean±standard deviation. Chi-square analysis was used to test for association between factors associated with and development of common mental disorders at 5% level of significant within 95% confidence interval. Findings from the study revealed that 28.4% of the respondents had Common Mental Disorders, awareness of the respondents were low as most of them believed that demonic possession (73.5%) and witchcraft (58.6%) were the causes of mental illness.   Significant association was found between factors associated with common mental disorders and age at first marriage (χ2=3.395, p=0.048) and low social integration (χ2=5.414, p=0.020), of the women.  The study concluded that common mental disorders in rural communities are mostly related to age at first marriage   It is recommended that mental health personnel should conduct advocacy to traditional and religious leaders, also the male parents in rural areas on the influence of early marriage on mental disorders and clear their misconceptions on its causes, for early prevention and improved mental health seeking behaviour.


2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund

Abstract Objective: Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with food insecurity, domestic violence and lack of social support. This study explores the relationship between household food insecurity, mental health status and several adverse social and economic factors experienced by perinatal women during the COVID-19 pandemic.Design: Cohort study, using telephonic interviews at two time-points, three months apart. Logistic regression analysis was used to model the associations of several baseline risk factors with the occurrence of household food insecurity at follow-up as the outcome.Setting: Midwife obstetric units or basic antenatal care units in Cape Town, South Africa.Participants: The sample comprised of 880 perinatal women at baseline and 660 women at follow-up. Results: At baseline 23% were pregnant, 54% were unemployed, 13% had a probable CMD, 43% were severely food insecure and 21% experienced domestic abuse in the past year. Of the 660 women interviewed at follow-up, 71% were unemployment, 3.5% were pregnant, 7% had a probable CMD, and 32% were severely food insecure. In the multivariate regression model, after controlling for ethnicity, number of children, being HIV-infected, and having a planned pregnancy, the odds of being food insecure were greater in women who were unemployed (OR=1.88; p=0.001) or had probable CMD (OR=2.20; p=0.019) at baseline. Conclusions: This study highlights a range of socio-demographic and mental health related variables that predict food insecurity among perinatal women during the COVID-19 pandemic.


Author(s):  
Zulfa Abrahams ◽  
Sonet Boisits ◽  
Marguerite Schneider ◽  
Martin Prince ◽  
Crick Lund

Abstract Purpose We aimed to explore the relationship between common mental disorders (CMDs), food insecurity and experiences of domestic violence among pregnant women attending public sector midwife obstetric units and basic antenatal care clinics in Cape Town during the COVID-19 lockdown. Methods Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data were collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of domestic violence. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs. Results Of the 2149 women enrolled in the ASSET study, 885 consented to telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was increased in women who were severely food insecure or who experienced psychological or sexual abuse. Conclusions This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low-resource settings in Cape Town and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 295-295
Author(s):  
Christine Walters ◽  
Joel Komakech ◽  
Hasina Rakotomanana ◽  
Barbara Stoecker

Abstract Objectives This study aimed to determine the association between child dietary diversity, household food insecurity, child stunting, and maternal mental health symptoms in the Vakinankaratra region of Madagascar. Methods This cross-sectional study included 391 mother-child dyads. The World Health Organization (WHO) standards were used for defining child dietary diversity and child stunting and the Household Food Insecurity Access Scale (HFIAS) was used for food insecurity scores. Maternal symptoms of common mental disorders were assessed using the WHO Self-Reporting Questionnaire (SRQ), which was translated into Malagasy and pre-tested; a cutoff of seven was used to indicate the occurrence of symptoms of common mental disorders. Multivariate linear and logistic regression models adjusted for strata, cluster, and confounding variables were conducted with statistical significance set at P &lt; 0.05. Results More than half (56.8%) of the mothers reported symptoms of common mental disorders and more than half of the children (69.4%) were stunted. The mean HFIAS score was 10.3 (±5.6) and mean child dietary diversity score was 3.0 (±1.31). Symptoms of common mental disorders were significantly associated with child dietary diversity score in the bivariate analysis but became nonsignificant in the final adjusted model (β = –0.22, P = 0.06, R2 = 0.07). In the adjusted model, having symptoms of common mental disorders was significantly associated with higher HFIAS score (β = 3.45, P &lt; 0.0001, R2 = 0.13) and HFIAS scores were significantly associated with having symptoms of common mental disorders (AOR = 1.31 [1.09–1.17], P &lt; 0.0001). Maternal symptoms of common mental disorders were significantly associated with stunting (AOR = 1.68 [1.02–2.78], P &lt; 0.05). Conclusions Maternal mental health and household food insecurity were significantly associated in this rural area of the Vakinankaratra region in Madagascar. Furthermore, assessing maternal symptoms of common mental disorders and referring mothers for mental health care appears to be an important consideration for improving child stunting in the region. Funding Sources Oklahoma State University.


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