Depression and Anxiety among Iraqi Women: A Systematic Review

  • Kathryn Mishkin Global Institute for Health and Human Rights, University at Albany, NY USA
  • Bibi Chaterpateah Global Institute for Health and Human Rights, University at Albany, NY USA
  • Valerie Bresier Global Institute for Health and Human Rights, University at Albany, NY USA
  • Jaleen Fraser Global Institute for Health and Human Rights, University at Albany, NY USA
Keywords: mental disorder, women, mental health, Iraq, Kurdistan

Abstract

Background and objective: Maternal mental health is considered an important subject among leading public health experts. Women are two to three times more likely to be diagnosed with mental illness compared to men. According to the World Health Organization, depression will be the biggest contributor to burden of disease among women by 2020. Chronic stress, experiencing war, and history of abuse are associated with mental illness. Iraq has experienced years of challenging circumstances due to the political and social environment as well as physical barriers to health care services. This paper presents findings from literature about mental illness among Iraqi women. Methods: A comprehensive literature review was conducted using PubMed, Google Scholar, and EBSCO Academic Search Complete to identify studies focused on mental illness in Iraq. Search terms included: maternal, anxiety, depression, Iraq, Middle Eastern and North African region, and women. Cross-sectional, cohort, and case-control studies were included. Results: Five papers were found that focused exclusively on mental illness in Iraq. Two described maternal mental illness and three focused on mental illness in the general population, with two of the three including information specific to women. Results suggest that the rate of mental illness among Iraqi women is not different from women in other countries. However, because there is a difference of seven years between the Iraqifocused study and other global studies, additional new research is required to best compare rates. Interestingly, Iraqi women experience maternal mental illness at higher rates than other women. While the global average rate for mental illness in pregnancy or the postpartum period is estimated at 15-20%, 37.5% of Iraqi women experience anxiety and 28.5% experience depression. Conclusion: Additional study focusing on women’s health and maternal mental health is necessary to describe women at highest risk for mental illness and to inform strategies.

References

[1] World Health Organization. Mental health aspects of women’s reproductive health: a global review of the literature . Geneva: World Health Organization; 2009.
[2] Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in - and lower-middle-income countries: a systematic review. Bulletin of the World Health Organization. 2012;90(2):139g49g.
[3] World Health Organazation. Depression and Other Common Mental Disorders Global Health Estimates. Geneva, Switzerland: WHO; 2017.
[4] World Health Organization. Mental health aspects of women’s reproductive health: A global review of the literature. Geneva: WHO; 2009.
[5] Humberstone S. Mental illness in pregnancy: midwives supporting women and safeguarding babies. Practicing Midwife. 2015;18(9):18-20.
[6] Ahmed HM, Alalaf SK, Al-Tawil NG. Screening for postpartum depression using Kurdish version of Edinburgh postnatal depression scale. Archives of gynecology and obstetrics. 2012;285[5]:124955.
[7] Wallace ME, Hoyert D, Williams C, Mendola P. Pregnancy-associated homicide and suicide in 37 US states with enhanced pregnancy surveillance. American Journal of Obstetrics and Gynecology. 2016;215(3): e1-364.e10. doi: 10.1016/j.ajog.2016.03.040
[8] Appleby L, Mortensen PB, Faragher EB. Suicide and other causes of mortality after post-partum psychiatric admission. The British Journal of Psychiatry. 1998;173:209-11.
[9] Kendig S, Keats JP, Hoffman MC, Kay LB, Miller ES, Simas TAM, et al. Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety. Obstetrics
While
& Gynecology. 2017;129(3):422430. doi: 10.1097/ AOG.0000000000001902.
[10] Fisher J, de Mello, M., Patel, V., Rahman, A., Tran, T., Holton, S., et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organazation. 2011;90(2):139-149H. doi: 10.2471/BLT.11.091850
[11] Pocock L. Mental Health Issues in the Middle East - An Overview. Middle East Journal of Psychiatry and Alzheimers. 2017;7(1).
[12] University of Washington. The global burden of disease: Generating evidence, Guiding Policy. Human Development Network, World Bank; 2010.
[13] Sadik S, Bradley M, Al-Hasoon S, Jenkins R. Public perception of mental health in Iraq. International Journal of Mental Health Systems. 2010;4(1):26. DOI: 10.1186/1752-4458-4-26
[14] Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clinical Obstetrics and Gynecology. 2008;51(2):333-48. doi: 10.1097/ GRF.0b013e31816f2709.
[15] Olfson M, Mechanic D, Hansell S, Boyer CA, Walkup J. Prediction of homelessness within three months of discharge among inpatients with schizophrenia. Psychiatric Services. 1999;50(5):667-73. DOI: 10.1176/ps.50.5.667
[16] Crawford DM, Trotter EC, Hartshorn KJS, Whitbeck LB. Pregnancy and Mental Health of Young Homeless Women. American Journal of Orthopsychiatry. 2011;81(2):173-83. DOI: 10.1111/j.19390025.2011.01086.x
[17] Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta psychiatrica Scandinavica. 2005;112(5):33050. DOI:10.1111/j.16000447.2005.00634.x

[18] Miller P, Lawrie SM, Hodges A, Clafferty R, Cosway R, et al. Genetic liability, illicit drug use, life stress and psychotic symptoms: preliminary findings from the Edinburgh study of people at high risk for schizophrenia. Social Psychiatry and Psychiatric Epidemiology. 2001;36(7):33842.
[19] Honkalampi K, Hintikka J, Haatainen K, Koivumaa-Honkanen H, Tanskanen A, Viinamaki H. Adverse childhood experiences, stressful life events or demographic factors: which are important in women's depression? A 2-year follow-up population study. Australian and New Zealand Journal of Psychiatry. 2005;39 [7]:627-32.
[20] Seng JS, Low LK, Sperlich M, Ronis DL, Liberzon I. Prevalence, trauma history, and risk for posttraumatic stress disorder among nulliparous women in maternity care. Obstetrics and Gynecology. 2009;114(4):839-47.
[21] Leigh B, Milgrom J. Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. 2008;8:24. doi: 10.1186/1471-244X-824
[22] Healing Iraqis: The challenges of providing mental health care in Iraq. 2013.
[23] World Health Organization. Iraq mental health survey 2006/7report. 2009.
[24] Alhasnawi S, Sadik S, Rasheed M, Baban A, Al-Alak MM, Othman AY, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey [IMHS]. World Psychiatry. 2009;8 (2):97-109.
[25] Al-Jawadi AA, Abdul-Rhman S. Prevalence of childhood and early adolescence mental disorders among children attending primary health care centers in Mosul, Iraq: a cross-sectional study. BMC Public Health. 2007;7:274. doi: 10.1186/1471-2458-7274
[ 26] Al-Dabbagh SA, Al-Taee WY. Risk factors for pre-term birth in Iraq: a case-control study. BMC pregnancy and childbirth. 2006;18(6):13. DOI:10.1186/1471-23936-13
[27] Higgins A, Downes C, Monahan M, Gill A, Lamb SA, Carroll M. Barriers to midwives and nurses addressing mental health issues with women during the perinatal period: The Mind Mothers study. Journal of Clinical Nursing. 2018;27(9– 10);18721883. doi: 10.1111/jocn.14252
Published
2018-11-30
How to Cite
Mishkin, K., Chaterpateah, B., Bresier, V., & Fraser, J. (2018). Depression and Anxiety among Iraqi Women: A Systematic Review. Erbil Journal of Nursing and Midwifery, 1(2), 85 - 93. https://doi.org/10.15218/ejnm.2018.11
Section
Original Articles