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Education and mental health outcomes among women in rural Gujarat 

PI: Dr. Nisha Fahey

Objective:
This cross-sectional study assessed the prevalence and healthcare impact of common mental disorder (CMD) symptoms among reproductive-aged women in rural western India. It also examined how perceived stress relates to CMD symptoms and whether sociodemographic factors modify that relationship. Additionally, it explored suicidal ideation (SI) among these women to understand whether SI occurs with and without underlying CMD.

Background:
This study assessed CMD among rural women in Gujarat, India, finding that about 24% screened positive. Factors like low income, low education, food insecurity, and trauma-related recurrent thoughts increased CMD risk. Perceived stress significantly predicted CMD, but higher education, greater income, and older age mitigated this relationship, suggesting these sociodemographic attributes could inform targeted mental health interventions.

Outcomes:

  • Nearly 23% screened positive for CMD using the WHO SRQ-20, with over 80% undiagnosed despite recent healthcare visits.

  • Most women with CMD presented with somatic symptoms, contributing to underdiagnosis and increased healthcare utilization.

  • Higher education markedly attenuated the impact of high perceived stress on CMD probability (82.3% → 32.9% across education levels; P trend = 0.03).

  • Among those with moderate stress, greater age and income also reduced CMD likelihood, though to a lesser degree than education.

  • Among women reporting suicidal ideation (SI):

    • CMD-negative individuals had higher self-rated health, education, and income.

    • CMD-positive women showed high stress (57%), anhedonia (55%), and worthlessness (67%).

    • Findings suggest two distinct SI phenotypes—one linked to impulsive distress without CMD and another associated with classic depressive symptoms.