A demographic and descriptive study on depression status of adolescent population of Ahmedabad city in India

INTRODUCTION

In primary care settings, depression is a prevalent diagnosis, accounting for 6% to 20% of all patient visits.^1-3 Similarly, spiritual sentiments have a significant impact on patients’ attitudes about medical care. According to a countrywide poll conducted in 1990, 75% of the population indicates that their attitude to life is based on their faith.⁴ According to a survey of patients in a primary care environment, 40% of patients desire their doctors to talk to them about their beliefs.⁵

A beneficial correlation between religious devotion and mental health has been found in several researches. Larson et al included all of the research on spirituality and mental health published in 2 prestigious psychiatric publications over an 11-year period using meta-analysis.⁶ A favorable correlation between spiritual views and mental health was found in 84% of the research reviewed, a statistically significant correlation was found in 13.5% of the studies, and a negative correlation was found in 2.5% of the studies. College students, the elderly, handicapped veterans, disabled women, and women healing from hip fractures are just a few of the particular categories where various components of spirituality have been linked to a decreased frequency of depression.^7-11 A poll in Washington County, Maryland revealed that persons who did not frequently attend religious services were 4 times more likely to commit suicide than those who did. This relationship goes beyond basic survey data to depressed behaviours.¹²

There haven't been many researches that link depression with spirituality among the urban poor, despite the range of these investigations. A patient's spiritual life may be a useful coping technique given the pressures inherent in many metropolitan neighbourhood, such as the elevated incidence of poverty, violence, and chronic disease, especially when other support networks are constrained.^13-16 As indicators of spirituality, many earlier researches have focused on church attendance and faith in a higher power.^7-10,12,17 Furthermore, several characteristics have been identified as crucial to one's spirituality, in addition to attending church: an inner life of prayer and meditation, attitudes toward other people, and belief in a connection with a higher force. In order to shed light on this crucial coping strategy, the current study was conducted to better understand the relationship between depression and spirituality in metropolitan medical individuals.

METHODS

The present cross-sectional study was carried out in Ahmedabad city in the months of November and December 2022. A total of 400 adults were included in the study, which were selected using multi-stage sampling aged between 18 years to 59 years. PHQ-9 (patient health questionnaire) was used to determine the depression.³² Findings were analysed using regression analysis. For every individual age (in completed years), gender, occupation, per capita income, internet addiction (Young’s internet addiction test), spirituality (Washington University psychiatrist Robert Cloninger), height and weight were recorded.³⁰ BMI was calculated for everyone using the formula,

The adults who were willing to participate in the study, were only enrolled in the study. Participants were interviewed through pre-formed semi structured questionnaire.

Health education regarding good eating practices and improving living quality (how to think positively) was given to participants for the improvement of their health and as prevention to depression. Data was tabulated in Microsoft Excel and analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, version 20.0. Armonk, New York and Microsoft Excel 2007.

RESULTS

Table 1 gives information about the association between genders, BMI, occupation, substance abuse (addiction), internet addiction and spirituality with depression. Cramer’s V test was used to test the association for the same, at 5% level of significance using IBM SPSS Statistics for Windows, Version 20.0. Armonk, New York and Microsoft Excel 2007.^25,26

BMI, occupation, internet addiction and spirituality were found to be associated with depression. The higher BMI & internet addiction lead to depression. Working people and non-spirituals are more prone to depression.

Table 2 shows the linear regression function for the depression (dependent factor) with age, gender (female: 1, male: 0), occupation (working: 1, non-working: 0), per-capita income, BMI, internet addiction, spirituality as independent factors. Linear regression model fits good for the factors affecting depression.

DISCUSSION

This study posed a number of interesting queries. Given the potentially overwhelming social stress connected to living in the inner city, one's belief in a higher power, and the effectiveness of prayer may shield one from depression. Though it's possible that a lack of faith is simply one of the helplessness, despair, and anhedonia that define severe depression. Although it may be easy to assume that spirituality and sadness are causally related, these results reflect just an association. Numerous studies had shown that a person's participation at religious services acted as a protective factor against depression.^7-10,12,17 It had been hypothesized that church goers were less sad because of the social support provided by the church.^9,10,12 This link, however, may be tainted by selection bias since depressed individuals may be too weak to go to religious services. People with depression were just as likely as those without depression who participated in religious activities, prayed and meditated.

However, in patients, with depression, appropriate encouragement of participation in spiritual activities or the incorporation of religious imagery into the regimen was recommended treatment and may be beneficial. The success of identifying a higher power in 12-step drug and alcohol addiction treatment programs suggested that incorporating spiritual language can be beneficial. Alcoholics Anonymous membership allowed 60-80% of alcoholics to drink less or not at all in a year and 40-50% to remain sober for many years.²⁷ In one study in 1981, opiate-dependent patients who used religious imagery and language had improved rates of abstinence at 1 year compared with those who did not use religious imagery (41% vs. 5%).²⁸

This study had some potential limitations. The 40% completion rate raised concerns about possible selection bias when participants opt out. However, a review of the partially completed questionnaires revealed that the last remaining items were generally unanswered, indicating that the incompleteness of the questionnaire. In addition, the criteria for inclusion of the questionnaires in the analysis were strict: the instrument had to be fully completed to be included in the data analysis. After examining the demographic data, there was no statistical difference between patients who completed and patients who did not complete the questionnaire (data not shown).

In summary, this study examined urban populations and found that higher spirituality scores were associated with fewer depressive symptoms, showed significant differences between depressed and non-depressed individuals. Finding patient-friendly ways to foster a patient's unique belief system may benefit depressive symptoms. Additionally, understanding the patient's spiritual life and its impact on mental health can provide caregivers with insight into important coping mechanisms. This continues to be an exciting area of research where the interrelationships of spirituality, medicine and mental health can find common ground for incorporating new modalities into the care of poverty-stricken depressed patients.

CONCLUSION

From the present study it was concluded that 68% (272/400) of the sample was depressed and BMI is associated positively with depression. So, obesity was more commonly seen in depressed and indirectly other diseases where obesity act as risk factor may also be more common in them. Working people were more suffering from depression, one of the reasons may be imbalance between social and professional life. Internet addiction was one of the important risk factors leading to depression. The linear regression function can be used for the determination of depression.

BMI, occupation, per capita income, and internet addiction have a significant positive relation while spirituality had a negative relation with depression.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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