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Background and Aim: On a global scale, an estimated 17.5% of the reproductive-aged population experiences clinical infertility. Beyond its categorization as a reproductive health concern, infertility emerges as a substantial independent risk factor for the development of various mental health disorders. The current study aims to investigate the prevalence of depression among women experiencing infertility compared to fertile women in Herat city, Afghanistan. Methods: This hospital-based case-control study was conducted in Herat city, Afghanistan, during the latter half of 2023 on women aged 15-49. Sociodemographic and infertility data were gathered by a gynecologist using a structured questionnaire with 14 items. Assessment of depression employed the Dari-translated version of the Patient Health Questionnaire. The data were scored and categorized following the instrument's guidelines. To examine the association between categorical variables, a chi-square test was conducted, with a significance level set at 0.05 for all analyses. These statistical procedures were performed using IBM Statistical Package for Social Sciences, version 27. Results: Our investigation revealed a statistically significant association (p < 0.001) between infertility and depression. Infertility was associated with a markedly increased risk of depression, as evidenced by a prevalence of 79.0% in infertile women compared to 44.4% in fertile women. The study found a link between depression, health, and nutritional status in both infertile and fertile participants. Notably, within the infertile group, the longer a woman struggled with infertility, the more likely she was to experience depression. Conclusion: Given the substantial prevalence and important correlates of depression among infertile women in Herat, Afghanistan, it is imperative for policymakers, mental health professionals, and gynecologists to specifically address the mental well-being of this vulnerable population.
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Background and Aims: Pregnancy is an important and natural event in a woman's life. It represents a time of substantial social and bio-psychological challenges for a pregnant woman that may increase vulnerability to emotional disturbances such as depression, anxiety, and stress (DAS). This study aims to assess the prevalence and associated factors of DAS among pregnant women in Herat city of Afghanistan. Methods: This hospital-based cross-sectional study was conducted between July and November 2019, on 691 Dari-speaking pregnant women aged 15-49 years, who attended the antenatal clinic of Herat Razaei Maternity Hospital. The interview process involved the use of a structured questionnaire that collected data on sociodemographic characteristics of participants, as well as the validated Dari-translated version of DASS-42 questionnaire. A χ 2 test was used to test for association between categorical data. Forward likelihood ratio was used to assess the strength of association between sociodemographic variables and DAS; independently. The significance level was set to 0.05 and the confidence interval to 95% in all statistical analyses. Statistical analyses were performed in IBM SPSS Statistics (version 27). Results: The mean age of participants was 26.17 ± 6.06. The overall prevalence of DAS among study participants were 42.8%, 40.0%, and 59.5%, respectively. Planning of current pregnancy, women's health, husband's health, women's nutrition, family support, husband's support, women's education, women's employment, and family economy were significantly associated with DAS, while gestational age was not significantly associated with DAS. Conclusion: The prevalence of DAS among pregnant women in Herat city of Afghanistan is very high. Considering scientific evidence on high prevalence and associated factors of DAS among pregnant women, policymakers, public health authorities, and medical practitioners must devote significant attention in reducing the magnitude of these mental disorders and/or reducing their impact on women, their families, and the society.
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Objectives: Coronavirus disease 2019 (COVID-19) pandemic has been associated with a great level of psychological distresses in people around the world. This study aims to assess the prevalence of depression, anxiety and stress among COVID-19 patients and identify the associated factors, in Herat Province of Afghanistan. Methods: This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021. Data was collected with a structured questionnaire on depression, anxiety and stress scale, which was the validated Dari-version. Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors. Results: The mean age of participants was 38.05; 51.9% (238/459) were male and 84.1% (386/459) were married. Median scores for depression, anxiety and stress were 5.0, 8.0, and 10.0, respectively. Gender, general health condition, nutritional status, COVID-19 clinical manifestation and concurrent comorbidities (except diabetes and hypertension) were significantly associated with mental disorders; while association between marital status and these psychological disorders was not significant. Moreover, a significant difference was observed in the level of anxiety between healthcare workers and other respondents. Conclusion: This is the first study to report the high prevalence of depression, anxiety and stress among COVID-19 patients in Herat, which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.
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BACKGROUND: Stigma is a barrier to mental healthcare. Understanding context-specific stigma is important in designing mental health interventions. AIM: This study explored the nature and patterns of mental health stigma among community members in Afghanistan. METHODS: Using cross-sectional data (n = 718), descriptive and inferential analyses were conducted. Multivariable linear regression identified determinants of stigma, as reflected by: (1) preference for social distance in relation to depression and psychosis, and (2) intended stigmatising behaviours in relation to mental illness. RESULTS: In descriptive analyses, stigma toward depression and psychosis, especially regarding work and marriage, was found. The label of 'mental illness' was especially stigmatising. Most respondents would disclose a mental health problem to family only. Findings of inferential analyses included: stigma was positively associated with higher socioeconomic status, depression and belief in dangerousness; and negatively associated with urban location, female gender, familiarity and belief in a positive prognosis. CONCLUSIONS: This study provides new insights on stigma, to inform action in Afghanistan, an under-researched context. Further research and actions must prioritise supportiveness at the family level, especially in remote regions and address cultural issues of the social cost of associating with mental illness. More culturally appropriate, non-stigmatising language surrounding mental illness should be developed.
