Postpartum depression in India: a systematic review and meta-analysis.

OBJECTIVE: To provide an estimate of the burden of postpartum depression in Indian mothers and investigate some risk factors for the condition. METHODS: We searched PubMed®, Google Scholar and Embase® databases for articles published from year 2000 up to 31 March 2016 on the prevalence of postpartum depression in Indian mothers. The search used subject headings and keywords with no language restrictions. Quality was assessed via the Newcastle-Ottawa quality assessment scale. We performed the meta-analysis using a random effects model. Subgroup analysis and meta-regression was done for heterogeneity and the Egger test was used to assess publication bias. FINDINGS: Thirty-eight studies involving 20 043 women were analysed. Studies had a high degree of heterogeneity (I2 = 96.8%) and there was evidence of publication bias (Egger bias = 2.58; 95% confidence interval, CI: 0.83-4.33). The overall pooled estimate of the prevalence of postpartum depression was 22% (95% CI: 19-25). The pooled prevalence was 19% (95% CI: 17-22) when excluding 8 studies reporting postpartum depression within 2 weeks of delivery. Small, but non-significant differences in pooled prevalence were found by mother's age, geographical location and study setting. Reported risk factors for postpartum depression included financial difficulties, presence of domestic violence, past history of psychiatric illness in mother, marital conflict, lack of support from husband and birth of a female baby. CONCLUSION: The review shows a high prevalence of postpartum depression in Indian mothers. More resources need to be allocated for capacity-building in maternal mental health care in India.

Sexual Dysfunction in Remitted Female Patients with Depression on SSRIs: Associated Factors and Relation to Marital Satisfaction and Quality of Life.

Background: Sexual dysfunction, a potential side effect of selective serotonin reuptake inhibitors (SSRIs), can lead to marital dissatisfaction in remitted depression patients, affecting their quality of life (QOL), and all of these are risk factors for treatment noncompliance. We aimed to estimate the proportion of female sexual dysfunction and its subtypes compared to the general population and correlate it with various factors, including marital satisfaction and QOL, in remitted depressive patients on SSRI treatment. Methods: This analytical cross-sectional study assessed 116 women, comprising 58 patients aged 18- to 45 years with rsemitted depression on SSRI monotherapy for a minimum of six weeks and their age-matched comparative group. Hamilton Depression Rating Scale was used to assess depression severity and Female Sexual Functional Index, to assess sexual dysfunction. Couple Satisfaction Index and WHOQOL-BREF version were used to assess marital satisfaction and QOL, respectively. Results: In total, 56.89% of the patients had sexual dysfunction, compared to 39.65% in the general population. Exploratory analyses revealed that overall sexual functioning had a significant positive correlation with education (P = .002), marital satisfaction (P < .001), and QOL (P < .01), and a significant negative correlation with the age of onset of depression (P = .004), total marital duration (P = .02), and duration of current treatment (P = .02). Conclusion: Sexual dysfunction is common in remitted female depression patients on SSRI treatment, which may further impair their marital satisfaction and QOL. Hence, routine screening for sexual dysfunction is necessary for them.

Pentazocine use among people who inject drugs in India.

Data regarding prevalence of Pentazocine use is sparse and intervention strategies aimed at it are meager. In view of the fact that Pentazocine has significant abuse potential contrary to what was earlier thought, along with the actuality that people who use injectable Pentazocine are at risk of various complications as HIV, this domain needs more attention. This review examines the extent of the problem of Pentazocine use with consequent effects on the overall health of the people. It is based on nationally representative large scale survey(s) and other reliable documented data on Pentazocine abuse. Possible strategies and future lines of actions have been delineated. Data suggests Pentazocine use from 0.1% to 21.8% in different parts of the country. Various reports have also linked it with unique health complications. Its use has been reported mostly among subjects seeking treatment, with recent reports suggesting increasing use at street level. The strategies to document the extent of injection drug use applied in most cases might not be adequate. There is a need for further research and monitoring to document the burden of the problem. Indirect methods to estimate the extent of problem may need to be implemented and regulatory mechanisms for prescription drug use may need to be strengthened.