Findings of a retrospective study on factors responsible for depression in a Northern Indian State

Öz

Objective: Depression is a leading cause of morbidity and disability worldwide. The factors responsible for the prevalence of depression vary across countries and cultures. This study was aimed to provide data on the prevalence of depression and the possible risk factors responsible for its prevalence in Haryana State, India. Methods: A retrospective study on factors responsible for depression in a Northern Indian State. A retrospective evaluation of the medical records of a total of 4512 patients with a confirmed diagnosis of depression was carried out at the psychiatric units of three different district government hospitals from September 2010 till August 2013. The data was analyzed using the statistical software, SPSS version 13®. Results: Prevalence of depression was found to be significant among females (?2=32.9, df=1, p<0.001), as a majority (58%) of the patients were females. In terms of ethnicity, seventy-eight percent patients were Hindus and belong to lower castes of community and other backward classes. However, in terms of age, 1714 (38%) were over 50 years of age (?2=38.78, df=1, p<0.0001). Social problems and medical complications were the most common identified stressors during patient evaluation. Marital and family problems, followed by relationship/childhood problems and death of loved ones, were the frequent risk factors identified among females. However, financial and job related problems were the most common stressors identified among males. Among medical complications, hypertension was the most frequent. Conclusions: Overall, the findings demonstrate a high rate of depression among people of low socioeconomic status and aged patients with medical conditions.

Anahtar Kelimeler

• depression, risk factor, socioeconomic, medical conditions, North India, Haryana state

Bir Kuzey Hindistan Bölgesinde depresyondan sorumlu olan etmenleri inceleyen geriye dönük çalışma bir çalışmanın sonuçları

Öz

Amaç: Depresyon, dünya genelinde hastalık ve özürlülük sebepleri arasında başı çekmektedir. Depresyon sıklığından sorumlu etmenler ülkeler ve kültürler arasında değişir. Bu çalışmada Hindistan’ın Haryana bölgesindeki depresyon yaygınlığı ve bundan sorumlu olası risk etmeleri ile ilgili bilgi sağlanması amaçlanmıştır. Yöntem: Üç farklı ilçe devlet hastanelerinin psikiyatri birimlerinden Eylül 2010 tarihinden Ağustos 2013 yılına kadar depresyon tanısı doğrulanmış toplam 4512 hastanın geriye dönük tıbbi kayıtları değerlendirilerek çalışma verisi oluşturuldu. Veriler bir istatistiksel yazılım olan SPSS versiyon 13® kullanılarak analiz edildi. Bulgular: Depresyon sıklığı kadınlarda anlamlı olarak daha yüksek saptandı (?2=32.9, df=1, p<0.001) ve hastaların çoğunluğu kadındı (58 %). Etnik yapı açısından, hastaların yüzde yetmiş sekizini Hindular ve toplumun düşük ve daha düşük sınıfları oluşturmaktaydı. Fakat, yaş açısından ise 1714’ü (38%) 50 yaş ve üstünde idi (?2=38.78, df=1, p<0.001). Hasta değerlendirmelerinde en sık tespit edilen stresörler; sosyal sorunlar ve tıbbi hastalıklardı. Kadınlarda depresyonla ilişkili belirlenen etmenler; evlilik ve aile problemleri, sonra sırası ile ilişki/çocuk sorunları ve sevilen birinin vefatıydı. Fakat erkeklerde ise; finansal ve iş ile ilişkili sorunlar en sık belirtilen stresörlerdi. Tıbbi hastalıklardan ise en sık olarak belirtileni hipertansiyon idi. Sonuç: Genel olarak, bulgular düşük sosyoekonomik düzeydeki ve tıbbi hastalıkları olan yaşlı hastalarda depresyonun yüksek oranda olduğunun göstermektedir.

Anahtar Kelimeler

• depresyon, risk etmenleri, sosyoekonomik, tıbbi hastalıklar, Kuzey Hindistan, Haryana bölgesi

Kaynakça

1. Lepine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat. 2011;7:3-7.
2. Murray CJL, Lopez AD. The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Geneva, Switzerland: World Health Organization; 1996.
3. Dhingra S, Parle M. Herbal remedies and nutritional supplements in the treatment of depression: a review. BCP. 2012;22:286-92.
4. Rai D, Zitko P, Jones K, Lynch J, Araya R. Country- and individuallevel socioeconomic determinants of depression: multilevel crossnational comparison. Br J Psychiatry. 2013; 202:195-203.
5. Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine. 2011;9:90.
6. People of Haryana, 2009. Retrieved September 16, 2013, from http://www.haryana online.com/people/people.htm.
7. Sethi BB, Prakash R. Depression in Industrial population. Indian J Psychiatry. 1979;21:359-61.
8. Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian population-The Chennai Urban Rural Epidemiology Study (CURES-70) PloS One. 2009;4:E7185.

9. Nandi DN, Banerjee G, Boral GC, Ganguli H, Ajmany S, Ghosh A, Sarkar S. Socio-economic status and prevalence of mental disorders in certain rural communities in India. Acta Psych Scand. 1979;59:276-93.
10. Bagadia VN, Jeste DV, Doshi SU, Shah LP. Depression: A clinical study of 233 cases. Indian J Psychiatry. 1973;15:224-30.
11. Ramachandran V, Menon MS, Arunagiri S. Socio-cultural factors in late onset depression. Indian J Psychiatry. 1982;24:268-73.
12. Ponnudurai R, Somasundaram O, Balakrishnan S, Srinivasan N. Depression-a study of 80 cases. Indian J Psychiatry. 1981;23:256-8. Mohandas E. Roadmap to Indian Psychiatry. Indian J Psychiatry. 2009;51:173-9.
13. Jain RK, Aras RY. Depression in geriatric population in urban slums of Mumbai. Indian J Pub Health. 2007;51:112-3.
14. Tiwari SC. Geriatric Psychiatric morbidity in rural Northern India: Implications for the future. Int Psychogeriatrics. 2000;12:35-48.
15. Sharma DK, Satija DC, Nathawat SS. Psychological determinants of depression in old age. Indian J Psychiatry. 1985;27:83-90.
16. Nandi PS, Banerjee G, Mukherjee SP, Nandi S, Nandi DN. A study of psychiatric morbidity of the elderly population of a rural community in West Bengal. Indian J Psychiatry. 1997;39:122-9.
17. Chatterjee RN, Mukherjee SP, Nandi DN. Life events and depression. Indian J Psychiatry. 1981;23:333-7.
18. Satija YK, Advani GB, Nathawat SS. Influence of stressful life events and coping strategies in depression. Indian J Psychiatry. 1998;40:165-71.
19. Prakash R, Trivedi JK, Sethi BB. Life events in depression. Indian J Psychiatry. 1980;22:56-60.
20. Venkoba Rao A, Nammalvar N. Life changes and depressive disease. Indian J Psychiatry. 1976;18:293-304.
21. Raju SS, Kumaraswamy N, Mani AJ. Socio-demographic factors of depressive disorders in India: A comparative appraisal. Indian J Psychiatry. 1980;22:356-60.
22. Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India Incidence and risk factors. British J Psychiatry. 2002;181:49950
23. Bhugra D, Gupta KR, Wright B. Depression in North India comparison of symptoms and life events with other patient groups. Int J Psychiatry Clin Prac. 1997;1:83-7.
24. Sherine MS, Nor AMZ, Mustaqim A. Prevalence of depression with chronic illness among the elderly in a rural community in Malaysia. Asia pacific Family medicine. 2003;2:196-9.
25. Nisar NB, Gadit AA. Prevalence of depression and the associated risks factors among adult women in a fishing community. J Pak Med Assoc. 2004; 54:519-25.
26. Natalie SE, Kathleen KT. Annya H. Childhood abuse, chronic pain, and depression in the National Comorbidity Survey. Child Abuse Negl. 2007;31:531-547.
27. Lynn E, Patricia H, Steven CM, Harold AP. Depression and the Ability to Work. Psychiatr Serv. 2004;55:29-34.
28. Hesse M. Integrated psychological treatment for substance use and co-morbid anxiety or depression vs. treatment for substance use alone. A systematic review of the published literature. BMC Psychiatry. 2009;9:6.
29. Anderson RJ, Freedland KE, Clouse E, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24:1069-1078.
30. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25:464-70.
31. Pies R, Rogers D. The recognition and treatment of depression: A review for the primary care clinician 2005. [online] Accessed on 18th July 2013 Available on:www.medscape.com/viewprogram/4572_ pn.
32. Goodnick PJ. Use of antidepressants in treatment of comorbid diabetes mellitus and depression as well as in diabetic neuropathy. Ann Clin Psychiatry. 2001;13:31-41.
33. Katon W, Sullivan MD. Depression and chronic medical illness. J Clin Psychiatry. 1990;51(Suppl 3-11);12-4.
34. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A. No health without mental health. The Lancet. 2007;370:859-77.