title: Symptoms related to the reproductive tract and mental health among women in rural southern India.
abstract: BACKGROUND
  Symptoms related to the reproductive tract and symptoms of psychological distress are commonly seen in women living in South Asia. This study aimed to determine the association, if any, between symptoms related to the reproductive tract and mental health among women in rural southern India.
  
  
  METHODS
  The study was conducted in a community setting of a comprehensive community health programme in a development block in rural southern India. It was a cross-sectional survey with a nested case-control study. The main outcome measure was the probability of mental distress as assessed by the Tamil version of the General Health Questionnaire-12 (GHQ).
  
  
  RESULTS
  Of the 622 subjects recruited, 150 (24.4%) complained of at least one symptom related to the reproductive tract. The commonest symptom was vaginal discharge (17.5%). Significantly higher scores on the GHQ were associated with the presence of many current and past symptoms related to the reproductive tract, and receiving treatment for the same, even after adjusting for age, education, current marital status and type of house, using multiple regression analysis. GHQ scores were positively correlated with a higher number of current and past symptoms. Significantly higher scores were also associated with greater knowledge about prevention of sexually transmitted diseases and reproductive tract infections. Being currently married and educated were significant protective factors. A nested case-control study was done with the presence of a current common mental disorder as the outcome. Symptoms and other factors dated prior to this outcome were considered potential risk factors. Logistic regression models were developed. The presence of a symptom related to the reproductive tract for more than one month (OR 3.6; 95% CI 1.8, 7.2) and a history of similar symptoms over the past year (OR 2.2; 95% CI 1.3, 3.7) were risk factors for the development of common mental disorders. Higher education (OR 0.5; 95% CI 0.3, 0.7) and being currently married (OR 0.2; 95% CI 0.1, 0.6) were protective factors.
  
  
  CONCLUSIONS
  The cross-sectional data suggest an association between symptoms pertaining to the reproductive tract and psychological distress. The results of the nested case-control study suggest that symptoms related to the reproductive tract are risk factors for common mental disorders, while education and being currently married are protective factors.
authors.affiliation: Department of Community Health, Christian Medical College, Vellore 632002, Tamil Nadu, India.
authors.forename: J
authors.initials: J
authors.lastname: Prasad
authors.forename: S
authors.initials: S
authors.lastname: Abraham
authors.forename: B
authors.initials: B
authors.lastname: Akila
authors.forename: A
authors.initials: A
authors.lastname: Joseph
authors.forename: K S
authors.initials: KS
authors.lastname: Jacob
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000523:psychology; D008603:Mental Health; D012424:Rural Population; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D013315:Stress, Psychological