Factors Affecting Depression among Married Women Living in Urban Squatter Settlements of Karachi, Pakistan

Background: Depression is one of the growing public health concerns among women worldwide. This is one of the most under-recognized and under-treated mental illnesses worldwide. Women of developing countries are inexplicably affecting with depression. Purpose: The purpose of study is to assess the prevalence and associative factors of depression among women of aged 20 to 40 years living in urban squatter settlements of Karachi, Pakistan. The identification of all the potential determinants will potentially help in formulating preventive strategies in order to decline the prevalence of depression among women and improve the wellbeing of women. Methods: An analytical cross-sectional survey was employed among women living in Reta Plot and Kala Board communities of Karachi, Pakistan. Beck Depression Inventory II (BDI-II) was used to measure depression. Systematic sampling was used to recruit 636 married women. Cox proportional hazard was run to compute prevalence ratios and their 95% confidence interval. Results: Our study estimated 33.3% of depression among study participants. The current study showed that age, possession of own vehicle, years of schooling and recent deaths in family were significantly associated with depression. Conclusion: This research was a bold step to address the issue of increasing rate of depression among Pakistani population. Our study results can convince policy makers to extend mental health support to women by improving accessibility of services. Recommendation: Our study recommends that the women of our society should be encouraged for attaining education. This study also recommends that at primary health care setting, every health professional should be trained to screen the depression. Moreover, the results of our study can also encourage policy makers to expand mental health support services for women.

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

Screening of Psychiatric Disorders among Hearing-Impaired Children and Adolescents Aged 4 - 16 Years Attending Special Education Institutions in Karachi

Aim: The aim of this study was to estimate the prevalence of psychiatric problems and to identify associated factors among hearing-impaired children and adolescents (aged 4 - 16 years) attending special education institutions in Karachi, Pakistan. Methods: A cross-sectional study, using stratified random sampling was conducted in two special education institutions in Karachi from September 2010 to July 2011 on 272 hearing-impaired children aged 4 - 16 years. Multi-informant rating (responding parent and teacher) was used to assess the prevalence of psychiatric problems on Strengths and Difficulties Questionnaire (SDQ). Kappa statistic was computed to assess agreement between parents/teachers ratings. Multivariable logistic regression analysis was conducted to identify the factors associated with psychiatric problems of children. Results: An overall parent-rated prevalence of psychiatric problems among hearing-impaired children was estimated as 18% and teacher-rated prevalence as 32.7%;poor inter-rater agreement was found between the two raters (Kappa statistic = 0.09). Multivariate model indicated protective effect of child’s age greater than 6 months at the time of diagnosis AOR: 0.49;95% CI (0.25, 0.96). Depression among responding parents AOR: 2.61;95% CI (1.34, 5.11) was identified as a risk factor. Children with good performance AOR: 3.09;95% CI (1.04, 9.25) and fair/poor performance AOR: 3.43;95% CI (1.17, 10.04) were more likely to have psychiatric problems compared to children with outstanding/excellent performance. Cronbach’s alpha of 0.71 on overall SDQ indicated an acceptable internal consistency. Conclusion: Awareness programs should be held for parents and teachers for better dealing with hearing-impaired children.

Association of Depression and Life Satisfaction with Low Resilience among Married Women of Karachi, Pakistan

Background: The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to assess the prevalence and the associated risk factors of resilience in Pakistan. Methods: It was a cross-sectional survey, using the Wagnild Resilience Scale (RS) to assess resilience, Beck Depression Inventory II (BDI-II) for measuring depression and Trait Wellbeing Inventory for determining Life Satisfaction. Systematic sampling was employed to enroll 636 participants of aged 20 to 40 years living in two urban squatter settlements of Karachi, Pakistan. Prevalence ratio was computed with their 95% confidence interval. Results: A total of 636 married women participated in the study. The average age of females with low resilience was 29.8 (5.7) whereas the mean age of females with high resilience was 31.1 (5.7). Around 90% of all the participants could speak in Urdu. The prevalence of low resilience among women was 21.9%. Moreover, the prevalence of depression among low resilience group was 43.9% whereas the mean life satisfaction score among females with low resilience was lower than females with high resilience. The females who had low resilience were younger and had no formal/informal education as compared to their counterparts. After controlling for other variables, the prevalence of low resilience was 1.78 times more among depressed females as compared to the non-depressed with a 95% CI: (1.27-2.51). Moreover with every one unit increase in the life satisfaction scores, the prevalence of low resilience decreased 9%. Furthermore, age and informal schooling were also found to be significantly associated with resilience. Conclusion: Depression and life satisfaction are the potential modifiable risk factors for resilience and hence we can improve resilience through interventions that may focus on reducing depression and improving satisfaction towards life. Our study also recommends that health care professionals should be educated about these modifiable risk factors to bring about a change in the society and reduce the mental health illness by promoting constructive adaptation.