title: Prevalence of major depressive episodes in rural women using primary care.
abstract: Women carry a disproportionate burden of depression in part because situational and other factors enhance their risk. Rural women may be at particular risk because of poverty and lack of treatment opportunities. For this study we investigated the rate of current major depressive episodes (MDE) in impoverished rural women seeking care in a community health center (CHC) in the rural South. We screened 982 women for MDE during a routine primary care visit: about half were positive for depressive symptoms. Of women positive at screening, 194 were then assessed for psychiatric disorder. A current MDE was observed in 14.3% of women screened for depression and 72.2% of women assessed for psychiatric disorder. Recognizing that neither of these percentages reflects the likely rate of MDE among the larger population of rural impoverished women, we used probability theory and binary logistic regression to estimate a depression rate that could be applied as one factor associated with unmet need in this population of women. We estimate that 44.3% of the population of women using the CHC had MDE. These findings underscore the need for mental health services in rural primary care, especially in facilities serving impoverished women.
authors.affiliation: Thomas A. Saunders III Family Professor of Nursing at the University of Virginia, USA. ejh7m@virginia.edu
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Hauenstein
authors.forename: Shyamal Das
authors.initials: SD
authors.lastname: Peddada
mesh_terms: D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008605:Mental Health Services; D020380:Needs Assessment; D011204:Poverty Areas; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011338:Probability Theory; D012424:Rural Population; D015144:Southeastern United States / Q000453:epidemiology