Prevalence and factors associated with depression, anxiety and stress symptoms among married women in Southern Nepal: a cross-sectional study.

OBJECTIVE

To determine the prevalence and factors associated with stress, anxiety and depression among married women in Chandrapur municipality, Nepal.

DESIGN

We conducted a cross-sectional study.

SETTING

Household Survey of Chandrapur municipality, Nepal.

PARTICIPANTS

We enrolled 545 married women from June to August 2022.

OUTCOME MEASURES: We administered the Depression, Anxiety and Stress Scale (DASS-21) through face-to-face interviews to determine the prevalence of stress, anxiety and depression. We performed univariable and multivariable linear regression to identify factors associated with stress, anxiety and depression. We reported 95% CIs with p values <0.05. We conducted all the analyses in Stata 14.

RESULTS

The prevalence of stress, anxiety and depression was 28.8%, 16.7% and 31.1% respectively. Univariable and multivariable linear regression analysis were conducted to identify factors associated with symptoms of stress, anxiety and depression. Symptoms of stress were significantly associated with Janajati and Dalit ethnicity (β=2.64; 95% CI 1.12 to 4.16; p value: 0.001) and Terai ethnicity (β=2.07; 95% CI 0.33 to 3.80; p value: 0.02), non-Hindu religion (β=-5.02; 95% CI -7.53 to -2.52; p value <0.001), residence other than husband's house (β=4.37; 95% CI 0.57 to 8.17; p value=0.02) and women's occupational status (β=3.30; 95% CI 0.64 to 5.96; p value: 0.01). Symptoms of anxiety were significantly associated with residence other than husband's house (β=2.62; 95% CI 0.11 to 5.13; p value: 0.04) and women's occupational status (β=5.10; 95% CI 3.34 to 6.86; p value <0.001). Symptoms of depression were significantly associated with non-Hindu religion (β=-3.23; 95% CI-5.24 to -1.22; p value=0.002), and living in joint family (β=-1.51; 95% CI -2.53 to -0.49; p value=0.004) after adjusting for age, ethnicity, religion, education, age of marriage, family type, residence, occupation and migrant husband. Other prespecified variables like age, age of marriage and migrant husband were not significantly associated with the symptoms of stress, anxiety and depression in adjusted analysis.

CONCLUSION

Stress, anxiety and depression symptoms were present in a significant proportion of women in Chandrapur municipality. Policy makers and health practitioners must provide significant attention in reducing the magnitude of these mental health conditions and reducing its impact on women and families.