Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women

Authors

  • Nisha Fahey Des Moines University, Des Moines, IA
  • Apurv Soni University of Massachusetts, Worcester, MA
  • Jeroan Allison University of Massachusetts, Worcester, MA
  • Jagdish Vankar Pramukhswami Medical College, Gujarat, India
  • Anusha Prabhakaran Pramukhswami Medical College, Gujarat, India
  • Tiffany A. Moore Simas University of Massachusetts, Worcester, MA
  • Nancy Byatt University of Massachusetts, Worcester, MA
  • Ajay Phatak Pramukhswami Medical College, Gujarat, India
  • Eileen O'Keefe Boston University, Boston, MA
  • Somashekhar Nimbalkar Pramukhswami Medical College, Gujarat, India

DOI:

https://doi.org/10.1016/j.aogh.2016.04.001

Keywords:

common mental disorders, epidemiology, perceived stress, rural India, SRQ-20, women's health

Abstract

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.

Author Biographies

Nisha Fahey, Des Moines University, Des Moines, IA

BA

Apurv Soni, University of Massachusetts, Worcester, MA

BA

Jeroan Allison, University of Massachusetts, Worcester, MA

MD, MSc

Jagdish Vankar, Pramukhswami Medical College, Gujarat, India

MD

Anusha Prabhakaran, Pramukhswami Medical College, Gujarat, India

MD

Tiffany A. Moore Simas, University of Massachusetts, Worcester, MA

MD

Nancy Byatt, University of Massachusetts, Worcester, MA

MD, MBA

Ajay Phatak, Pramukhswami Medical College, Gujarat, India

MPH

Eileen O'Keefe, Boston University, Boston, MA

MD, MPH

Somashekhar Nimbalkar, Pramukhswami Medical College, Gujarat, India

MD

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Published

2017-03-08

Issue

Vol. 82 No. 5 (2016)

Section

Original Research

License

Copyright (c) 2017 The Author(s)

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