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      Prevalence of Depression, Anxiety and Stress among Adult Population: Results of Yazd Health Study

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          Abstract

          Objective: The burden of mental disorders continues to grow with significant impacts on health. This study aimed to investigate the prevalence of stress, anxiety, and depression in Yazd adult population and to examine the associated socioeconomic factors.

          Method : In a 2-step cluster sampling process, 10 000 residents of Yazd Greater Area (200 clusters of 50) were selected during 2014-2015. The short version of Depression, Anxiety and Stress Scale (DASS) Questionnaire was used to assess relevant depression, anxiety, and stress. Data were analyzed by chi-square test. All statistical analyses were done using SPSS version 16.0. P-values less than 0.05 were considered statistically significant.

          Results: Depression, anxiety, and stress were seen in 29%, 32.2%, and 34.8% of adult residents of Yazd Greater Area, respectively. The symptoms of the disorders were moderate, severe, and very severe in 18.2%, 20.2%, and 23.4% of the population, respectively. Also, a significant difference was found between the symptoms of depression, anxiety, and stress and sex, age group, education, employment, marriage status, and country of birth. Of the total population under study, 3.7% were depressed, 7.7% were anxious, 9.5% had stress alone and 16.4% had symptoms of all the 3 disorders. Frequency of depression among Zoroastrians was more than muslims (42.1% vs 29.7%).

          Conclusion: Despite achievemments in higher education and economic development of Yazd population over the past 2 decades, the trend of these disorders has alarmingly been increased. Considering the findings, it is necessary to develop evidence-based and appropriate community-based primary and secondary mental health prevention programs.

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          Most cited references32

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          Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones.

          Increased prevalence, severity, and burden of anxiety, trauma-related and stress-related disorders in women compared with men has been well documented. Evidence from a variety of fields has emerged suggesting that sex hormones, particularly oestradiol and progesterone, play a significant part in generation of these sex differences. In this Series paper, we aim to integrate the literature reporting on the effects of sex hormones on biological, behavioural, and cognitive pathways, to propose two broad mechanisms by which oestradiol and progesterone influence sex differences in anxiety disorders: augmentation of vulnerability factors associated with anxiety disorder development; and facilitation of the maintenance of anxious symptoms post-development. The implications for future research, along with novel approaches to psychological and pharmacological treatment of anxiety disorders, are also considered.
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            Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women

            Background Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. The aim of this study was to validate the 21-item Depression Anxiety and Stress Scale (DASS21) for use in screening for these common mental disorders among rural women with young children in the North of Vietnam. Methods The DASS-21 was translated from English to Vietnamese, culturally verified, back-translated and administered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview for DSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representative cohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach’s alpha, Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale. Results Complete data were available for 221 women. The internal consistency (Cronbach’s alpha) of each sub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale, but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and the combinations of two or three of them were able to detect the common mental disorders of depression and anxiety in women with a sensitivity of 79.1% and a specificity of 77.0% at the optimal cut off of >33. However, they did not distinguish between those experiencing only depression or only anxiety. Conclusions The total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible and sensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained settings.
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              Mental health survey of the adult population in Iran.

              No national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention. To determine the mental health status of a population sample aged 15 years and over. Through random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability ('mental retardation'), epilepsy and psychosis. About a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.3% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability, epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively. Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people. Prevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.
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                Author and article information

                Journal
                Iran J Psychiatry
                Iran J Psychiatry
                IJPS
                Iranian Journal of Psychiatry
                Psychiatry & Psychology Research Center, Tehran University of Medical Sciences (Tehran, Iran )
                1735-4587
                2008-2215
                April 2019
                : 14
                : 2
                : 137-146
                Affiliations
                [1 ]Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
                [2 ]Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
                [3 ]Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
                Author notes
                [* ]Corresponding Author: Address: Yazd Cardiovascular Research Centre, Afshar Hospital, Jomhouri Boulevard, Yazd, Iran. Postal Code: 8917945556. Tel: 98-3535231421, Fax: 98-3535231421, Email: masoud_mirzaei@ 123456hotmail.com
                Article
                IJPS-14-137
                10.18502/ijps.v14i2.993
                6702282
                31440295
                3eb909e2-1bf7-4639-ae2c-ebb612d50070
                Copyright © Psychiatry & Psychology Research Center, Tehran University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 June 2018
                : 25 September 2018
                : 29 September 2018
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                anxiety,anxiety and stress scale (dass),depression,iran,prevalence,stress

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