Format

Send to

Choose Destination
J Affect Disord. 2014 Mar;156:76-86. doi: 10.1016/j.jad.2013.11.018. Epub 2013 Dec 1.

Predictors of psychological distress among postnatal mothers in rural Nepal: a cross-sectional community-based study.

Author information

1
University College London Institute for Global Health, 30 Guilford Street, London WC1N 1EH, United Kingdom. Electronic address: k.clarke.09@ucl.ac.uk.
2
University College London Institute for Global Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
3
Mother and Infant Research Activities (MIRA), P.O. Box 921, Kathmandu, Nepal.
4
Mental Health Sciences Unit, University College London, United Kingdom.

Abstract

BACKGROUND:

Perinatal common mental disorders are a major cause of disability among women and have consequences for children's growth and development. We aimed to identify factors associated with psychological distress, a proxy for common mental disorders, among mothers in rural Dhanusha, Nepal.

METHODS:

We used data from 9078 mothers who were screened for distress using the 12-item General Health Questionnaire (GHQ-12) around six weeks after delivery. We assessed the association between GHQ-12 score and socioeconomic, gender-based, cultural and reproductive health factors using a hierarchical analytical framework and multilevel linear regression models.

RESULTS:

Using a threshold GHQ-12 score of ≥6 to indicate caseness, the prevalence of distress was 9.8% (886/9078). Factors that predicted distress were severe food insecurity (β 2.21 (95% confidence interval 1.43, 3.40)), having a multiple birth (2.28 (1.27, 4.10)), caesarean section (1.70 (0.29, 2.24)), perinatal health problems (1.58 (1.23, 2.02)), no schooling (1.37 (1.08, 1.73)), fewer assets (1.33 (1.10, 1.60)), five or more children (1.33 (1.09, 1.61)), poor or no antenatal care (1.31 (1.15, 1.48) p<0.001), having never had a son (1.31 (1.14, 1.49)), not staying in the parental home in the postnatal period (1.15 (1.02, 1.30)), having a husband with no schooling (1.17 (0.96, 1.43)) and lower maternal age (0.99 (0.97, 1.00)).

LIMITATIONS:

The study was cross-sectional and we were therefore unable to infer causality. Because data were not collected for some established predictors, including infant death, domestic violence and history of mental illness, we could not assess their associations with distress.

CONCLUSIONS:

Socioeconomic disadvantage, gender inequality and poor reproductive health predict distress among mothers in Dhanusha. Maternal and child health programmes, as well as poverty-alleviation and educational interventions, may be beneficial for maternal mental health.

KEYWORDS:

Common mental disorder; Maternal mental health; Nepal; Postnatal depression; Postnatal psychological distress; Rural health

PMID:
24370265
PMCID:
PMC3969296
DOI:
10.1016/j.jad.2013.11.018
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center