Predictors of Major Depressive Disorder among Pakistani Women: A Case Study

Saleha  Bibi; Iffat  Rohail; Tanvir  Akhtar

doi:10.32350/ccpr.21.05

Saleha Bibi Foundation University (Rawalpindi Campus), Rawalpindi, Pakistan
Iffat Rohail Foundation University (Rawalpindi Campus), Rawalpindi, Pakistan
Tanvir Akhtar Foundation University (Rawalpindi Campus), Rawalpindi, Pakistan

DOI: https://doi.org/10.32350/ccpr.21.05

Keywords: cognitive behavioral therapy, major depressive disorder (MDD), social and cultural pressure

Abstract

Abstract Views: 606

Social and cultural pressures play a significant role in the development of depressive disorders. Women are at a greater risk of experiencing depressive disorders because they always become the subject of social and cultural pressure. This paper presents the case study of a 23-year-old female who developed symptoms of Major Depressive Disorder (MDD) due to cultural constraints. Initial pre-testing and therapist observation of the client’s verbal and non-verbal attitude / behavior confirmed the diagnosis of MDD. Diagnosis was made according to DSM-5. After initial intake interview, psychological tests including House-tree-person (HTP), Thematic Apprehension Test (TAT), Rotter Incomplete Sentence Blank (RISB), Beck Depression Inventory (BDI), Raven Standard Progressive Matrices (SPM) and Clinical Structured Interview (CIS-R) were administered on the client. After exploring the causal factors of her problem and conducting diagnostic sessions, therapeutic sessions were also conducted. Some techniques of cognitive behavioral therapy were selected for the client based on the strong empirical evidence available that advocates for their use in effectively treating depressive disorders. After achieving the goals of psychotherapy set at the first session with the help of the client as well as gaining satisfactory results of post-testing and therapist observation of the client’s progress, psychotherapy was terminated. Follow up sessions were conducted to monitor the progress of the client. Our research study has clinical and community implications.

Downloads

Download data is not yet available.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Author.

Ali, F.A., Israr, S.M., Ali, B.S., Janjua, N.Z. (2009). Association of various reproductive rights, domestic violence and marital rape with depression among Pakistani women. BMC Psychiatry, 9,77.

Ali, B. S., Rahbar, M. H., Naeem, S., Tareen, A. L., Gul, A., &Samad, L. (2002). Prevalence of and factors associated with anxiety and depression among women in a lower middle class semi-urban community of Karachi, Pakistan. Journal of Pakistan Medical Association, 52(11), 513–517.

Andrade, L., Caraveo, J.J., Berglund, P., Bijil, R.V., DeGraaf, R.,Volbergh, W. (2003).The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. International Journal of Methods Psychiatric Research, 12, 3–21.

Ayub, M., Irfan, M., Nasr, T., Lutufullah, M., Kingdon, D., & Naeem, F. (2009). Psychiatric morbidity and domestic violence: A survey of married women in Lahore. Social Psychiatry and Psychiatric Epidemiology, 44,953–60.

Barnet, B., Joffe, A., Duggan, A. K., Wilson, M. D., & Repke, J. T. (1996). Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Archives of Pediatric & Adolescent Medicine,150(1), 64–69.

Chandran, M., Tharyan, P., Muliyil, J., Abraham, S. (2002). Post-partum depression in a cohort of women from a rural area of TamilNadu, India: Incidence and risk factors. British Journal of Psychiatry, 181,499–504.

Dodani, S., Zuberi, R. (2000).Center-based prevalence of anxiety and depression in women of the Northern areas of Pakistan. Journal of Pakistan Medical Association, 50,138–40.

Gadit, A.A.(2004).Economic burden of depression in Pakistan. Journal of Pakistan Medical Association,54,43–4.Husain, N., Parveen, A., Husain, M., Saeed, Q., Jafri, F., ... Choudhry, I. B. (2011). Prevalence and psychosocial correlates of perinatal depression: A cohort study from urban Pakistan. Archives of Women’s Mental Health, 14,395–403.

Husain, N., Chaudhry, I.B., Afridi, M.A., Tomenson, B., Creed, F. (2007). Life stress and depression in a tribal area of Pakistan. British Journal of Psychiatry, 190, 36–41.

Husain, N., Creed, F., & Tomenson, B. (2000). Depression and social stress in Pakistan. Psychological Medicine, 30,395–402.

Koniak, D.-G., Lominska, S., & Brecht, M. L. (1993). Social support during adolescent pregnancy: A comparison of three ethnic groups. Journal of Adolescence,16, 43–56.

Mumford, D. B., Minhas, F. A., Akhtar, I., Akhter, S., & Mubbashar, M. H. (2000). Stress and psychiatric disorder in urban Rawalpindi: Community survey. British Journal ofPsychiatry,177, 557–562.

Mumford, D. B., Nazir, M., Jilani, F. U., &Baig, I. Y. (1996).Stress and psychiatric disorder in the Hindu Kush: A community survey of mountain villages in Chitral, Pakistan. British Journal of Psychiatry,168(3), 299–307.

Mumford, D. B., Saeed, K., Ahmad, I., Latif, S., & Mubbashar, M. H. (1997). Stress and psychiatric disorder in rural Punjab: A community survey. British Journal of Psychiatry, 170,473–478.

Mulder, E. J., Robles de Medina, P. G., Huizink, A. C., Van denBergh, B. R., Buitelaar, J. K., &Visser, G. H. (2002). Prenatal maternal stress: Effects on pregnancy and the (unborn) child. Early Human Development, 70(1–2), 3–14.

Niaz, U. (2001). Overview of women’s mental health in Pakistan. Pakistan Journal of Medical Sciences, 17(4), 203–209.

Nilsson, P. M., Engberg, M., Nilsson, J. A., Karlsmose, B., Lauritzen, T. (2003). Adverse social factors predict early ageing in middle-aged men and women: Ebeltoft health study, Denmark. Scandinavian Journal of Public Health, 31(4), 255–60.

Rabbani, F., & Raja, F. F. (2000). The minds of mothers: Maternal mental health in an urban squatter settlement of Karachi. Journal of Pakistan Medical Association, 50(9),306–312.

Riso, L. P., Miyatake, R. K., & Thase, M. E. (2002). The search for determinants of chronic depression: A review of six factors. Journal of Affected Disorders, 70(2), 103–115.

Stotland, N. L. (1995). Psychiatric issues. In W. M. Barron, &M.D. Kindheimer (Eds.), Medical disorders during pregnancy(pp. 519–531). Mosbys publisher.

Stuchbery, M., Matthey, S., & Barnett, B. (1998). Postnatal depression and social support in Vietnamese, Arabic and Anglo-Celtic mothers. Social Psychiatry and Psychiatric Epidemiology, 33(10), 483–490.

Zahidie, A., Kazi, A., Fatmi, Z., Bhatti, M.T., Dureshahwar, S. (2011). Social environment and depression among pregnant women in rural areas of Sindh, Pakistan. Journal of Pakistan Medical Association, 61,1183–9.