title: The complex array of antecedents of depression in women with physical disabilities: implications for clinicians.
abstract: OBJECTIVE
  This article discusses the complex interrelation of elements of the physical, psychological, social, and environmental life context of women with physical disabilities and the association of these elements with significant disparities in rates of depression and access to mental health care for this population.
  
  
  METHODS
  Literature and concept review.
  
  
  RESULTS
  High rates of depression in women with physical disabilities are well documented in the literature. Many elements that are disproportionately common in the lives of women with physical disabilities, including socio-economic disadvantage, functional limitations, pain and other chronic health conditions, poor diet, physical inactivity, smoking, violence, low self-esteem, sexuality problems, chronic stress, environmental barriers, and barriers to health care, have also been linked with higher rates of depression and depressive symptomatology. Depression self-management interventions tailored for women with disabilities have been developed and proven effective.
  
  
  CONCLUSIONS
  Many women who must deal with the stresses surrounding an array of health problems may experience symptoms of depression without necessarily meeting the criteria for clinical depression. Psychologists, counselors, primary care physicians, specialists, and other medical and rehabilitation professionals are challenged to recognize the symptoms of depression in women with physical disabilities and assist them in obtaining appropriate psychological and pharmacological interventions.
authors.affiliation: Center for Research on Women with Disabilities, Baylor College of Medicine, PO Box 890286, Houston, Texas 77289, USA. mnosek@bcm.edu
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Nosek
authors.forename: Rosemary B
authors.initials: RB
authors.lastname: Hughes
authors.forename: Susan
authors.initials: S
authors.lastname: Robinson-Whelen
mesh_terms: D000203:Activities of Daily Living; D003866:Depressive Disorder / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D004777:Environment; D005260:Female; D015438:Health Behavior; D006801:Humans; D011203:Poverty; D015995:Prevalence; D011613:Psychotherapy; D012649:Self Concept; D013315:Stress, Psychological