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Cited by 166Mental Health Treatment and AccessMaternal Mental Health During Pregnancy and PostpartumGender Roles and Identity Studies

The explanatory models of depression in low income countries: listening to women in India

Pereira, Bernadette, Andrew, Gracy, Pednekar, Sulochana, Pai, Reshma, Pelto, Pertti, Patel, Vikram·2007·Journal of Affective Disorders
DOI 10.1016/j.jad.2006.09.025
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Abstract

Introduction Women, and persons facing social and economic disadvantage, are at greater risk for depressive disorders. Our objective was to describe the explanatory models of illness in depressed women, in particular, their idioms of distress, and their views of their social circumstances and how this related to their illness.Method We carried out a qualitative investigation nested in a population based cohort study of women's mental and reproductive health in Goa, India. We purposively sampled women who were ever-married and who had been found to be suffering from a depressive disorder on the basis of a structured diagnostic interview. In-depth interviews were carried out about six months apart exploring stressors in women's lives, a typical day in their recent lives, and their illness narratives (idioms of distress, causal models, impact of illness, help-seeking).Results 35 women consented to participate in the study, 28 completing both interviews. Women gave expression to their problems primarily through somatic complaints, typically a variety of body aches, autonomic symptoms, gynecological symptoms and sleep problems. There was frequent mention of overall "weakness" and tiredness. Economic difficulties and difficulties with interpersonal relationships (particularly related to marital relationships) were the most common causal models. However, women rarely considered biomedical concepts, for example, the notion that they may suffer from an illness or that their complaints were due to a biochemical disturbance in the brain. Despite the lack of a biomedical concept, most of the participants had sought medical help, typically for reproductive and somatic complaints.Conclusions We recommend the use of somatic idioms as the defining clinical features, and a broader, psychosocial model for understanding the aetiology and conceptualization of the clinical syndrome of depression for public health interventions and mental health promotion in the Indian context.

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Authors
Pereira, B., Andrew, G., Pednekar, S., Pai, R., Pelto, P., & Patel, V.
Affiliations
  • Sangath (IN)
  • University of Connecticut (US)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Patel, Vikram
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2007-09
Volume
102
Issue
1-3
Pages
209-218
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2006.09.025
OpenAlex
W2027074768
Cited by
166
References
38
Citations by year
2026: 4 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 10 · 2019: 9 · 2018: 14 · 2017: 12 · 2016: 16 · 2015: 12 · 2014: 10 · 2013: 10 · 2012: 14
FWCI
3.89
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
Wellcome Trust
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Gender Studies › Gender Roles and Identity Studies
Keywords
depression, women, explanatory models of illness, idioms of distress, somatic symptoms, causal models, help-seeking, marital relationships, economic hardship, low-income countries, India, mental health promotion
MeSH terms
Adaptation, Psychological, Adult, Depressive Disorder, Developing Countries, Female, Humans, Income, India, Middle Aged, Patient Acceptance of Health Care, Social Perception, Socioeconomic Factors, Stress, Psychological, Battered Women

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