Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan's Gross National Happiness Study, 2015

G Sithey, M Li, LM Wen, PJ Kelly, Kelly Clarke

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Objective Common mental disorders (CMDs) are a major cause of the global burden of disease. Bhutan was the first country in the world to focus on happiness as a state policy; however, little is known about the prevalence and risk factors of CMDs in this setting. We aim to identify socioeconomic, religious, spiritual and health factors associated with symptoms of CMDs.

Design and setting We used data from Bhutan’s 2015 Gross National Happiness (GNH) Survey, a multistage, cross-sectional nationwide household survey. Data were analysed using a hierarchical analytical framework and generalised estimating equations.

Participants The GNH Survey included 7041 male and female respondents aged 15 years and above.

Measures The 12-item General Health Questionnaire was used to measure symptoms of CMDs. We estimated the prevalence of CMDs using a threshold score of ≥12.

Results The prevalence of CMDs was 29.3% (95% CI 26.8% to 31.8%). Factors associated with symptoms of CMDs were: older age (65+) (β=1.29, 95% CI 0.57 to 2.00), being female (β=0.70, 95% CI 0.45 to 0.95), being divorced or widowed (β=1.55, 95% CI 1.08 to 2.02), illiteracy (β=0.48, 95% CI 0.21 to 0.74), low income (β=0.37, 95% CI 0.15 to 0.59), being moderately spiritual (β=0.61, 95% CI 0.34 to 0.88) or somewhat or not spiritual (β=0.76, 95% CI 0.28 to 1.23), occasionally considering karma in daily life (β=0.53, 95% CI 0.29 to 0.77) or never considering karma (β=0.80, 95% CI 0.26 to 1.34), having poor self-reported health (β=2.59, 95% CI 2.13 to 3.06) and having a disability (β=1.01, 95% CI 0.63 to 1.40).

Conclusions CMDs affect a substantial proportion of the Bhutanese population. Our findings confirm the importance of established socioeconomic risk factors for CMDs, and suggest a potential link between spiritualism and mental health in this setting.

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: http://creativecommons.org/licenses/by-nc/4.0/

Original languageEnglish
JournalBMJ open
Volume8
Issue number2
Early online date16 Feb 2018
DOIs
Publication statusPublished - Feb 2018

Keywords

  • Bhutan, anxiety, common mental disorders, depression, disabilities, health policy, health promotion, non-communicable diseases, questionnaire, social determinants

Fingerprint

Dive into the research topics of 'Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan's Gross National Happiness Study, 2015'. Together they form a unique fingerprint.

Cite this