1. Farhana Ahmed
Senior Child Psychologist &
Nasmin A Hayat
Child Psychologist
Chittagong Maa Shishu O General Hospital.

3.  A recent review led by icddr,b found that mental disorders in
Bangladesh are a serious but overlooked problem. Better data,
awareness and more mental health practitioners are needed to
address the unmet needs for mental health care.
 Mental health disorders– such as depression, anxiety, addiction,
schizophrenia and neurosis – have a serious impact on health:
they contribute up to 13% to the global burden of disease. Low-
and middle-income countries experience a higher burden of
mental disorders, and yet mental health conditions are often not
perceived as serious health problems in these countries and are
not prioritized in prevention programmes and in health care
delivery. In addition, in countries like Bangladesh, there are
often few prevalence data, making recognition of the problem
difficult and posing a challenge to developing effective health
care responses. 5th February 2015

4.  Women bear the burden of responsibility associated
with being wives, mothers and careers of others.
 Increasingly, women are becoming an essential part
of the labor force and in one-quarter to one-third of
households they are the prime source of income
(WHO, 1995).

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6. Specific Hypotheses Are:
1. Women have greater genetic resistance to infectious
diseases and also some rare X-chromosome linked
diseases.
2. Women are protected from cardiovascular morbidity by
sex hormones until menopause.
3. The reproductive events of pregnancy, child birth and
puerperium give women unique morbidity risks not
experienced by men. In addition they have female
specific disorders such as those related to breast,
genital and geniio-urinary areas [ eg: cervicitis,
menstrual or menopausal symptoms].
4. The pathology of some diseases, their symptoms and
developmental course may differ for men and women
19/6/2009 6

7.  Women feel more psychological distress (anxiety,
depression, guilt, conflicting demands) on a day-
today basis and over their life-times than men do,
and this may decrease their physiological
resistance to acute and chronic conditions.
 Women tend to be less delighted about life than
men and this may make them more vulnerable to
stress-related illnesses, but women also buffer the
route from stress to disease by reacting to
disrupting life events and upsets in more benign
ways.
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8.  Over their lifetime, women maintain stronger emotional
ties with more people. Intimate ties with friends,
colleagues and neighbors offer social support and deter
loneliness. This may act as a buffer for disease -
reducing its occurrence, severity and especially, its
duration.
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9.  A working woman performs multiple roles in life
including that of a wife, mother, employee,
maintainer of extended family ties and caretaker
of elderly relatives. This trend has raised
questions even in the West whether the
prevalence of heart disease amongst women
would begin to rise as a response to occupational
stress and multiple role tensions
 In an eight year prospective study reported by
Eaker (1989) clerical workers who reported
having an unsupportive boss were at increased
risk of developing coronary artery disease.
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11.  Prevalence rates of depression and
anxiety disorders as well as psychological
distress are higher for women than for
men.
 Women are much more likely to receive a
diagnosis of obsessive compulsive
disorder, summarization disorder and
panic disorder (Russo, 1990).
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12.  It has been speculated that some women might be
particularly vulnerable during periods of intense
hormonal fluctuations
 comparative recent evidence suggesting that major
mood symptoms may be linked to decrease in
serotonin measure
 From psychosocial point of view, “empty-nest
syndrome” was proposed as a psychosocial cause of
psychological symptoms manifesting during the
menopausal transition.
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13.  During their lifetimes, women are twice as
likely as men to have
 panic disorder (5.0% versus 2.0%),
 agoraphobia (7.0% versus 3.5%),
 PTSD (10.4% versus 5.0%), or
 GAD (6.6% versus 3.6%).1,5
 Social anxiety disorder (15.5% versus 11.1%) and
 OCD (3.1% versus 2.0%)
19/6/2009 13

14.  Women who were sexually abused as children appear
to be at increased risk of adult onset PTSD and panic
disorder.
19/6/2009 14

15.  Compared with men, panic disorder in women
tends to be more severe and associated with
higher rates of significant comorbidity, such as
agoraphobia, GAD, and somatization disorder.
 OCD exhibit sex differences, with females being
more likely to exhibit cleaning/contamination
or aggression/ checking compulsions, comorbid
depression or an eating disorder, and a less
severe clinical course.
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16.  Approximately 2:1 ratio of depression in women compared
with men took this difference in prevalence to be
indicative of a biologically based sex difference in women’s
proneness or vulnerability to depression compared with
men. Explanations invoking genetic, neurotransmitter and
endocrinological differences related to reproductive
hormones have all been advanced
 Gender differences in rates of depression are maintained
across the life span with prevalences among elderly women
generally higher than those among men (Vazquez- Barquero et al.,
1992; Beekman, Kriegsman & Deeg, 1995; Zunzunegui et al., 1998
19/6/2009 16

17.  Women are three times more likely than men to
engage in non-fatal suicidal behavior (e.g., taking
an excessive dose of sleeping pills), though less
likely to use a lethal method (e.g., firearm) and
die by suicide.
 Girls from nuclear family and women married at
very young age, to be at higher risk for attempted
suicide and self harm-Biswas et al.(SP Agarwal)
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18.  The earlier appearance of symptoms in men than women.
 Goldstein et al (1989) studied the age of onset and found
that the mean age was 24.3 for males, and 27.9 for
females. Onset at age forty occurred in 8% of females and
only 1% of males.
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..

21.  Build evidence on the prevalence and causes of
mental health problems in women as well as on
the mediating and protective factors.
 Promote the formulation and implementation of
health policies that address women's needs and
concerns from childhood to old age.
 Enhance the competence of primary health care
providers to recognize and treat mental health
consequences of domestic violence, sexual
abuse, and acute and chronic stress in women.
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Women’s mental health touches the lives of almost everyone,
either directly or through the women we love.

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