In a recently published study, Dr BMC Public Health, Researchers explored gender-specific factors associated with depression among married adults in Rajshahi, Bangladesh.
Study: Factors influencing depression in married adults: A gender-based family cross-sectional study. Image credit: Ken Stocker/Shutterstock.com
Depression is a widespread mental health concern worldwide, characterized by feelings of sadness, loss of interest in daily activities, fatigue and even suicidal thoughts. The World Health Organization (WHO) considers it a priority because of its impact on quality of life.
In Asia, high rates of depression have been reported across urban, rural and elderly populations in India and Pakistan, while in Bangladesh, studies reveal higher levels of depression among university students, indigenous communities, teenagers, women and the elderly.
Several factors are associated with depression, including age, gender, and socioeconomic status. Notably, a gender-specific examination of depression among married Bangladeshi adults remains unexplored.
Further research is essential because, despite the high prevalence of depressive disorders globally and within Bangladesh, there remains a gap in gender-specific understanding of depression among married adults in the country.
About the study
The present study was a household cross-sectional survey conducted in Rajshahi City Corporation (RCC) area, focusing on married couples. Given the known number of households in the area, the researchers calculated that a minimum of 324 households would be needed for the study but aimed to survey 375 households for potential non-participation.
Three of the 30 wards of the RCC were selected using a multi-stage random sampling technique, from which five neighborhoods (or ‘muhallas’) were selected. In each mohalla, 25 households were selected, resulting in 375 households. From these households, 708 married adults were selected for analysis, one couple per household.
The study was conducted from August to October 2019, using a semi-structured questionnaire that was initially developed in English but later translated into Bengali for better understanding of the respondents. It includes the globally acclaimed Patient Health Questionnaire (PHQ-9) to measure depression. Based on the score, participants were classified into the ‘no depression’ or ‘depression group’.
The researchers also considered various factors such as demographic details, household information and health data as independent variables. To understand the relationship between these factors and depression, both multiple binary logistic and simple models were employed. Statistical Package for Social Sciences (SPSS) software was used for data analysis maintaining a 5% significance level.
The researchers focused on married couples in a household cross-sectional study in the Rajshahi City Corporation (RCC) area. Given the count of known households, they determined a need for at least 324 households but targeted 375 for potential non-response.
They employed a multi-stage random sampling method. Initially, three out of 30 wards of RCC were selected. From these five ‘muhallas’ or neighborhoods are selected. In each mohalla, 25 households were selected, resulting in 375 households. From these households, 708 married adults were selected for analysis, one couple per household.
Results of the study
The study included 708 married individuals, equally divided between sexes, with an average participant age of 33.21 years. About 80% were young adults, with females slightly outnumbering males in this age bracket.
Approximately one-third were classified as over-nourished, while a minority were under-nourished. Surprisingly, 15.3% experienced multiple marriages, a more prevalent phenomenon among women.
Financially, 23% of those surveyed lived in economic constraints, earning Rs 20,000 or less per month. Regarding family dynamics, 41% shared their family with five or more members and 87.85% were parents of at least one child. Most participants’ marriages can be divided into three periods: 1-6 years, 7-12 years or more than 13 years.
The data revealed that 28% of the female participants married before the age of 18, while the majority of the cohort married between the ages of 18 and 25. However, many, mainly women, reported chronic health problems.
On the relationship side, more than half described their marital bond as strained. The study also noted that most female participants were housewives, while many males were engaged in labor-intensive occupations.
The mental health component of the survey revealed that 25.8% of these married adults experienced mild depression, with women more prone to moderate and severe forms. Overall, 14.4% of participants were dealing with depression, with a significantly higher incidence among women.
A deep dive into data indicating specific risk factors and correlations. For example, underweight women were more likely to experience depression than their male counterparts.
Younger women, especially those under 40, are more susceptible to depression than men in the same age bracket. Strained spousal relationships, multiple marriages, and certain socioeconomic factors also play a role in the prevalence of depression.
The study also examined how different life experiences, such as whether men and women were in the 7-12-year bracket of their married life, affected the prevalence of depression. Chronic medical conditions also affect rates of depression, particularly among women.
Importantly, age at first marriage, income level and parenthood are also correlated with depression. Regression analysis identified polygamy as a significant predictor of depression for both sexes.
Furthermore, women with poor spousal relationships or chronic medical conditions were at increased risk, while men involved in hard work were at higher risk for depression.