Depression in Malay women with low socio-economic status : prevalence and risk factors

Abstract

A community study was conducted to examine (1) the prevalence of current depression and lifetime depression in rural and urban women with low socioeconomic status (SES), and (2) the relationship between different risk factors and the rate of current depression. Data were collected from a total of 487 respondents (N rural=242, N urban=245) in the first interview, and selected 120 respondents (N rural=60, N urban=60) in the second interview. The data consisted of seven sociodemographic variables and ten psychosocial risk factors. Four types of standardised measurements were used: Center for Epidemiologic Studies Depression Scale (CESD), Rosenberg Self-Esteem Scale (R-SES), Interpersonal Support Evaluation List (ISEL), and Parental Bonding Instrument (PBI). The results indicated that the prevalence rate of current depression was 11.5% and the rate of lifetime major depression was 27.5%. No significant effect of socio-demographic factors on the rate of current depression was found. Although there was a significantly higher rate of current depression in the urban sample, no definite conclusion could be drawn on the significance of the SES variables as predictors of current depression. Seven psychosocial risk factors namely lifetime major depression, lifetime dysthymia, current life stressors, family history of mental health problems, adverse childhood experiences (ACEs), self-esteem, and social support were significantly associated with depression in the expected direction. Except for ACEs, these factors were significant predictors of current depression accounting for 25% of the variance in the rate of current depression. The interaction effect of age and family history of mental health problems on the rate of current depression was found to be significant. Overall, the results were not able to fully support the hypothetical model used in the study. Two alternative models with good fitness indices were presented. The relatively higher prevalence of depression in this study as compared to past studies may reflect the high prevalence of depression in Malay women with low SES. This may also be due to other additional socio-cultural factors such as devalued women’s mothering and home-making roles and additional psychological stress experienced by urban women with low SES.