Depressive symptoms in low-income women in rural Mexico.
BACKGROUND
Depression is a leading cause of death and disability worldwide. This paper reports a cross-sectional analysis of demographic, socioeconomic, physical, and psychosocial factors associated with depressive symptoms among poor women in rural Mexico.


METHODS
A cross-sectional study of 5457 women, age 20-70 years, were interviewed from a random sample of households from 279 poor communities with fewer than 2500 inhabitants in 7 rural Mexican states. Depressive symptoms were assessed using the Spanish translation of the Center for Epidemiologic Studies-Depression scale. Several other individual- and household-level variables were also obtained. Using hierarchical modeling, linear regression analysis, and population intervention model parameters, we explored correlates of depressive symptoms in this population.


RESULTS
Most of the variation in depressive symptoms was at the individual level. Psychosocial factors were most strongly correlated with depressive symptoms; perceived stress, lack of personal control or social support, and low social status exhibited the strongest associations. Using the US-based standard Center for Epidemiologic Studies-Depression cutoff score of 16, 51% of this population fall into the category "at risk" for clinical depression; however, this cutoff may not be the most appropriate in this context.


CONCLUSIONS
This sample of low-income women in rural Mexico reported a relatively high prevalence of depressive symptoms. The analyses suggest that reducing perceived stress would have the largest potential impact on depressive symptoms in this population. However, any interventions should take into account the broad context of the population's overall health. The alleviation of poverty, improvement of educational opportunities, and other interventions to address root causes of poor mental health must also be considered.
Fleischer
Nancy L
NL
Division of Epidemiology, School of Public Health, University of California, Berkely, CA, USA. nancyfl@umich.edu
Fernald
Lia C
LC
Hubbard
Alan E
AE
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011203:Poverty; D012424:Rural Population