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<ul><li>Vuong Diem Khanh Doan </li></ul><ul><li>Michael Dunne </li></ul><ul><li>Vo Van Thang  </li></ul><ul><li>Gavin Turr...
<ul><li>INTRODUCTION </li></ul><ul><li>A consistent pattern of an  inverse  relationship socioeconomic status (SES)-depres...
<ul><li>  “ a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or...
<ul><li>Intermediate paths </li></ul><ul><li>Behavioral factors:  Negative health practices </li></ul><ul><li>Biological p...
<ul><li>1. What is the prevalence of depression among Vietnamese adults?  </li></ul><ul><li>2. Is the socioeconomic-depres...
low SES -Education - Income - Occupation - Employment more DEPRESSION more  Stress -Lifetime trauma -Chronic stress -Recen...
Part 1 Exploratory  qualitative research  Part 2 Pilot quantitative research Main survey  - 2  in-depth interviews  psychi...
<ul><li>Hue city </li></ul><ul><li>- Central Vietnam  </li></ul><ul><li>- Population : 350,000 </li></ul><ul><li>- 27 quar...
<ul><li>Section 1 :  Demographics & SES  </li></ul><ul><li>Section 2 :  Self-esteem  : Rosenberg self esteem scale    (RSE...
<ul><li>Randomly selected  5 units  / 16 units </li></ul><ul><li>From the  booklet  of each units :  </li></ul><ul><li>- S...
<ul><li>Descriptive statistics  </li></ul><ul><li>Bivariate data analysis : </li></ul><ul><li>- Chi-square </li></ul><ul><...
PREVALENCE OF  DEPRESSIVE  SYMPTOMS (%) Figure 1:  Prevalence of depressive symptoms  ( CES-D > 21) by  Education       le...
Figure 2: Prevalence of depressive symptoms ( CES-D >21) by  Income   ( quartile groups) < 16,000VND  (< 1.2 AUD per day) ...
Figure 3: Prevalence of depressive symptoms ( CES-D >21) by  Occupation  casual manual non-specialized workers  non-manual...
<ul><li>1 .  Very strong social gradient wrt depressive symptoms </li></ul><ul><li>Higher education  levels report  fewer ...
<ul><li>2.  Mediating effects  </li></ul><ul><li>Lifetime trauma  did  not  have mediating effects on SES- depression  </l...
<ul><li>1.  Mental health care  program in Vietnam: </li></ul><ul><ul><li>New evidence regarding the burden of mental dist...
<ul><li>Thank you! </li></ul>
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10. doan vuong diem khanh

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Transcript of "10. doan vuong diem khanh"

  1. 1. <ul><li>Vuong Diem Khanh Doan </li></ul><ul><li>Michael Dunne </li></ul><ul><li>Vo Van Thang </li></ul><ul><li>Gavin Turrell </li></ul>The Association between Socioeconomic status & Depression in Vietnamese Adults: pilot study
  2. 2. <ul><li>INTRODUCTION </li></ul><ul><li>A consistent pattern of an inverse relationship socioeconomic status (SES)-depressive symptoms. </li></ul><ul><li>The mechanism not well understood. </li></ul><ul><li>A significant barrier </li></ul><ul><li>Most research from developed countries. </li></ul><ul><li>In Vietnam, serious dearth of research on depression & no investigation of SES and depression </li></ul>
  3. 3. <ul><li> “ a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and </li></ul><ul><li>poor concentration” (WHO) </li></ul>
  4. 4. <ul><li>Intermediate paths </li></ul><ul><li>Behavioral factors: Negative health practices </li></ul><ul><li>Biological pathway </li></ul><ul><li>SAM a , HPA b , immune function, metabolic factors </li></ul>Reserve capacity - Stressful life events - Social support - Psychological resources (a) SAM: Sympathetic adrenal - medullary system (b) HPA: Hypothalamic- pituitary-adrenocortical axis Low SES Negative emotion and cognition Depression Anxiety hopelessness Health outcome Mortality Morbidity Quality of life Life expectancy
  5. 5. <ul><li>1. What is the prevalence of depression among Vietnamese adults? </li></ul><ul><li>2. Is the socioeconomic-depression gradient in Vietnam similar to, or different from other cultures? </li></ul><ul><li>3. Among Vietnamese adults, what factors mediate the relationship between SES and depression? </li></ul>
  6. 6. low SES -Education - Income - Occupation - Employment more DEPRESSION more Stress -Lifetime trauma -Chronic stress -Recent life events lower Social support <ul><li>lower </li></ul><ul><li>Psychological resources </li></ul><ul><ul><li>- Mastery </li></ul></ul><ul><ul><li>- Self esteem </li></ul></ul>
  7. 7. Part 1 Exploratory qualitative research Part 2 Pilot quantitative research Main survey - 2 in-depth interviews psychiatrist experts - 10 in-depth interviews with residents 100 Structured interviews with residents Structured interview Phase 2
  8. 8. <ul><li>Hue city </li></ul><ul><li>- Central Vietnam </li></ul><ul><li>- Population : 350,000 </li></ul><ul><li>- 27 quarters </li></ul><ul><li>(15 -25 units / each quarter) </li></ul><ul><li>Phu hoi quarter : </li></ul><ul><li>- Population: 10,121 </li></ul><ul><li>- Total unit: 16 </li></ul>Phu hoi
  9. 9. <ul><li>Section 1 : Demographics & SES </li></ul><ul><li>Section 2 : Self-esteem : Rosenberg self esteem scale (RSES) </li></ul><ul><li>Section 3 : Mastery </li></ul><ul><li>Section 4 : Social support : Multidimensional Scale of Perceived Social Support ( MSPSS) </li></ul><ul><li>Section 5 : Depressive symptoms : Centre for Epidemiological Studies-Depression scale ( CES-D) </li></ul><ul><li>Section 6 : Stress (Lifetime trauma, chronic stress, recent life events) </li></ul>
  10. 10. <ul><li>Randomly selected 5 units / 16 units </li></ul><ul><li>From the booklet of each units : </li></ul><ul><li>- Selected every 5 th households </li></ul><ul><li>- Each household: Aged 25-55 </li></ul><ul><li>- 20 households /each booklet </li></ul><ul><li>- 100 participants / 104 household approached (response rate 96%) </li></ul>
  11. 11. <ul><li>Descriptive statistics </li></ul><ul><li>Bivariate data analysis : </li></ul><ul><li>- Chi-square </li></ul><ul><li>- t-tests, ANOVA </li></ul><ul><li>- Simple linear regression </li></ul><ul><li>Multivariable data analysis </li></ul><ul><li>- OLS regression & 3 steps in Barron & Kenny ‘s Framework </li></ul>
  12. 12. PREVALENCE OF DEPRESSIVE SYMPTOMS (%) Figure 1: Prevalence of depressive symptoms ( CES-D > 21) by Education level
  13. 13. Figure 2: Prevalence of depressive symptoms ( CES-D >21) by Income ( quartile groups) < 16,000VND (< 1.2 AUD per day) 16,000 - < 26,000 VND (1.2 - < 2.0 AUD per day) 26,000-46,000 VND (2.0 - 3.4 AUD per day) > 46,000 VND (> 3.4 AUD per day)
  14. 14. Figure 3: Prevalence of depressive symptoms ( CES-D >21) by Occupation casual manual non-specialized workers non-manual workers, no professional qualifications employed manual non-specialized workers non-manual professional or business people with prestigious post.
  15. 15. <ul><li>1 . Very strong social gradient wrt depressive symptoms </li></ul><ul><li>Higher education levels report fewer depressive symptoms </li></ul><ul><li>Only individuals at the bottom of the quartile income were strongly associated with higher depressive symptoms compared with the highest income group) </li></ul><ul><li>U shape in relationship between occupation & depressive symptoms (??) </li></ul>
  16. 16. <ul><li>2. Mediating effects </li></ul><ul><li>Lifetime trauma did not have mediating effects on SES- depression </li></ul><ul><li>Self esteem & mastery have very strong mediating effects on SES – depression </li></ul><ul><li>Recent life events have mediating effects on 3 indicators of SES –depression ( education, income, employment) </li></ul><ul><li>Chronic stress has mediating effects on 2 indicators of SES –depression ( education, income) </li></ul><ul><li>Social support has mediating effects on 1 indicators of SES –depression ( occupation) </li></ul>
  17. 17. <ul><li>1. Mental health care program in Vietnam: </li></ul><ul><ul><li>New evidence regarding the burden of mental distress in Vietnam. </li></ul></ul><ul><ul><li>Practical relevance for advocacy for mental health promotion and health care services. </li></ul></ul><ul><li>2. International scientific literature on the social determinants of depression. </li></ul>
  18. 18. <ul><li>Thank you! </li></ul>
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