Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

10. doan vuong diem khanh


Published on

  • Be the first to comment

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>