Correlates of depression and anxiety in a cohort of Baltimore women

Background: Poverty is a known risk factor mental health issues. We examined what factors were associated with mental distress in a cohort of low-income Baltimore women.

Methods: The Pathways to Adulthood cohort consists of children born in Baltimore from 1960-1965 with follow-up from 1992-1994 at ages 27 to 33. For this study, 989 female respondents were analyzed. Our outcome was a score greater than 4 on the General Health Questionnaire (GHQ-28) across the domains of depression and anxiety. We used t-tests and chi-square for bivariate comparisons. For multivariate analysis, we used logistic regression clustered on census tract.

Results: The sample was 18% White and 72% African-American. In unadjusted analysis, rates of depression were low (<2%) and rates of anxiety were higher (10.33%); neither were significantly different between White and African-Americans. In adjusted analysis both anxiety and depression are associated with poverty (p<0.05). In adjusted analysis, greater odds of depression are associated with lower age at childbearing, substance abuse and social dysfunction (all p<0.05). Greater odds of anxiety was associated with more than one chronic health problems, lower age at childbearing, social dysfunction and somatization in adjusted analysis (all p<0.05).

Conclusion: In this sample of women with high poverty rates, prevalence of depression was lower than expected, and rates of anxiety were as expected. Anxiety and somatization were correlated, as were depression and social dysfunction. Low-income teen mothers may be at a high risk for mental distress.