A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal

Nepal has high prevalence of early marriage and remains a patrilocal society with women moving into their husbands' home after marriage. Spousal relationship quality can be an important predictor of health and mental well-being of married women in a patriarchal setting like Nepal but is underst...

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Main Authors: Lakshmi Gopalakrishnan, Bibhav Acharya, Mahesh Puri, Nadia Diamond-Smith
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:SSM - Mental Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666560323000087
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author Lakshmi Gopalakrishnan
Bibhav Acharya
Mahesh Puri
Nadia Diamond-Smith
author_facet Lakshmi Gopalakrishnan
Bibhav Acharya
Mahesh Puri
Nadia Diamond-Smith
author_sort Lakshmi Gopalakrishnan
collection DOAJ
description Nepal has high prevalence of early marriage and remains a patrilocal society with women moving into their husbands' home after marriage. Spousal relationship quality can be an important predictor of health and mental well-being of married women in a patriarchal setting like Nepal but is understudied in this population. We examined the association between spousal relationship quality, mother-in-law relationship quality and mental health among newly married women in Nepal. We recruited 200 newly married women aged 18–25 years within 4 months of their marriage cohabiting with their mothers-in-law and collected four rounds of data at 6-month intervals between 2018 and 2020 in Nawalparasi district of Nepal. Depressive symptom severity was measured using Hopkins Symptom Checklist Depression and relationship quality with spouse was measured using Couples' Relationship Quality scale. We fitted a random effects linear regression model to estimate if women’s spousal relationship quality and mother-in-law relationship quality were associated with depressive symptom severity, controlling for socio-demographic covariates and secular trends. We conducted a sensitivity analysis using linear fixed effects and logistic random effects models. Our results suggest that better relationship quality with the spouse was positively associated with reduced depression among women, and greater relationship quality with the mother-in-law was also positively associated with lower levels of depression. Furthermore, our results suggest that the relationship with mothers-in-law moderates the association between spousal relationship quality and depression. This highlights the importance of considering the interplay of these relationships among this vulnerable population who are faced with multiple stressors, including the risk of depression and strained marital relationships. Our results underscore the importance of addressing the role of both husbands and mothers-in-law as key stakeholders in advancing the mental health outcomes of newly married women.
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spelling doaj.art-bb119df0a55841dc81ec279f6757a4312023-06-22T05:05:32ZengElsevierSSM - Mental Health2666-56032023-12-013100193A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural NepalLakshmi Gopalakrishnan0Bibhav Acharya1Mahesh Puri2Nadia Diamond-Smith3Institute for Global Health Sciences, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA; Corresponding author.Department of Psychiatry, UCSF Weill Institute for Neurosciences, School of Medicine, 675 18th Street, San Francisco, CA, 94107, USACenter for Research on Environment Health and Population Activities (CREHPA), Kathmandu, NepalDepartment of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USANepal has high prevalence of early marriage and remains a patrilocal society with women moving into their husbands' home after marriage. Spousal relationship quality can be an important predictor of health and mental well-being of married women in a patriarchal setting like Nepal but is understudied in this population. We examined the association between spousal relationship quality, mother-in-law relationship quality and mental health among newly married women in Nepal. We recruited 200 newly married women aged 18–25 years within 4 months of their marriage cohabiting with their mothers-in-law and collected four rounds of data at 6-month intervals between 2018 and 2020 in Nawalparasi district of Nepal. Depressive symptom severity was measured using Hopkins Symptom Checklist Depression and relationship quality with spouse was measured using Couples' Relationship Quality scale. We fitted a random effects linear regression model to estimate if women’s spousal relationship quality and mother-in-law relationship quality were associated with depressive symptom severity, controlling for socio-demographic covariates and secular trends. We conducted a sensitivity analysis using linear fixed effects and logistic random effects models. Our results suggest that better relationship quality with the spouse was positively associated with reduced depression among women, and greater relationship quality with the mother-in-law was also positively associated with lower levels of depression. Furthermore, our results suggest that the relationship with mothers-in-law moderates the association between spousal relationship quality and depression. This highlights the importance of considering the interplay of these relationships among this vulnerable population who are faced with multiple stressors, including the risk of depression and strained marital relationships. Our results underscore the importance of addressing the role of both husbands and mothers-in-law as key stakeholders in advancing the mental health outcomes of newly married women.http://www.sciencedirect.com/science/article/pii/S2666560323000087Marital relationship qualityMental healthMarital qualityMarried womenSouth AsiaMIL
spellingShingle Lakshmi Gopalakrishnan
Bibhav Acharya
Mahesh Puri
Nadia Diamond-Smith
A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
SSM - Mental Health
Marital relationship quality
Mental health
Marital quality
Married women
South Asia
MIL
title A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
title_full A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
title_fullStr A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
title_full_unstemmed A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
title_short A longitudinal study of the role of spousal relationship quality and mother-in-law relationship quality on women’s depression in rural Nepal
title_sort longitudinal study of the role of spousal relationship quality and mother in law relationship quality on women s depression in rural nepal
topic Marital relationship quality
Mental health
Marital quality
Married women
South Asia
MIL
url http://www.sciencedirect.com/science/article/pii/S2666560323000087
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