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Bipolar disorder among married women in Bangladesh: Survey in Rajshahi city.

ABSTRACT: BACKGROUND:Bipolar disorder (BPD) is a major mental disorder which not only affects the personal and social functioning of an individual, but also inflicts a huge economic burden on the family. Yet, the study of BPD in Bangladesh is rare and poorly documented. Responding to the dire need, we conducted a new study to determine the prevalence of, and detect the associated factors of, BPD among married women in Rajshahi City, Bangladesh. METHODS:We conducted a cross-sectional study, selecting households in Rajshahi City using a multi-stage random sampling design. The data consisted of 279 married women, who were screened for BPD using the bipolar spectrum diagnostic scale (BSDS). Frequency distribution, chi-square test and binary logistic regression model were used respectively to determine the prevalence, identify the associated factors and quantify their effects on BPD. RESULTS:The prevalence of BPD among married women in Rajshahi City was 2.5%, with an additional 7.2% classified as probable BPD. A binary logistic regression analysis established the following six main factors of BPD: (1) comorbid mental disorder [AOR = 8.232, 95% CI = (1.397, 50.000), p<0.05]; (2) poor relationship with husband [AOR = 11.775, 95% CI = (2.070, 66.667), p<0.01]; (3) poverty [AOR = 1.600, 95% CI = (2.086, 122.709), p<0.01]; (4) high educational level [AOR = 0.177, 95% CI = (0.037, 0.843), p<0.05]; (5) lack of immediate treatment if sick [AOR = 2.941, 95% CI = (1.259, 6.871), p<0.05]; and (6) death of beloved one/s [AOR = 2.768, 95% CI = (1.130, 6.777), p<0.05]. LIMITATIONS:Our survey involved self-reporting, which is typically affected by differing levels of understanding and bias. Also, a cross-sectional, observational study cannot establish an actual cause-and-effect relationship. Some other potentially important factors such as environment, lifestyle, familial customs, effects of drugs, treatment options and outcomes, etc. were not studied. Also, save mental disorder, all other comorbidities remained undocumented. CONCLUSION:This study laid down the foundation for conducting further research on identifying different factors affecting BPD, and for studying other issues related to BPD among married women in Bangladesh. Among such factors are familial environment and culture, comorbidities, treatment options, treatment outcomes, biochemical feature, environmental factors, etc. This study also recommends that, while treating BPD patients, health professionals should focus on comorbidities and family matters.

SUBMITTER: Wadood MA

PROVIDER: S-EPMC7046238 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Bipolar disorder among married women in Bangladesh: Survey in Rajshahi city.

Wadood Md Abdul MA Karim Md Rezaul MR Hussain Abdullah Al Mamun AAM Rana Md Masud MM Hossain Md Golam MG

PloS one 20200227 2

<h4>Background</h4>Bipolar disorder (BPD) is a major mental disorder which not only affects the personal and social functioning of an individual, but also inflicts a huge economic burden on the family. Yet, the study of BPD in Bangladesh is rare and poorly documented. Responding to the dire need, we conducted a new study to determine the prevalence of, and detect the associated factors of, BPD among married women in Rajshahi City, Bangladesh.<h4>Methods</h4>We conducted a cross-sectional study, ...[more]

PMID: 32107501

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Project description:BackgroundSuicide is a serious public health concern all over the world including Bangladesh. About 9% of the patients admitted with suicidal ideation (SI) or suicide attempt (SA) later complete suicide. To understand and prevent suicide, the study of SI and SA is necessary but research in this area is scanty in Bangladesh. Therefore, we studied suicidality (SI and SA) among married adults in Rajshahi City, Bangladesh.MethodsThis was a household cross-sectional study. A total of 708 married adults were selected for this study using a multi-stage random sampling. Suicidality was measured based on two factors: (i) suicidal ideation, and (ii) suicide attempt. Frequency distribution, Chi-square test and multiple binary logistic regression model were used in this study according to our objectives.ResultsThe prevalence of suicidal ideation, suicide attempt, and suicidality was 5.8%, 3.4%, and 8.3% respectively among married adults. A multiple binary logistic regression model provided the following risk factors of suicidality: (i) joint family (AOR = 0.310, p<0.01), (ii) ≥26 years of age at the first marriage (AOR = 0.379, p<0.05), (iii) twice or more marriage (AOR = 0.214, p<0.01), (iv) conjugal life of ≥16 years (AOR = 0.410, p<0.05), (v) having no child (AOR = 6.343, p<0.01) and (vi) having 1-2 children (AOR = 6.190, p<0.01), (vii) medical comorbidity (AOR = 0.421, p<0.01), (viii) mental comorbidity (AOR = 0.253, p<0.01), (ix) stress-anxiety (AOR = 0.311, p<0.01), (x) family history of mental disorders (AOR = 0.059, p<0.01), (xi) family history of suicide/suicide attempt (AOR = 0.009, p<0.01), (xii) substance abuse (AOR = 0.065, p<0.01), (xiii) poor relationship with spouse (AOR = 0.209, p<0.01), and (xiv) poor relationship with other family members (AOR = 0.347, p<0.05).ConclusionThe prevalence of suicidality is remarkable in Rajshahi city, Bangladesh. The government and non-government agencies can use the findings of this study to identify the vulnerable groups and undertake measures for preventing and reducing suicidality.

Project description:BackgroundSmoking is one of the bad habits in social environment and is one of the main causes of immature death in Bangladesh. Rajshahi is one of the cleanest, most peaceful cities in Bangladesh, but the inhabitants often feel uncomfortable about smokers who smoke in public places and often on transport. Smoking frequency is very high among males compared to females, and a large number of smokers are building or road construction laborers and people involved in offering different services such as transportation, vending from vans, etc. The practice of smoking in this area is destructive for mental and physical health especially for students compared to other professionals because the city is known as the City of Education.MethodsThe study analyzes smokers' characteristics, general health, and their (smokers) perception of smoking in public places. Cross-sectional data were collected randomly from 160 smokers through face-to-face questionnaire survey. The determinants of complexities with regard to social environment and human health were studied using frequency distribution, chi-square test, and binary and multinomial logistic regression analysis using IBM SPSS version 24.ResultsFrequency distributions reveal that 93.8% of smokers believe that smoking creates public health hazards, 51.3% of smokers think it causes breathing complexities for non-smokers, 48.8% of smokers feel smoking causes air pollution, 68.8% of smokers think smoking causes gastric problems, 24.4% of smokers had headache problems due to smoking and cigarette fumes, 86.3% of smokers learnt smoking from friends, 48.8% of smokers smoke due to their addiction and 25.6% for depression, and 80.6% usually smoke after having a meal. The chi-square test reveals that class of smokers was significantly associated with frequency of heartbeat rate, starting smoking at specific age level was significantly associated with suffering from diseases, category of smoking articles was significantly associated with suffering from disease, class of smokers was significantly associated with causes for smoking, and starting smoking at specific age level was significantly associated with profession of the smokers at 1% level of significance respectively. A significant odds ratio was found (OR?=?6.363, 95% CI 1.918-21.104, p?<?0.01) for the profession group of students/labour at 1% level; their outcomes for suffering from diseases such as gastric problem and fever/headache/others were 6.363 times those for the profession group of service/other smokers.ConclusionSmoking in public places should be restricted because non-smokers cannot breathe freely and it is not healthy for them to inhale smoke indirectly, which has many adverse effects on public health. The study also reveals that the majority of the smokers have gastric problems, abnormal heartbeat rates, frequent headaches, depression and addiction problems, etc., and that they believe that smoking causes significant health hazard on human health and social environment. Therefore, necessary interventions should be taken immediately by policy-makers to prevent smoking in public places.Supplementary informationThe online version contains supplementary material available at 10.1007/s10389-020-01413-w.

Project description:BackgroundBipolar disorder (BPD) is a common condition associated with significant morbidity and reduced quality of life. In addition to challenges caused by their mood symptoms, parents affected with BPD harbor concerns about the mental health of their children. Among adult parents who perceive themselves to have BPD, this study aims to examine participants' coping methods; identify predictors of adaptation; assess parental perceptions of risks for mood disorders among their children; and describe the relationships among illness appraisals, coping, adaptation to one's own illness, and perceived risk to one's children.MethodsParents who self-identified as having BPD completed a web-based survey that assessed dispositional optimism, coping, perceived illness severity, perceived etiology of BPD, perceived risk to offspring, and adaptation to BPD. Participants had at least one unaffected child who was 30 years of age or below.Results266 parents were included in the analysis. 87% of parents endorsed a "somewhat greater" or "much greater" risk for mood disorders in one's child(ren) than someone without a family history. Endorsing a genetic/familial etiology to BPD was positively correlated with perceived risk for mood disorders in children (rs = .3, p < 0.01) and active coping with BDP (r = .2, p < 0.01). Increased active coping (β = 0.4, p < 0.001) and dispositional optimism (β = 0.3, p < 0.001) were positively associated with better adaptation, while using denial coping was negatively associated with adaptation (β = -0.3, p < 0.001). The variables explained 55.2% of the variance in adaptation (F = 73.2, p < 0.001). Coping mediated the effect of perceived illness severity on adaptation.ConclusionsThese data inform studies of interventions that extend beyond symptom management and aim to improve the psychological wellbeing of parents with BPD. Interventions targeted at illness perceptions and those aimed at enhancing coping should be studied for positive effects on adaptation. Parents with BPD may benefit from genetic counseling to promote active coping with their condition, and manage worry about perceived risk to their children.

Project description:Bipolar disorder (BD) and premenstrual dysphoric disorder (PMDD) are two cyclic mood illnesses, sometimes presenting together. Their comorbidity appears to be linked to common biological mechanisms and usually results in more severity of mood symptoms and a poorer long-term outcome. Nevertheless, the management of comorbid PMDD/BD has been scarcely studied. Therefore, the aim of the present paper was to review the published literature on the treatment of comorbid PMDD/BD and to provide point-by-point hypotheses to address these complex clinical cases. We searched PubMed to identify the studies focused on the treatment and management of comorbid PMDD/BD using the following search words, alone and in combination: premenstrual dysphoric disorder, bipolar disorder, comorbid, treatment, management, pharmacotherapy, psychotherapy. The search was conducted on the 1st of June 2019 and yielded 55 records. Four papers met our inclusion/exclusion criteria and were therefore included in our qualitative synthesis. Integrating the few data pertaining to the treatment of comorbid PMDD/BD with the large amount of published data on the two conditions separately, we can suggest that the management of comorbid PMDD/BD needs as a first step to stabilize the bipolar symptoms by means of optimal dosages of mood stabilizers. Then, in euthymic BD patients, the PMDD symptoms could be treated with estroprogestins (first-line treatment). On the contrary, during acute phases of BD, antidepressants (for major depressive episodes) and atypical antipsychotics/hormonal modulators (for manic episodes) could be considered as promising add-on treatments to mood stabilizers. In case of resistant PMDD/BD symptoms, combined strategies should be taken into account, as well as alternative treatments, such as lifestyle changes. In conclusion, RCTs on comorbid PMDD/BD are still lacking. The management of this complex condition is therefore challenging and it requires a tailored treatment.

Project description:BackgroundThe use of complementary and alternative medicine (CAM) among type 2 diabetes mellitus (T2DM) patients is increasing worldwide. It can affect optimum glycemic management. This study was to determine the rate and influencing factors of CAM use among diabetes patients as well as their effect on glycemic control.MethodsThis cross-sectional study was conducted among T2DM patients attending the outpatient department of Rajshahi Medical College Hospital. It is a tertiary hospital in the northern part of Bangladesh. A face-to-face interview with a pretested structured questionnaire was used for data collection. Chi-square (χ2) test and multivariate logistic regression model were used in this study for data analysis.ResultsOut of 244 T2DM patients, 86 (35.2%) used CAM. Multivariate logistic regression model showed that lower family income group (AOR = 8.7, 95% CI: 2.15-35.22, p-value 0.002), having no institutional education (AOR = 3.4, 95% CI: 1.17-9.87, p-value 0.025) and having diabetes for more than five years (AOR = 2.821, 95% CI: 1.34-5.94, p-value 0.006) were the most influential predictors of CAM use. The most commonly used CAMs were herbal products (67.4%) and homeopathic medicine (37.2%). Most of the CAM users (72%) were influenced by friends, neighbors, and family members. The most common reasons behind CAM use were reported to be the belief that CAM helped control diabetes better (44.2%) and easy availability and lower cost (27.9%). More than half of the users reported the efficacy of CAM as 'nothing significant', while others reported as somewhat good. 14% of CAM users experienced side-effects, especially gastrointestinal upset. It was observed that using CAM was associated with poor glycemic control (AOR = 2.25, 95% CI: 1.14-4.44, p-value 0.018).ConclusionOur study demonstrated that some modifiable factors are associated with the use of CAM, and it cannot maintain good glycemic control. So, patients should be made aware of the ineffectiveness and bad effects of CAM by enhancing educational and poverty-alleviating programs.

Project description:BACKGROUND: Sexual coercion is an important public health issue due to its negative association with social and health outcomes. The paper aims to examine the prevalence of sexual coercion perpetrated by husbands on their wives in Nepal and to identify the characteristics associated with this phenomenon. METHODS: The data used in this paper comes from a cross-sectional survey on "Domestic Violence in Nepal" carried out in 2009. A total of 1,536 married women were interviewed and associations between sexual coercion and the explanatory variables were assessed via bivariate analysis using Chi-square tests. Logistic regression was then applied to assess the net effect of several independent variables on sexual coercion. RESULTS: Overall, about three in five women (58%) had experienced some form of sexual coercion by their husbands. Logistic regression analysis found that the literacy status of women, decision-making power regarding their own health care, husband-wife age differences, alcohol consumption by the husband, and male patriarchal control all had significant associations with women's experience of sexual coercion. Literate women had 28% less chance (adjusted odds ratio (aOR) = 0.72) of experiencing sexual coercion by their husbands than did illiterate women. Women who made decisions jointly with their husbands with regard to their own health care were 36% less likely (aOR = 0.64) to experience sexual coercion than those whose health care was decided upon by their mothers/fathers-in-law. On the other hand, women whose husbands were 5 or more years older than they were more likely to report sexual coercion (aOR = 1.33) than were their counterparts, as were women whose husbands consumed alcohol (aOR = 1.27). Furthermore, women who experienced higher levels of patriarchal control from their husbands were also more likely to experience sexual coercion by their husbands (aOR = 7.2) compared to those who did not face such control. CONCLUSION: The study indicates that sexual coercion among married women is widespread in Nepal. Programs should focus on education and women's empowerment to reduce sexual coercion and protect women's health and rights. Furthermore, campaigns against alcohol abuse and awareness programs targeting husbands should also focus attention on the issue of sexual coercion.

Dataset Information

Bipolar disorder among married women in Bangladesh: Survey in Rajshahi city.

Publications

Bipolar disorder among married women in Bangladesh: Survey in Rajshahi city.

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