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Advanced Neurology Depression and its risk factors in India

the substantial number indicates that challenges remain in study conducted in 2002 (11%). Meanwhile, a study
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fully eradicating the dowry system. Notably, dowry-related conducted in North India (specifically, New Delhi)
abuse is significantly associated with depression among indicated a 6% risk of PPD after utilizing the Edinburgh
women. 36-38 Thus, despite the Dowry Prohibition Act’s aim postnatal depression scale. Another community-based
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of safeguarding women from the financial and emotional cross-sectional study conducted in Bihar showed a 23.9%
strains associated with the dowry system, cultural and prevalence of AD, similar to the findings of Patel et al.
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societal pressures, coupled with economic disparities, in a study conducted in Western India (specifically, Goa),
often perpetuate the practice. which reported an incidence of PPD of 23%. These studies
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Another notable contributor of stress among women clarify the potential risk factors that strongly correlate with
in India is particularly evident during their reproductive an increased risk of depression, including financial strain
years, with infertility emerging as a major issue. In India, and income, the birth of a daughter, relationship difficulties
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the infertility rate has risen from 22.4% in 1992 – 93 to with the spouse’s parents. a history of miscarriages
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30.7% in recent years and is a significant contributor to or stillbirths, martial conflicts, non-arranged marriages,
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stress. Infertile women report considerable conflicts and a nuclear family structure. AD and PPD critically
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with their husbands and families, with the prevalence affect the growth of a child and are thus considered as risk
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of intimate partner violence (IPV) among these women factors for malnutrition in children aged 6 – 12 months
being 50%. 40-42 Studies have indicated a significant link and are also associated with low birth weight (LBW)
between infertility in women and experiencing IPV, among infants, with female infants presenting a greater
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which can include physical and sexual abuse, stalking, likelihood of LBW.
and emotional mistreatment by partners. These traumatic The desire for a male child is a common one in India
experiences are often associated with increased rates of for a number of reasons, such as patrilineal inheritance
depression. 40-42 Notably, 32% of married women in India systems, patrilocal marriage frameworks, dowry, and
report experiencing some form of spousal violence, with the reliance among older parents on their sons. The
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physical, emotional, and sexual violence being the most risk factor of “not living in a joint family system” reflects
frequently reported 28%, 14%, and 6%, respectively). 43 a distinct sociocultural norm in India compared with
Other than infertility, after pregnancy, women can Western countries. Living in a joint family may decrease
experience depression, largely categorized into two types: the chance of PPD due to support from family member,
antenatal depression (AD) and postpartum depression however, many women avoid living in a joint family due to
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(PPD). AD represents the onset of depressive symptoms extra work and responsibilities. Gopalakrishnan et al.
during pregnancy, whereas PPD is experienced after discovered a significant correlation among newlywed
giving birth. In particular, PPD significantly impacts the females – strengthened bonds with their husbands and
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mother-infant relationship and the child’s development. mothers-in-law are associated with a significant reduction
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Factors such as cesarean births, health complications in depressive symptoms. Crucially, these insights
for the infant, difficulties in nursing, and psychological emphasize the influential role of mothers-in-law in the
and obstetric challenges significantly impact maternal association between spousal relationships and depressive
mental health, particularly in less developed countries. In symptoms.
particular, stillbirths, defined by the WHO as losing the Finally, widowhood can be a predictor of depression;
baby before or during delivery, are profoundly devastating widows face significant mental health challenges, although
events. Approximately 1 million stillbirths occur annually longer-term widows exhibit stability or slight improvements.
across the world, equivalent to 1 every 16 s; this staggering Over 3 years, both groups (recent and longer-term widows)
statistic highlights the immense global burden of this experienced unintentional weight loss, with minimal
phenomenon. In this regard, Swain et al. highlighted and inconsistent variations in health habits and physical
psychosocial risks such as stressful life events, family health modifications. Married women generally show
psychiatric history, domestic abuse, financial strain, and better physical, emotional, and health behaviors than their
the lack of spousal support during delivery. Therefore, widowed counterparts. Meanwhile, Jangam et al. compared
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identifying vulnerable mothers before they give birth is women with unipolar depression (UD) who sought therapy
crucial for effective interventions. 46 with healthy women, observing that women with UD had
With respect to statistical estimations, in a cross- significantly higher rates of emotional maltreatment during
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sectional, community-based study conducted in South childhood than healthy women.
Indian, George et al. observed an incidence rate for AD In conclusion, depression has profound effects on
of approximately 16.3% m, an increase from a previous women in India, affecting not only individuals themselves
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Volume 4 Issue 3 (2025) 38 doi: 10.36922/an.5940