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Depression in India: An Exploratory Study of the Social Determinants of Depressive Symptoms and Gender Differences in symptom endorsement among adults in India
Banerjee, Kasturi
Banerjee, Kasturi
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Abstract
India has been urgently tasked with meeting the needs of a highly diverse, rapidly aging population with disparate resources. Mechanisms of social determinants of health are not well understood within developing countries like India with its unique socio-economic, political and cultural landscape. The Longitudinal Ageing Study in India (LASI) is the first epidemiological study to apply uniform methodology to assess social determinants of health across all regions of India. We conducted a cross-sectional study using the LASI Wave 1 data from 2017-18. Aims & Method. We hypothesized that 1) demographics, health, neighborhood factors, and social inclusion/non-discrimination experiences are predictors of depressive symptoms as measured by the CES-D 2) there are sex differences in symptom endorsement on a measure of probable major depression (CIDI-SF) and that women report more somatic symptoms. Results. We found that older age, being female, being married, having pain and rating health poorly were significantly associated with depressive symptoms, as were, lower perceived neighborhood safety, food insecurity, experiences of disasters and violent crime. The variances explained by these sets of variables were significant but quite small (Δ =0.004 and Δ =0.012, p<.05). Social inclusion and discrimination predictors explained the most variance (Δ =.036). Frequent engagement with social obligations, experiences of ill treatment and perceived discrimination and civic engagement/voting associated with more depressive symptoms. Our chi square analysis identified significant sex differences in symptoms of appetite changes and feelings of worthlessness among those with probable major depression (all p<.05). Among somatic symptoms, women only endorsed more appetite changes, not sleep and fatigue. Discussion. The overarching message from our study is that consistent with global trends, women remain disproportionately affected by depressive symptoms in India. However, the true picture is incomplete without accounting for the complex intersectional social identities that shape the lived experiences of individuals in India and the culturally unique expression of psychological distress. Our study serves as a mere starting point and has several limitations. We were not able to study state-level differences and adequately represent complex demographic identities and associated lived experiences within this population. Future research should focus on how these determinants interact as well as qualitatively exploring culturally unique symptom presentations for better screening and treatment.
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2023-01-01
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University of Kansas
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Clinical psychology,