Review
Depression among women in the South-Asian region: The underlying issues

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Abstract

Background

The condition of women in third-world countries continues to be dismal. They are constantly exposed to such circumstances which make them prone to sufferings. These sufferings bear an irreparable brunt upon the mental health condition of females which are presented as greater psychological problems in terms of depressive disorders. The impact, in turn is felt by the society as a whole which lags behind due to the huge burden. This study is presented to highlight the various factors affecting the presentation of women in the region.

Methods

This is a review of studies in which various issues pertaining to presentation, course, and outcome of depression among women in South-Asian region are discussed. The studies were chosen from Internet-based search.

Results

The various factors affecting the problems can be grouped into: social milieu, reproductive health factors, and biological milieu.

Limitations

This study incorporates various studies which were undertaken at different time durations; hence, its finding cannot be reproduced in an exact sense. It is worth mentioning that these factors need to be studied comprehensively for better health care.

Conclusion

This study gives an indication of specific health care needs of women in the region which are to be customized as per local needs and cultural sanctions.

Introduction

Over the last quarter century, great advances have been made worldwide in improving all aspects of female lives; yet, women continue to lead complexly difficult lives. Globalization and international capitalism portray the pathological differences between the comforts of the first world woman and the wide spread exploitation, dismal social and general living conditions of the third world woman. This blatant disparity led Dr. Mahbub-ul-Haq in the “Human Development in South-Asia, 1997” (WHO, 1997) to say — “To be a woman in this region (South-Asia) is to be a non-person!!”

According to UNDP (1995) women constitute more than 70% of the world's poor and carry the triple burden of productive, reproductive and caring work. Based on all available data, UNDP (1997) concludes that “no society treats its women as well as its men”. Comparing and analyzing the socio-cultural and economic background of the female natives of South-Asia in the context of psychiatric disorders brings forth interesting revelations and peculiarities of the suffering of the women in this region. The women in the region continue to suffer manifold in comparison to their male counterparts as stated in a study by Mumford et al. (1997): Depression and anxiety was found to be present in 46% of women compared to 15% of men. The problem is further highlighted by the impact it has on the society as a whole. Estimation of Global Burden of Disease indicates that unipolar depression among women will be the second most important cause of disease burden by the year 2020! (Murray and Lopez, 1996). It has been projected that problems are bound to increase in coming times. By 2020, unipolar major depression alone will account for 8.62 of all DALYS for women. The most disturbing fact is that the impact would be felt by women in their productive years, particularly between the ages of 15 and 44 (Thara and Patel, 1998). The study of various factors and their outcomes may help to develop fruitful strategies by common workforce to create logical solutions.

Section snippets

Demography, social status and cultural background

The countries grouped under the umbrella of South-Asia are India, Pakistan, Sri Lanka, Nepal, Bangladesh, Maldives and Bhutan. The majority is located in the Indian subcontinent. A total of approximately 2 billion people reside in the region, out of which nearly 860 million are females i.e. about 48% of native population is female (Table 1). More than half of the females of the region reside in India. Women, whether they are from Pakistan, the Philippines or India all have similar problems

The social milieu

The social milieu, one of the most important determinants of health is characterized by poverty, overcrowded living conditions, unemployment, job insecurity and inequity, a growing number of broken marriages, man-made and natural disasters and wars. A study showed that women with lower levels of education had an increased risk for psychiatric disorders — nearly 66% of women and 25% of men suffered from depression and anxiety disorders (Mumford et al., 1997). Evidence on the specific effect of

Need of the hour: A step forward

The problems are many and a proper approach towards their solution is the need of the hour. The need for this has been emphasized by W.H.O. (1998) as “Women's health is inextricably linked to their status in society. It benefits from equality, and suffers from discrimination.” The many priorities should be organized in a hierarchy as per the needs:

  • Protection should be given to those most vulnerable to abuses, including rape and sexual violence,

  • Reconstructing and developing the health sector,

References (45)

  • P.S. Chandra et al.

    Marital life among infertile spouse: the wife's perspective and its implications in therapy

    Fam. Ther.

    (1991)
  • J. Cornwell et al.

    Do GPs prescribe antidepressants differently for South Asian patients?

    Fam. Pract.

    (1998)
  • A. Crisp et al.

    Stigmatization of people with mental illnesses

    Br. J. Psychiatry

    (2000)
  • B. Davar

    The Mental Health of Indian Women: A Feminist Agenda

    (1999)
  • S. Dubovsky

    Psychiatry in Saudi Arabia

    Am. J. Psychiatry

    (1983)
  • Fakhr el Islam

    Social psychiatry and the impact of religion

  • S. Gautam et al.

    Postpartum psychiatric syndromes: an analysis of 100 cases

    Indian J. Psychiatry

    (1982)
  • Gosh, M. Social capital and postnatal depression among South Asian women,...
  • M. Hakimi et al.

    Silence for the sake of harmony: domestic violence and women's health in Central Java

  • K.S. Jacob et al.

    Common mental disorders, explanatory models and consultation behavior among Indian women living in the UK

    J. R. Soc. Med.

    (1998)
  • R.C. Kessler et al.

    Posttraumatic stress disorder in the National Comorbidity Survey

    Arch. Gen. Psychiatry

    (1995)
  • M.M. Khan et al.

    Parasuide in Pakistan: an experience at a University Hospital

    Acta Psychiatr. Scand.

    (1996)
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