Social Class, Gender and Psychological Distress in Mumbai: Risk and Protective Factors

Abstract

BACKGROUND: Common mental disorders contribute to a large proportion of the non-fatal disease burden in India. Mumbai is among the most crowded cities in Asia with half the population housed in slums creating an environment of vulnerability. In this context, the risks and protective factors associated with depression symptoms are explored by investigating the role of social class and gender in Mumbai. METHODS: 491lower income and 326 middle income respondents were screened for depressive symptoms and compared on 4 subscales of the GHQ 28: somatization, anxiety, social dysfunction and severe depression. RESULTS: The relative risk (RR) of depressive symptoms for lower income individuals was 1.27. The relative risk associated with being female was 1.04 in the lower income group and 1.55 in the middle-income group. Apart from stress and perceived health which proved to be significant predictors for every sub scale, hope emerged as a protective variable for somatization and severe depression, positive emotional style emerged as a protective factor against anxiety and severe depression and tobacco was found to be a risk factor for social dysfunction. CONCLUSION: The incidence of depressive symptoms was the highest for middle income women. This work provides insights from an intersectional framework of class and gender. The inclusion of positive variables in conjunction with risk factors highlight the role of positive protective factors such as hope and positive emotional style for mental health.