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Gender, depression and physical impairment: an epidemiologic perspective from Aleppo, Syria

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

Examine the association of physical impairment with gender, depression, and socio-demographics in the community in Aleppo, Syria.

Method

We conducted a cross-sectional, population-based study in Aleppo on adults aged 18–65 (N = 2,038). We used a computerized interviewer-administered structured questionnaire. Physical impairment was measured via an adapted 12-item World Health Organization, Health State Description Individual Questionnaire which includes both physical and emotional items. We used physical impairment items score to classify individuals into low, middle, and high physical impairment category. Self-report of physician-diagnosed depression and chronic diseases active in the past year and their current treatment status were obtained.

Results

Sample mean age (SD) was 35.3 (12.1) years, 55% were female, and 4.5% had depression. Female gender, low socioeconomic status (SES), and depression were associated with high physical impairment. Women had more impairment (OR = 3.35, 95% CI: 2.15–5.21) with little change after controlling for depression and chronic diseases, but significantly decreased after controlling for socio-demographics (OR = 1.51, 95% CI: 0.84–2.73). The association with low (vs. high) SES was prominent (OR = 2.48, 95% CI: 1.32–4.67) after controlling for all variables. Depression’s association (OR = 4.85, 95% CI: 1.93–12.15) lost significance after controlling for chronic diseases (OR = 2.81, 95% CI: 0.96–8.25), but further adjustment for socio-demographics had little effect.

Conclusion

Women and individuals of low SES appear more vulnerable to physical impairment in the community in Aleppo. Depression’s association with physical impairment may be mediated through co-existing chronic diseases. Public health planning regarding physical impairment in Syria should encompass these as putative risk factors.

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Acknowledgments

This work is supported by US Public Health Service grants R01 TW05962 and R21 TW006545; and NIDA grant R01DA024876-01. Nael Kilzieh is supported by The Fulbright Scholar Grant, Bureau of Cultural and Educational Affairs, US Department of State and the Veterans Affairs Mental Illness Research, Education, and Clinical Center (MIRECC), VISN 20.

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Authors and Affiliations

  1. American Lake Division, VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA

    Nael Kilzieh

  2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    Nael Kilzieh

  3. Syrian Center for Tobacco Studies, Aleppo, Syria

    Samer Rastam & Wasim Maziak

  4. Department of Health and Sport Sciences, and Center for Community Health, University of Memphis, 633 Normal Street, Memphis, TN, 38152, USA

    Kenneth D. Ward & Wasim Maziak

Authors
  1. Nael Kilzieh
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  2. Samer Rastam
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  3. Kenneth D. Ward
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  4. Wasim Maziak
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Correspondence to Nael Kilzieh.

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Kilzieh, N., Rastam, S., Ward, K.D. et al. Gender, depression and physical impairment: an epidemiologic perspective from Aleppo, Syria. Soc Psychiat Epidemiol 45, 595–602 (2010). https://doi.org/10.1007/s00127-009-0076-7

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  • DOI: https://doi.org/10.1007/s00127-009-0076-7

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