The social contexts of depression during motherhood: A study of explanatory models in Vietnam

Niemi, Maria; Falkenberg, Torkel; Nguyen, Mai Thi; Nguyen, Minh Truong; Patel, Vikram; Faxelid, Elisabeth

doi:10.1016/j.jad.2009.09.017

Cited by 24 publications

(34 citation statements)

References 110 publications

(169 reference statements)

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“…Researchers constructed vignettes to depict DSM disorders, with the aim of eliciting local terminology and etiology. Vignettes that were labeled as “thinking too much” by participants were typically about depression (Abbo, 2011; Karasz, 2005b; Niemi et al, s2010; Okello & Ekblad, 2006; Patel et al, 1995), though vignettes about psychotic depression (Abbo et al, 2008), adjustment disorder with depressed mood (Okello & Ekblad, 2006), somatization (Sorsdahl et al, 2010), and schizophrenia (Sorsdahl et al, 2010) were also sometimes termed “thinking too much.” In other cases, vignettes that were attributed to “thinking too much” were considered not to represent illnesses per se but merely “problems” (Muga & Jenkins, 2008; Sorsdahl et al, 2010). …”

Section: Resultsmentioning

confidence: 99%

“Thinking too much”: A systematic review of a common idiom of distress

Kaiser¹,

Haroz²,

Kohrt³

et al. 2015

Social Science & Medicine

217

175

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Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical and public health communication. This systematic review is a qualitative synthesis of “thinking too much” idioms globally, to determine their applicability and variability across cultures. We searched eight databases and retained publications if they included empirical quantitative, qualitative, or mixed-methods research regarding a “thinking too much” idiom and were in English. In total, 138 publications from 1979–2014 met inclusion criteria. We examined the descriptive epidemiology, phenomenology, etiology, and course of “thinking too much” idioms and compared them to psychiatric constructs. “Thinking too much” idioms typically reference ruminative, intrusive, and anxious thoughts and result in a range of perceived complications, physical and mental illnesses, or even death. These idioms appear to have variable overlap with common psychiatric constructs, including depression, anxiety, and PTSD. However, “thinking too much” idioms reflect aspects of experience, distress, and social positioning not captured by psychiatric diagnoses and often show wide within-cultural variation, in addition to between-cultural differences. Taken together, these findings suggest that “thinking too much” should not be interpreted as a gloss for psychiatric disorder nor assumed to be a unitary symptom or syndrome within a culture. We suggest five key ways in which engagement with “thinking too much” idioms can improve global mental health research and interventions: it (1) incorporates a key idiom of distress into measurement and screening to improve validity of efforts at identifying those in need of services and tracking treatment outcomes; (2) facilitates exploration of ethnopsychology in order to bolster cultural appropriateness of interventions; (3) strengthens public health communication to encourage engagement in treatment; (4) reduces stigma by enhancing understanding, promoting treatment-seeking, and avoiding unintentionally contributing to stigmatization; and (5) identifies a key locally salient treatment target.

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Section: Resultsmentioning

confidence: 99%

“Thinking too much”: A systematic review of a common idiom of distress

Kaiser¹,

Haroz²,

Kohrt³

et al. 2015

Social Science & Medicine

217

175

View full text Add to dashboard Cite

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“…Just one study, from Pakistan, did not find an association (Husain et al, 2006b). A clue to better ways of framing and capturing economic stress in research -moving beyond simplistic income measures -is to be found in the two qualitative studies included in our mapping, one from Vietnam (Niemi et al, 2010;Rodrigues et al, 2003) and one from India . Both studies show how women highlight financial or economic "difficulties" as being key to causal models for PND.…”

Section: Table 3 About Herementioning

confidence: 93%

“…The majority (61.7%) of studies were facility-based, 34.0% were community-based and n=2 studies were conducted in both settings. The range of study designs is wide, from small-n (n=18) qualitative research (Niemi et al, 2010) to case control design (n=320) Rahman et al, 2004a) to large-scale (n=19,030) experimental intervention research (Tripathy et al, 2010). …”

Section: Figure 1 About Herementioning

confidence: 99%

Poverty and postnatal depression: a systematic mapping of the evidence from low and lower middle income countries

et al. 2012

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This study systematically maps, assesses and aggregates research relating to postnatal depression (PND) and poverty in low and lower middle income countries (LLMICs). Our search of 12 databases yielded 2,202 articles, of which 47 items from 17 countries were included in our mapping. We highlight mechanisms for the relationships between poverty and PND in LLMICs. The research base on the relationships between poverty and PND in LLMIC is limited, but has recently expanded. It is dominated by studies that consider whether poverty is a risk factor for PND. Income, socio-economic status and education are all inconsistent risk factors for PND. Clues to better ways of framing and capturing economic stress in PND research is found in the qualitative studies included in our mapping. Evidence focuses overwhelmingly on individual-level analyses. To understand the scale and implications of PND in LLMICs, research has to take account of neighbourhoods, communities, and localities.

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“…While the first line treatment for major depression is usually anti-depressant medication, many pregnant and breast-feeding women are reluctant to take such medications due to concerns for effects on the baby (Dimidjian and Goodman 2009). In addition, anti-depressant medications are not readily available and are expensive and have to be paid for out of pocket in the Vietnamese setting (Niemi et al 2010a). While women are more affected by depression than men, effective care in low-income countries may be available to only 5 % of these women (Patel et al 2004).…”

Section: Introductionmentioning

confidence: 99%

The Experience of Perinatal Depression and Implications for Treatment Adaptation: A Qualitative Study in a Semi-rural District in Vietnam

et al. 2014

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This study sought to provide an understanding of how perinatal depression is experienced, and how interventions targeting it should be adapted to suit the local context. The study was conducted in a semi-rural district in Vietnam. It comprised of individual interviews with nine women who obtained high scores in a depression selfreport measure during pregnancy, two focus group discussions (FGDs) with health workers from the local community health stations, and two FGDs with elderly women from the local community. Interviews addressed the experience of depression during pregnancy and FGDs addressed the perceptions of depression and the suitability and provision of a mindfulness intervention. Interventions targeting perinatal depression should take into account the particular social aspects that may be intimately linked to its causation and course. The causation of depression was deemed to be predominantly social, including problems between family members and son preference. The mindfulness intervention was thought suitable for the local context. Delivery through well-supported community meetings was recommended. A locally adapted intervention is thus deemed suitable for the local context, and could be provided as a component of a stepped-care model for depression treatment. The results of this study may not be generalizable beyond the group studied, or the context of Ba Vi, Vietnam.

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The social contexts of depression during motherhood: A study of explanatory models in Vietnam

Cited by 24 publications

References 110 publications

“Thinking too much”: A systematic review of a common idiom of distress

“Thinking too much”: A systematic review of a common idiom of distress

Poverty and postnatal depression: a systematic mapping of the evidence from low and lower middle income countries

The Experience of Perinatal Depression and Implications for Treatment Adaptation: A Qualitative Study in a Semi-rural District in Vietnam

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