Socio-economic factors for depression in women of northern Pakistan: A case-control study

Abstract

OBJECTIVE: To find out the association between socio-economic factors with depression in women of Gilgit Baltistan (GB), Pakistan. METHODS: This case-control study was conducted at various psychiatric facilities located in three districts of GB. Out of 450 participants, recruited through convenient sampling technique, 300 were depressed women according to DSM-5 criterion of depression, while 150 were well-matched controls from the same population. Logistic regression was applied to find out the association of socioeconomic factors with depression. RESULTS: Mean age of the participants was 36±11.2 years. About 40.7% (n=122/300) of cases and 16% (n=24/150) of controls were un-educated. Majority of cases (n=222/300: 74%) and controls (n=94/150; 62.7%) were married. About 66.7% (n=200/300) of cases and 48% (n=72/200) of controls were housewives. Odds of depression were 0.334 (95% CI: 0.132-0.848), 0.524 (95% CI: 0.186-1.475), 0.17 (95% CI: 0.045-0.637), & 0.38 (95% CI: 0.127-1.158) for women having primary, secondary, higher-secondary or graduationlevel education respectively. Emotional abuse (odds=34.92, 95% CI: 6.281-194.190), lack of economic independence (freedom to spend) [odds=6.39; 95% CI: 1.535-26.630] and do not own land (odds=3.40; 95% CI: 1.126-10.307) were significantly associated with depression. Families with household income >20,000 rupees/month (odds=0.22; 95% CI: 0.051-0.961) and cordial relationships with in-laws (odds=0.55; 95% CI: 0.241-1.262) were less likely to be depressed. CONCLUSION: The study showed significant association of low level of education, emotional abuse, and lack freedom of spending with depression in women of northern Pakistan. The study underscores that socio-economic factors need to be considered in the management of depression among women.