Journal of Primeasia

Shedding Light on Silent Struggle: Unveiling Depression in Rural Bangladesh

Md. Ammar Hossain^1*

The study introduces rural depression, together with its contributing factors, to the importance of mental health education immediately.

Abstract

Background: Depression is perhaps the most common yet “silently” expressed mental illness in the world on the one hand, while in the context of “silently” expressed mental illnesses, in the specific context of Bangladesh, it has left unexamined the cases specific to the depressed population in the “rural” parts of the country, with the most extreme cases going unexamined.

Methods: To this end, the specific and most rural parts of the Bangladesh region, the Kushtia District, with a focus on Lahini village, were chosen. There, a particular survey population of 100 was administered the PHQ-9. Thereafter, the most determining demographic factors of rural setting depression in Bangladesh- age, Gender, Marital Status, Occupation, and income - were analysed through Chi-squared (χ²) tests for interrelated variables within the set.

Results: The portion of the survey population showing increasingly higher and more extreme cases of depression (the most concerning of cases) stands at 36%. The χ² tests, which are demographic factors, are most closely and distinctly interlinked with depression. Of specific mention, Age (p = 0.00016) and Income (p = 0.00064) could be the most determining variables in understanding and even predicting cases of depression. Close to 70% of the population of the most depressed cases were 60-70 years, while 57.14% of the most depressed were widowed. In contrast, younger students exhibited the lowest symptoms of depression.

Conclusion: Mental health awareness is 19% and hence calls for a psychosocial intervention program in rural Bangladesh.

Keywords: Depression, PHQ-9, Mental Health, Rural Bangladesh, Kushtia

References

Akpa-Inyang, F., & Chima, S. C. (2021). South African traditional values and beliefs regarding informed consent and limitations of the principle of respect for autonomy in African communities: a cross-cultural qualitative study. BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-00678-4

Bos, J. (2020). Research ethics step by step. In Springer eBooks (pp. 227–273). https://doi.org/10.1007/978-3-030-48415-6_10

Cerveri, G., Gesi, C., & Mencacci, C. (2019). <p>Pharmacological treatment of negative symptoms in schizophrenia: update and proposal of a clinical algorithm</p> Neuropsychiatric Disease and Treatment, Volume 15, 1525–1535. https://doi.org/10.2147/ndt.s201726

Dardas, L. A., & Simmons, L. A. (2015). The stigma of mental illness in Arab families: a concept analysis. Journal of Psychiatric and Mental Health Nursing, 22(9), 668–679. https://doi.org/10.1111/jpm.12237

Evans, C. J., Yorganci, E., Lewis, P., Koffman, J., Stone, K., Tunnard, I., Wee, B., Bernal, W., Hotopf, M., Higginson, I. J., Tanner, D., Henry, C., Grande, G., Dewar, S., Owen, G., Burman, R., Adamis, D., Dunn, M., Kim, S., . . . Vohora, R. (2020). Processes of consent in research for adults with impaired mental capacity nearing the end of life: systematic review and transparent expert consultation (MORECare_Capacity statement). BMC Medicine, 18(1). https://doi.org/10.1186/s12916-020-01654-2

Fine, T. H., Contractor, A. A., Tamburrino, M., Elhai, J. D., Prescott, M. R., Cohen, G. H., Shirley, E., Chan, P. K., Goto, T., Slembarski, R., Liberzon, I., Galea, S., & Calabrese, J. R. (2013). Validation of the telephone-administered PHQ-9 against the in-person administered SCID-I major depression module. Journal of Affective Disorders, 150(3), 1001–1007. https://doi.org/10.1016/j.jad.2013.05.029

Goodwin, J., & Tiderington, E. (2020). Building trauma-informed research competencies in social work education. Social Work Education, 41(2), 143–156. https://doi.org/10.1080/02615479.2020.1820977

Hinga, A., Marsh, V., Nyaguara, A., Wamukoya, M., & Molyneux, S. (2021). The ethical implications of verbal autopsy: responding to emotional and moral distress. BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-00683-7

Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8), 987–996. https://doi.org/10.1007/s00127-019-01697-8

Knifton, L. (2012). Understanding and addressing the stigma of mental illness with ethnic minority communities. Health Sociology Review, 21(3), 287–298. https://doi.org/10.5172/hesr.2012.21.3.287

Lawton, J., Hallowell, N., Snowdon, C., Norman, J. E., Carruthers, K., & Denison, F. C. (2017). Written versus verbal consent: a qualitative study of stakeholder views of consent procedures used at the time of recruitment into a peripartum trial conducted in an emergency setting. BMC Medical Ethics, 18(1). https://doi.org/10.1186/s12910-017-0196-7

Liu, L., Zhou, X., Zhang, Y., Liu, Y., Yang, L., Pu, J., Zhu, D., Zhou, C., & Xie, P. (2016). The identification of metabolic disturbances in the prefrontal cortex of the chronic restraint stress rat model of depression. Behavioural Brain Research, 305, 148–156. https://doi.org/10.1016/j.bbr.2016.03.005

Mahnke, A. H., Sideridis, G. D., Salem, N. A., Tseng, A. M., Carter, R. C., Dodge, N. C., Rathod, A. B., Molteno, C. D., Meintjes, E. M., Jacobson, S. W., Miranda, R. C., & Jacobson, J. L. (2021). Infant circulating MicroRNAs as biomarkers of effect in fetal alcohol spectrum disorders. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-020-80734-y

Mathiasen, K., Andersen, T. E., Riper, H., Kleiboer, A. a. M., & Roessler, K. K. (2016). Blended CBT versus face-to-face CBT: a randomised non-inferiority trial. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-1140-y

McLaughlin, R. H., & Alfaro-Velcamp, T. (2015). The Vulnerability of Immigrants in Research: Enhancing protocol development and ethics review. Journal of Academic Ethics, 13(1), 27–43. https://doi.org/10.1007/s10805-015-9225-7

Millum, J., Campbell, M., Luna, F., Malekzadeh, A., & Karim, Q. A. (2019). Ethical challenges in global health-related stigma research. BMC Medicine, 17(1). https://doi.org/10.1186/s12916-019-1317-6

Rice, F., Riglin, L., Lomax, T., Souter, E., Potter, R., Smith, D., Thapar, A., & Thapar, A. (2018). Adolescent and adult differences in major depression symptom profiles. Journal of Affective Disorders, 243, 175–181. https://doi.org/10.1016/j.jad.2018.09.015

Russell, D. J., Humphreys, J. S., Ward, B., Chisholm, M., Buykx, P., McGrail, M., & Wakerman, J. (2013). Helping policy-makers address rural health access problems. Australian Journal of Rural Health, 21(2), 61–71. https://doi.org/10.1111/ajr.12023

Seagle, E. E., Dam, A. J., Shah, P. P., Webster, J. L., Barrett, D. H., Ortmann, L. W., Cohen, N. J., & Marano, N. N. (2020). Research ethics and refugee health: a review of reported considerations and applications in published refugee health literature, 2015-2018. Conflict and Health, 14(1). https://doi.org/10.1186/s13031-020-00283-z

Siriwardhana, C., Adikari, A., Jayaweera, K., & Sumathipala, A. (2013). Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation. BMC Medical Ethics, 14(1). https://doi.org/10.1186/1472-6939-14-13

Ssali, A., Poland, F., & Seeley, J. (2015). Volunteer experiences and perceptions of the informed consent process: Lessons from two HIV clinical trials in Uganda. BMC Medical Ethics, 16(1). https://doi.org/10.1186/s12910-015-0073-1

Su, J., & Hung, J. (2011). Empirical analysis of jump dynamics, heavy-tails and skewness on value-at-risk estimation. Economic Modelling, 28(3), 1117–1130. https://doi.org/10.1016/j.econmod.2010.11.016

Teymoori, A., Real, R., Gorbunova, A., Haghish, E., Andelic, N., Wilson, L., Asendorf, T., Menon, D., & Von Steinbüchel, N. (2019). Measurement invariance of assessments of depression (PHQ-9) and anxiety (GAD-7) across sex, strata and linguistic backgrounds in a European-wide sample of patients after Traumatic Brain Injury. Journal of Affective Disorders, 262, 278–285. https://doi.org/10.1016/j.jad.2019.10.035

Twenge, J. M. (2014). Time period and birth cohort differences in depressive symptoms in the U.S., 1982–2013. Social Indicators Research, 121(2), 437–454. https://doi.org/10.1007/s11205-014-0647-1

Uddin, M. N., Bhar, S., & Islam, F. M. A. (2019). An assessment of awareness of mental health conditions and its association with socio-demographic characteristics: a cross-sectional study in a rural district in Bangladesh. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4385-6

Ventevogel, P., Jordans, M., Reis, R., & De Jong, J. (2013). Madness or sadness? Local concepts of mental illness in four conflict-affected African communities. Conflict and Health, 7(1). https://doi.org/10.1186/1752-1505-7-3

Watkins, E., Newbold, A., Tester-Jones, M., Javaid, M., Cadman, J., Collins, L. M., Graham, J., & Mostazir, M. (2016). Implementing multifactorial psychotherapy research in online virtual environments (IMPROVE-2): study protocol for a phase III trial of the MOST randomized component selection method for internet cognitive-behavioural therapy for depression. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-1054-8

Williams, A., LaRocca, R., Chang, T., Trinh, N., Fava, M., Kvedar, J., & Yeung, A. (2014). Web-Based Depression Screening and Psychiatric Consultation for College Students: A Feasibility and Acceptability Study. International Journal of Telemedicine and Applications, 2014, 1–9. https://doi.org/10.1155/2014/580786

Xu, A., Baysari, M. T., Stocker, S. L., Leow, L. J., Day, R. O., & Carland, J. E. (2020). Researchers’ views on, and experiences with, the requirement to obtain informed consent in research involving human participants: a qualitative study. BMC Medical Ethics, 21(1). https://doi.org/10.1186/s12910-020-00538-7

Zidaru, T., Morrow, E. M., & Stockley, R. (2021). Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice. Health Expectations, 24(4), 1072–1124. https://doi.org/10.1111/hex.13299