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cross-sectional study of depression and help-seeking in uttarakhand, north india - clear plastic corrugated sheets

by:Cailong     2019-08-20
cross-sectional study of depression and help-seeking in uttarakhand, north india  -  clear plastic corrugated sheets
The purpose of this study is to use population-based cross-
A segmented survey describing the prevalence of depression in a region of northern India, the search for health care and the association with socio-economic determinants.
The site of the study was set up in July 2014 at Sahaspur and Raipur, administrative block, handaddon district, utarak.
Number of participants-
According to rural areas: after the urban census ratio was stratified, 960 people over the age of 18 were selected as the base sample in 30 random groups.
The primary outcome measurement survey used an effective screening tool, a patient health questionnaire to identify people with depression, and collected information on socio-economic variables and help
Seeking behavior.
Depression prevalence and health-seeking behavior were calculated, and associations between risk factors and depression were evaluated using multivariate logistic regression.
Results The prevalence of depression was 6% (58/960)
There's another 3. 9% (37/960)
Describes more than 2 weeks of depression in the past 12 months.
For those who are illiterate, classified as Scheduled Caste/tribe or other backward caste, statistically significant adjustments or depression are more than 2, who live in temporary material housing and who have recently lent money.
Depression patients over three quarters79%)
No one has been treated for conversation in the last 3 months (
100% treatment gap)
Two people (3. 3%)
Prescribed an anti-depression.
Conclusion in this population, social, educational and economic disadvantages are significantly associated with depression.
Strategies to Address Social determinants of depression, such as education, social exclusion, financial protection, and affordable housing for all, were pointed out.
In order to address the huge treatment gap in Uttarakhand, we must ensure that access to primary and secondary mental health providers who are able to identify and properly manage depression.
Purpose This study attempts to take advantage of the population-based cross-
A segmented survey describing the prevalence of depression in a region of northern India, the search for health care and the association with socio-economic determinants.
The site of the study was set up in July 2014 at Sahaspur and Raipur, administrative block, handaddon district, utarak.
Number of participants-
According to rural areas: after the urban census ratio was stratified, 960 people over the age of 18 were selected as the base sample in 30 random groups.
The primary outcome measurement survey used an effective screening tool, a patient health questionnaire to identify people with depression, and collected information on socio-economic variables and help
Seeking behavior.
Depression prevalence and health-seeking behavior were calculated, and associations between risk factors and depression were evaluated using multivariate logistic regression.
Results The prevalence of depression was 6% (58/960)
There's another 3. 9% (37/960)
Describes more than 2 weeks of depression in the past 12 months.
For those who are illiterate, classified as Scheduled Caste/tribe or other backward caste, statistically significant adjustments or depression are more than 2, who live in temporary material housing and who have recently lent money.
Depression patients over three quarters79%)
No one has been treated for conversation in the last 3 months (
100% treatment gap)
Two people (3. 3%)
Prescribed an anti-depression.
Conclusion in this population, social, educational and economic disadvantages are significantly associated with depression.
Strategies to Address Social determinants of depression, such as education, social exclusion, financial protection, and affordable housing for all, were pointed out.
In order to address the huge treatment gap in Uttarakhand, we must ensure that access to primary and secondary mental health providers who are able to identify and properly manage depression.
Depression, the most common mental illness (CMD)
Accounted for 9.
Of the 7% global disease burden studies, persons with disabilities lived in 2010. 1 Depression-
Due to lack of access to care, the associated disability has an impact on social and physical health.
Based on the assessment tools used and the social population profile of the community, the prevalence estimates of depression in India vary significantly.
Ganuli3 reviewed 15 Psychiatric Morbidity studies and found an average prevalence of 3. 4%.
4 yuan for Reddy and chandrasekhar
The analysis of 33 ÷ 572 participants described the prevalence of 8 years of age.
At 9%, the urban population is almost twice that of the rural population.
Other studies in South Asia show that this ratio is even higher, for example, 15.
1% kilometers South India, 45 kilometers.
9% kilometers in urban Pakistan.
Strong evidence from India and other low-and middle-income countries (LMIC)
Link socio-economic poverty with increased risk of depression.
7-9 in India, other groups that have been shown to be at a higher risk of depression are women, the elderly, urban residents, and those who are divorced or widowed.
Highly unfair allocation of mental health resources in India means at least 90% of patients with mental illness (PWMDs)
Without diagnosis and treatment.
There are also huge differences in access to mental health services, especially in rural areas.
4 obstacles to help
Access to services includes: lack of access to services, poor quality of existing services, lack of knowledge about mental illness, fear of stigma and discrimination.
In India, 11 or 12 people with depression have reported that depression is primarily due to unexplained physical symptoms and often seeks help from primary care rather than professional mental health care providers.
At the same time, the current disease classification system does not capture the conceptual understanding of depression well and needs to constantly reflect on when mental pain becomes a disease.
There is an urgent need to understand the burden of disease in areas where prevalence studies have never been conducted, 16 and to understand the pathways of care currently used.
There are few studies in India that investigate the association between depression and healthy social determinants, and few have considered the association between depression and caste.
2-5,7 there are very few studies on the prevalence of depression in Hindi
Mainly from existing studies in southern and eastern India.
2-5, 9, 18 we could not find studies on the prevalence or epidemiology of depression in the northern state of akamde in 10 million people.
This study describes the prevalence of depression, social population associations, and help
Seeking the behavior of patients with depression
The study was conducted in two groups (
Administrative units with a maximum of 200000 inhabitants)
In the Dehradun district of Uttarakhand as part of the Burans baseline survey of the Community Mental Health Partnership program with the Emmanuel Hospital Association (
Global Network of Community Health in the north (
Burans is directed by the first author.
In this case, housing is an important indicator of socio-economic status.
Permanent material housing refers to a shell made mainly of sealed floors, solid material walls (eg, brick)
And a corrugated tin roof.
Temporary material housing refers to a housing with dirt floors and/or walls and roofs built with straw/TARP or plastic plates.
At the time of the survey, the northern region had not yet implemented a national and regional mental health plan.
During the investigation, there were two government psychiatrists, none of whom was a government psychologist, and 10-15 private psychiatrists and psychologists in Uttarakhand.
The government's primary care services generally do not treat PWMDs, nor do they provide essential drugs such as anti-depression.
Sample selection we selected 960 people from 30 random groups.
Group sampling in three stages :(1)
Ward or panchayat (
Administrative Unit, about 5000 people); (2)household and (3)participant.
We calculated the sample size of n = 480 using STATA19 (
The prevalence of depression is estimated at 10% (
According to other population of Indiabased studies)3 ,5)
And a sample box of 235000 000 (
Population, 2 blocks, Dehradun District)
, 30 clusters, 95% CIs.
To illustrate the impact of clustering, we allow the design effect to be 2, with a total of 960 people in the end.
According to the rural areas in the 2011 census in the region: the proportion of cities, 20 to 21 cities and 9 rural clusters are required, the clusters are layered.
These are selected from random numbers in the open Census Board and Ward list.
In order to choose at the family level, the investigation team went to the community center and rotated a pen to determine the direction of the start.
Every 6 houses are investigated on the right and at each intersection, the roads/alleys on the right are followed.
If no one is present in a selected family, the group will revisit the family later.
If no one is present on the second visit, select the first house on the right.
Only one person in each family was surveyed.
In general, male field staff surveyed male respondents and female field staff surveyed female respondents.
Once the necessary 50% of female participants were reached, all investigators conducted a survey of male respondents.
Inclusion criteria are that participants should be family occupants aged 18 or over and be able to understand and respond to the survey.
Burans field staff for data collection project, all from Dehradun District (
Equal number of men and women)
Data for July and August 2014 were collected.
All personnel were trained in sampling strategies, the use of survey tools, data recording and management, and ethics research, and were supervised and supported by KM.
A comprehensive survey tool was translated into Hindi and translated into English, and a wide range of pilots were conducted by the main team of the central state.
The survey was conducted in Hindi.
The contents of this report are: social demographic information, including indicators of housing quality, debt, caste, marital status, highest level of education and employment status, adapted from the Indian version of the Demographic and Health Survey.
Alternative measures of socio-economic status include housing quality, educational status and employment status.
We use the norms of the Indian government to assess the quality of housing, in which permanent material housing refers to "pukka" and "half"
Kaccha and temporary materials housing refer to the category "kaccha.
23 general health help-
Seeking the use of behavior and health services (
Include "have you been to any medical institution/provider for the last 3 months? ’).
23 adaptation questions in the list of customer service receipts, 24 used to ask participants about recent inpatient and outpatient services, including provider types (
Government Level 1 provider, government Level 2 provider, private medical sector or charity provider, mental health provider, traditional or religious therapist).
A prescription for a conversation treatment or medication (
Generic or brand name, dose, duration and source).
Patient Health Questionnaire (PHQ9)—a self-
Reporting screening tools for evaluating clinical depression (
Verification in international and India).
25-27 this questionnaire consists of nine items with a score of 0 to 3 for each item, so a severity score is obtained from 0 to 27.
Depending on the frequency of specific symptoms over the last 2 weeks, the response category was rated 0, 1, 2 and 3 because "not at all", "days", "more than half a day ", and "almost every day ".
In our study, people with a PHQ9 score of 10 or higher were assessed to have at least moderate depression, according to the international norms of PHQ9.
27 mental health services seek behavior among those who use the same code as general health seeking behavior to screen for depression-positive.
At the time of Census and birth registration, the Indians of Jain, Sikh and Hindu must identify themselves as ordinary caste and Other Backward Classes (OBC)
Or a member of a scheduled tribe/caste (SC/ST)
Based on the identity of their parents.
28 The vast majority of Muslims are included in the OBC category in the draytown area.
Christians and Buddhists belong to the general caste.
Analyze survey data using stata v. 13. 1.
Translate open text into English, group and code by topic.
Logistic regression analysis of single variables using all relevant socio-economic variables and significant variables (p
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