The minds of mothers: maternal mental health in an urban squatter settlement of Karachi.
BACKGROUND
Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan.


OBJECTIVE
To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health.


METHODS
With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity.


RESULTS
The proportion of probable cases of mental disorder was 28.8% (n = 75). Reviewing the gradient of responses the most frequently expressed psychiatric symptoms were "being worried" and "crying". Amongst somatic complaints the most frequently reported was headache. Study also suggests that women in the older age group (OR 2.30, CI 1.27-4.19, p = 0.0031) and those with longer duration of marriage (OR 1.80, CI 1.01-3.22, p = 0.032) are more likely to be mentally distressed. Arguments with husband (OR 5.0, CI 2.19-11.52, p = 0.00001) or in-laws (OR 2.43, CI 1.22-4.85, p = 0.0059), husband's unemployment (OR 4.1, CI 1.27-13.6, p = 0.0058), not having permanent source of income and lack of autonomy in making decisions significantly contributed towards mental illness.


CONCLUSIONS
Approximately 1 out of 4 women suffer from mental illness. This is alarmingly high. Besides counseling in cases of matrimonial disharmony, community-based interventions should aim to improve the socioeconomic status of households.
Rabbani
F
F
Department of Community Health Sciences, Aga Khan University, Karachi.
Raja
F F
FF
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008429:Maternal Welfare / Q000639:trends*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D016017:Odds Ratio; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012494:Sampling Studies; D012959:Socioeconomic Factors; D014505:Urban Population