Arab Men and Women’s Conceptualization of Mental Health and Depression: A Qualitative Study from the Middle East

Abstract

Cardiovascular diseases are the leading cause of death worldwide. Among cardiovascular patients, depression is associated with an increased morbidity and mortality. Understanding how depression is conceptualized from cardiovascular patients' perspective can help with prevention, early detection, and treatment for depression. This might reduce cardiovascular morbidity and mortality, and save health care costs. To the best of our knowledge, there is no study in the Gulf region exploring depression among Arab cardiovascular patients. The purpose of this exploratory ethnographic qualitative research is to investigate how Arab male and female patients with cardiovascular disease conceptualize mental health and depression. Two theoretical frameworks guided this research: (1) The Ecological Perspective, and (2) Kleinman's Explanatory Model of Health and Illness. Using maximum variation purposive sampling, thirty (30) male and twenty-five (25) female, self-identified, Arab cardiovascular patients were recruited as research participants. Individual in-depth interviews were conducted using a semi-structured questionnaire. Thematic analysis was performed to generate themes. Nvivo 10, a qualitative data analysis software, was used to organize the narrative data. The participants in this study placed great emphasis on the manifestations of mental illness and their impact on both themselves and their families. Four major themes were identified from their narratives: psychological and physical disturbances; unfavorable personal characteristics; work issues and financial constraints; lack of family and social support. The knowledge generated in this study might help increase awareness, prevention of and treatment for depression among cardiovascular patients in Qatar. The findings from this study can also be used to inform a multi-disciplinary and multi-sectoral intervention approach that is contextualized to meet the mental health care needs of Arab cardiovascular patients, thus reducing cardiovascular diseases morbidity and mortality in Qatar and the Gulf region.

A qualitative study of a mental health awareness intervention for Jordanian and resettled Syrian refugees in host communities

“…Stigma has also been associated with low utilization of mental health treatment in Arab communities, and individuals in need of these services may experience fear of compromised social status or damaged reputation for an entire family (Ayalon et al, 2015; Gearing et al, 2013). In accordance with previous research, increased awareness led to greater acceptance and a more constructive view of mental illness (Donnelly et al, 2019; Zolezzi et al, 2018). Moreover, findings reinforce previous scholarly work suggesting that mental health education is an important step to reducing stigmatizing views of mental illness (Gearing et al, 2013; Zolezzi et al, 2018).…”

A proverbial double-edged sword

“…This can negatively affect how people think and feel about themselves, their personal identity, and self-esteem that may be the cause of depression. (Donnelly et al, 2019(Donnelly et al, , 1108 As well as loss, conflict or communication difficulties, studies also report that family habits relating to poor self-care such as sedentary behaviour or low physical activity can be felt to have impacted on participants' adult lifestyles and might contribute to adult depression (Azar et al, 2010;Teychenne et al, 2011).…”

“…Among women with depressive symptoms, family/household responsibilities and distance to university/work were also cited as a cause for lack of time for physical activity participation. (Azar et al, 2010, 6) Heavy family responsibilities could also exacerbate depression (Donnelly et al, 2019) and among Qatari and Indian men, worry about financial responsibility to the family appeared to contribute to depression (Donnelly et al, 2019;Liang and George, 2012). In contrast, young adults in the USA who remained financially dependent on their parents were found to be unable to access mental health care because their parents were unable to fund treatment (Kuwabara et al, 2007).…”