This chapter outlines the data collection procedure for the research. The information about the study area and sample size is provided.

About the Study

Background 

Summarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study.

Method 

A systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis.

Results 

The literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD.

Conclusions 

Our findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.

Global variation in the prevalence and incidence of major depressive disorder : a systematic review of the epidemiological literature

While economic inequalities have been a key focus of attention through the COVID 19 pandemic, gendered relations of power at every level have undermined health rights of women, girls and gender diverse individuals. Sexual and reproductive health rights (SRHR) have always been sites of power contestations within families, societies, cultures, and politics; these struggles are exacerbated by economic, racial, religious, caste, citizenship status, and other social inequities, especially in times of crisis such as these. Policy responses to the COVID pandemic such as lockdown, quarantine, contact tracing and similar measures are premised on the existence of a social contract between the government and the people and among people, with the health sector playing a key role in preventive and curative care. We propose the use of an intersectional lens to explore the impact of the COVID-19 pandemic on the social contract, drawing on our field experiences from different continents particularly as related to SRHR. Along with documenting the ways in which the pandemic hinders access to services, we note that it is essential to interrogate state-society relations in the context of vulnerable and marginalized groups, in order to understand implications for SRHR. Intersectional analysis takes on greater importance now than in non-pandemic times as the state exercises more police or other powers and deploys myriad ways of ‘othering’. We conclude that an intersectional analysis should not limit itself to the cumulative disadvantages and injustices posed by the pandemic for specific social groups, but also examine the historical inequalities, structural drivers, and damaged social contract that underlie state-society relationships. At the same time, the pandemic has questioned the status quo and in doing so it has provided opportunities for disruption; for re-imagining a social contract that reaches across sectors, and builds community resilience and solidarities while upholding human rights and gender justice. This must find place in future organizing and advocacy around SRHR.

/pdf/axes-of-alienation-applying-an-intersectional-lens-on-the-4nb1etdt2u.pdf

Axes of alienation: applying an intersectional lens on the social contract during the pandemic response to protect sexual and reproductive rights and health.

We summarized recent findings on insufficient sleep and insomnia, two prominent sleep issues that impact public health. We demonstrate the socio-ecologial impact of sleep health with findings on gender and couples' relationships as exemplars.Robust gender differences in sleep duration and insomnia are due to biological and socio-ecological factors. Gender differences in insufficient sleep vary by country of origin and age whereas gender differences in insomnia reflect minoritized identities (e.g., sexual, gender). Co-sleeping with a partner is associated with longer sleep and more awakenings. Gender differences and couples' sleep were affected by intersecting social and societal influences, which supports a socio-ecological approach to sleep. Recent and seminal contributions to sleep health highlight the importance of observing individual sleep outcomes in a socio-ecological context. Novel methodology, such as global measures of sleep health, can inform efforts to improve sleep and, ultimately, public health. 

/pdf/socio-ecological-context-of-sleep-gender-differences-and-2xafox62.pdf

Socio-Ecological Context of Sleep: Gender Differences and Couples’ Relationships as Exemplars

Given the important role of sexual activity in most people’s lives, in response to the question of whether the coronavirus is transmitted through sexual contact, this study was conducted to investi...

Do Not Neglect the Covid-19 Transmission Through Sexual Intercourse.

Chinese youth have become more sexually active over the years, yet their behaviours of contraceptive use are influenced by socioeconomic and lifestyle factors. This study aimed to investigate the socioeconomic and lifestyle determinants of contraceptive use among Chinese college students, and to investigate quantitatively their reasons for choosing different contraceptive methods. The study used the data from a cross-sectional survey, which was conducted in 2015 among 17,517 students from 130 colleges and professional schools in mainland China. Chi-square tests were performed to test the differences in the awareness and uses of contraceptives between male and female students. Multivariable logistic regression models were used to analyse the associations between socioeconomic and lifestyle factors and contraceptive uses. Condoms (95%), oral contraceptives (91%) and emergency contraceptives (71%) were the most commonly known contraceptive methods among the sample of Chinese youth that were surveyed. Among male participants, high monthly expenditure (OR = 1.37, 95%CI: 1.07–1.75), light alcohol consumption (OR = 1.47, 95%CI: 1.03–2.11), and high sexual knowledge (OR = 1.96, 95%CI: 1.57–2.45) were positively associated with contraceptive uses, while tobacco use (OR = 0.47, 95%CI: 0.23–0.95) showed a negative association with contraceptive uses. Among female students, suburban residency (OR = 1.38, 95%CI: 1.03–1.83), high level of parental education (OR = 1.96, 95%CI: 1.19–3.22), moderate alcohol consumption (OR = 2.66, 95%CI: 1.05–6.77), and high sexual knowledge (OR = 1.50, 95%CI: 1.18–1.91) were positively associated with contraceptive uses, while tobacco use (OR = 0.60, 95%CI: 0.36–0.99) showed a negative association. A series of socioeconomic and lifestyle factors were associated with contraceptive choices among Chinese college students. Targeted sexual education programs are in demand to improve the awareness and the use of contraceptives in this population.

/pdf/the-socioeconomic-and-lifestyle-determinants-of-413m6klevd.pdf

The socioeconomic and lifestyle determinants of contraceptive use among Chinese college students: a cross-sectional study.

Pregnancy and parenthood have been associated with physical and mental health. Previous literature concerning the impacts of parity on mental health was inconsistent and lack epidemiolocal evidence. China, with growing mental health problems and changing fertility patterns, faces unique challenges. This study aims to examine the relationship between parity and the prevalence of major depression and insomnia among men and women in the Chinese population. Baseline data from a Chinese population-based study of 512,891 adults (59.01% women) from 10 areas, aged 30–79 were analyzed. Number of children was based on self-report by the participants. Major depression (MD) was assessed using the Composite International Diagnostic Inventory. Insomnia symptoms were accessed by a questionnaire comparable to that used in the Diagnostic and Statistical Manual of Mental Disorders. Logistic regression was used to assess the relationship between MD/Insomnia and number of children, after stratifications and adjustments. For women, each additional child was associated with a 9% decreased odds of MD (OR: 0.91, 95%CI: 0.88–0.96), with the associations significant for those who lived in urban areas (OR: 0.76, 95%CI: 0.70–0.83), or had a lower education (OR: 0.90, 95%CI: 0.85–0.94), or had lower household income (OR: 0.89, 95%CI: 0.85–0.94), or had ever used alcohol (OR: 0.89, 95%CI: 0.84–0.93). The association between per additional children and MD was not significant in men (OR: 1.02, 95%CI: 0.97–1.07), but a decreased odd of MD with per additional child was found in men who lived in urban areas (OR: 0.81, 95%CI: 0.71–0.96). For women, each additional child was associated with a 4% decreased odds of insomnia (OR: 0.96, 95%CI: 0.95–0.96). Each additional child was also associated with a 2% decreased odds of insomnia in men (OR: 0.98, 95%CI: 0.97–1.00). MD and insomnia were inversely associated with number of children in women while the association was not overall significant in men. The association was mediated by socioeconomic and lifestyle factors. Future mental health public health programs should address parity and sex differences when designing interventions.

/pdf/number-of-children-and-the-prevalence-of-later-life-major-51ccs7vucc.pdf

Number of children and the prevalence of later-life major depression and insomnia in women and men: findings from a cross-sectional study of 0.5 million Chinese adults

This study assesses the ability of an online sexuality education (OSE) module ('You and Me') to enhance sexual and reproductive health (SRH) knowledge and attitudes among 10th-grade vocational high school students in China. We conducted a cluster randomized controlled trial, randomizing 29 vocational high schools to (i) receiving the module (intervention) or (ii) not receiving the module (control). Students completed a baseline questionnaire, then completed the module within 8 weeks and then completed a follow-up questionnaire within the following 2 weeks. We assessed the differences in intervention effects using hierarchical linear modeling. No significant differences between intervention and control groups were found for knowledge and attitude scores at baseline among the 2985 students included in the analyses. For the intervention group at follow-up, we observed significant improvements in SRH knowledge scores of approximately 20% for boys and girls although girls responded to the module with larger knowledge gains than boys. At follow-up, intervention group students also had higher SRH attitude scores toward views that are more contemporary than the control group. In addition, girls held more contemporary attitudes than boys. The comprehensive OSE module assessed is effective in improving SRH knowledge, and attitude among Chinese vocational high school students after the module is completed.

The effectiveness of an online sexuality education module in promoting sexual knowledge and attitude change: a cluster randomized controlled trial.

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Papers

The socioeconomic and lifestyle determinants of contraceptive use among Chinese college students: a cross-sectional study.

Number of children and the prevalence of later-life major depression and insomnia in women and men: findings from a cross-sectional study of 0.5 million Chinese adults

The effectiveness of an online sexuality education module in promoting sexual knowledge and attitude change: a cluster randomized controlled trial.