Ease of marital communication and depressive symptom severity among men and women in rural Uganda: cross-sectional, whole-population study

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 57; no. 2; pp. 343 - 352
• Main Authors: Jurinsky, Jordan, Perkins, Jessica M., Kakuhikire, Bernard, Nyakato, Viola N., Baguma, Charles, Rasmussen, Justin D., Satinsky, Emily N., Ahereza, Phionah, Kananura, Justus, Audet, Carolyn M., Bangsberg, David R., Tsai, Alexander C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2022; Springer; Springer Nature B.V
• Subjects: Adult; Analysis; Communication; Confidence intervals; Cross-Sectional Studies; Depression - diagnosis; Depression - epidemiology; Depression, Mental; Epidemiology; Female; Humans; Male; Medicine; Medicine & Public Health; Men; Mental depression; Mental health; Original Paper; Psychiatry; Psychological aspects; Regression models; Rural Population; Statistical analysis; Uganda - epidemiology; Women; Uganda; Depression; Marital support; Psychological distress; Mental health; Communication; Emotional support
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-021-02135-4

Purpose
Depression is a major contributor to the global burden of disease. The extent to which marital communication may influence depression in contexts with little mental health support is unknown.
Methods
We conducted a whole-population study of married adult residents of eight villages in a rural region of southwestern Uganda. Depression symptom severity was measured using a modified version of the Hopkins Symptom Checklist for Depression, with > 1.75 classified as a positive screen for probable depression. Respondents were asked to report about ease of marital communication (‘never easy’, ‘easy once in a while’, ‘easy most of the time’ or ‘always easy’). Sex-stratified, multivariable Poisson regression models were fit to estimate the association between depression symptom severity and marital communication.
Results
Among 492 female and 447 male participants (response rate = 96%), 23 women and 5 men reported communication as ‘never easy’ and 154 women and 72 men reported it as ‘easy once in a while’. Reporting communication as ‘never easy’ was associated with an increased risk of probable depression among women (adjusted relative risk [ARR], 2.06; 95% confidence interval [CI], 1.08–3.93,
p
 = 0.028) and among men (ARR, 7.10; 95% CI 1.70–29.56,
p
 = 0.007).
Conclusion
In this whole-population study of married adults in rural Uganda, difficulty of marital communication was associated with depression symptom severity. Additional research is needed to assess whether communication training facilitated by local leaders or incorporated into couples-based services might be a novel pathway to address mental health burden.