UMMS Affiliation

School of Medicine; Graduate School of Biomedical Sciences; MD/PhD Program; Department of Psychiatry; Systems and Psychosocial Advances Research Center; Department of Obstetrics and Gynecology; Department of Quantitative Health Sciences

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Clinical Epidemiology | Community Health and Preventive Medicine | Epidemiology | Health Services Research | International Public Health | Mental Disorders | Psychiatry | Translational Medical Research | Women's Health


OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were recruited in a quasi-randomised manner.

PRIMARY AND SECONDARY OUTCOMES MEASURES: CMD symptoms, ascertained using WHO's Self-Reporting Questionnaire-20 (SRQ-20), were associated with self-reported (1) number of healthcare visits in the prior year; (2) health status and (3) portion of yearly income expended on healthcare.

RESULTS: Data from 658 participants were used in this analysis; 19 surveys were excluded due to incompleteness, 18 surveys were excluded because the participants were visiting hospitalised patients and 5 surveys were classified as outliers. Overall, 155 (22·8%) participants screened positive for CMD symptoms (SRQ-20 score ≥8) with most (81.9%) not previously diagnosed despite contact with healthcare provider in the prior year. On adjusted analyses, screening positive for CMD symptoms was associated with worse category in self-reported health status (cumulative OR=9.39; 95% CI 5·97 to 14·76), higher portion of household income expended on healthcare (cumulative OR=2·31; 95% CL 1·52 to 3.52) and increased healthcare visits in the prior year (incidence rate ratio=1·24; 95% CI 1·07 to 1·44).

CONCLUSIONS: The high prevalence of potential CMD among women in rural India that is unrecognised and associated with adverse health and financial indicators highlights the individual and public health burden of CMD.


UMCCTS funding, epidemiology, mental health, global health

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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

DOI of Published Version



Soni A, Fahey N, Byatt N, Prabhakaran A, Moore Simas TA, Vankar J, Phatak A, O'Keefe E, Allison J, Nimbalkar S. Association of common mental disorder symptoms with health and healthcare factors among women in rural western India: results of a cross-sectional survey. BMJ Open. 2016 Jul 7;6(7):e010834. doi:10.1136/bmjopen-2015-010834. PubMed PMID: 27388353. Link to article on publisher's website

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BMJ Open


First author Apurv Soni is a medical student in the MD/PhD Program at UMass Medical School.

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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License