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Intimate partner violence and depression among women in rural Ethiopia: a cross-sectional study
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
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2009 (Engelska)Ingår i: Clinical Practice and Epidemiology in Mental Health, E-ISSN 1745-0179, Vol. 5, nr 1, s. 8-Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Studies from high-income countries have shown intimate partner violence to be associated with depression among women. The present paper examines whether this finding can be confirmed in a very different cultural setting in rural Ethiopia.

METHOD: A community-based cross-sectional study was undertaken in Ethiopia among 1994 currently married women. Using the Composite International Diagnostic Interview (CIDI), cases of depressive episode were identified according to the ICD-10 diagnosis. Using a standardized questionnaire, women who experienced violence by an intimate partner were identified. A multivariate analysis was conducted between the explanatory variables and depressive status of the women, after adjusting for possible confounders.

RESULTS: The 12-month prevalence of depressive episode among the women was 4.8% (95% CI, 3.9% and 5.8%), while the lifetime prevalence of physical intimate partner violence was 49.5%. Physical violence (OR=2.56, 95% CI, 1.61, 4.06), childhood sexual abuse (OR=2.00, 95% CI, 1.13, 3.56), mild emotional violence (OR=3.19, 95% CI, 1.98, 5.14), severe emotional violence (OR= 3.90, 95% CI, 2.20, 6.93) and high spousal control of women (OR=3.30, 95% CI, 1.58, 6.90) by their partners were independently associated with depressive episode, even after adjusting for socioeconomic factors.

CONCLUSIONS: The high prevalence of intimate partner violence, a factor often obscured within general life event categories, requires attention as an independent factor for depression, and thus to find new possibilities of prevention and treatment in terms of public health strategies, interventions and service provision.

Ort, förlag, år, upplaga, sidor
2009. Vol. 5, nr 1, s. 8-
Nationell ämneskategori
Psykiatri
Forskningsämne
psykiatri
Identifikatorer
URN: urn:nbn:se:umu:diva-22267DOI: 10.1186/1745-0179-5-8PubMedID: 19397834Scopus ID: 2-s2.0-66949120028OAI: oai:DiVA.org:umu-22267DiVA, id: diva2:214192
Tillgänglig från: 2009-05-04 Skapad: 2009-05-04 Senast uppdaterad: 2024-03-07Bibliografiskt granskad
Ingår i avhandling
1. Intimate partner violence and depression among women in rural Ethiopia
Öppna denna publikation i ny flik eller fönster >>Intimate partner violence and depression among women in rural Ethiopia
2010 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background: Several studies have reported socioeconomic, socio-demographic factors, including violence against women to be associated with depression among women, but knowledge in the area among women living under extreme poverty in developing countries remains scarce. Relationship between intimate partner violence and women’s literacy in societies where violence is normative is complex, there are only limited data describing this difference in the distribution of violence exposure by residency and literacy. Few studies have addressed consequences of maternal depression and experiencing violence among women on children’s survival.

Objective: The aim of this thesis is to determine prevalence of depressive episode and examine its association with violence by intimate partner and socioeconomic status It also assesses contribution of residency and literacy of women on vulnerability to physical violence by intimate partner, and independent effect of intimate partner violence and maternal depression on the risk of child death in rural Ethiopia.

Methods: A community-based cross-sectional study was undertaken among 3016 randomly selected women in the age group between 15-49 years conducted from January to December 2002. A cohort study was done through following up women who gave birth to a live child within a year of the survey, in rural Ethiopia. Analysis was made using all the 3016 women, 1994 of the married women and 561 of women who gave birth within a year of the data collection time. Cases of depression were identified using the Amharic version of the Composite International Diagnostic Interview, experience of physical, sexual and emotional violence by intimate partner was made using the WHO multi-country study on women’s life events, and child death was measured by continuous demographic surveillance data from the Butajira Rural Health Program.

Result: The twelve-month prevalence of depression was estimated to be 4.4%. In the analyses being currently married, divorced and widowed women, living in rural villages, having frequent khat chewing habit, having seasonal job and living in extreme poverty were factors independently associated with depression. Similarly, among the married women, experiencing physical violence, childhood sexual abuse, emotional violence and spousal control were factors independently associated with depressive episode. Women in the overall study area had beliefs and norms permissive towards violence against women. Violence against women was more prevalent in rural communities, in particular, among rural literate women and rural women who married a literate spouse. In this study, maternal depression was associated with under five child death. Although no association was seen between experiencing violence and child death, the risk of child death increases when maternal depression is combined with physical and emotional violence.

Conclusion: Prevalence of depression among women was still in the lower range as compared to studies from high-income countries. Though depression is associated with socio-demographic factors and extreme poverty, the association is complex. The high prevalence of violence against women could be a contributing factor for preponderance of depression among women than in men. Urbanization and literacy are thought to promote changes in attitudes and norms against intimate partner violence. However, literacy within rural community might expose women to the higher risk of violence. Improving awareness of clinicians and public health workers on the devastating consequences of violence against women and depression is essential in order to identify and take measure when violence and maternal depression co-occurred.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2010. s. 60
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1335
Nyckelord
depression, extreme poverty, intimate partner violence, spousal-control, child death, rural Ethiopia
Nationell ämneskategori
Psykiatri
Forskningsämne
psykiatri
Identifikatorer
urn:nbn:se:umu:diva-32856 (URN)978-91-7264-959-0 (ISBN)
Disputation
2010-09-13, Tandläkarhögskolan, 9 trp., Sal A, Norrlands universitetssjukhus, Umeå, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2010-04-01 Skapad: 2010-03-29 Senast uppdaterad: 2011-04-08Bibliografiskt granskad

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Deyessa Kabeta, NegussieAlem, AtalayEmmelin, MariaHögberg, UlfKullgren, Gunnar

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Deyessa Kabeta, NegussieAlem, AtalayEmmelin, MariaHögberg, UlfKullgren, Gunnar
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PsykiatriObstetrik och gynekologiEpidemiologi och folkhälsovetenskap
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Clinical Practice and Epidemiology in Mental Health
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