BACKGROUND: Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India.
METHODS: Data from \"Understanding the Lives of Adolescents and Young Adults\" (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis.
RESULTS: The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence <10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (>25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws\' to conceive (for young married women only) were associated with MDD.
CONCLUSIONS: For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes.

BACKGROUND: The negative impact of adverse perinatal mental health extends beyond the mother and child; therefore, it is essential to make an early intervention for the management of mental illness during pregnancy. Resilience-building interventions are demonstrated to reduce depression and anxiety among expectant mothers, yet research in this field is limited. This study aims to examine the effect of the \'Safe Motherhood-Accessible Resilience Training (SM-ART)\' on resilience, marital adjustment, depression, and pregnancy-related anxiety in a sample of pregnant women in Karachi, Pakistan.
METHODS: In this single-blinded block randomized controlled study, 200 pregnant women were recruited and randomly assigned to either an intervention or a control group using computer-generated randomization and opaque sealed envelopes. The intervention group received the SM-ART intervention consisting of six, weekly sessions ranging from 60 to 90 min. Outcomes (Resilience, depression, pregnancy-related anxiety and marital harmony) were assessed through validated instruments at baseline and after six weeks of both intervention and control groups.
RESULTS: The results revealed a significant increase in mean resilience scores (Difference:6.91, Effect size: 0.48, p-value < 0.05) and a decrease in depressive symptoms (Difference: -2.12, Effect size: 0.21, p-value < 0.05) in the intervention group compared to the control group. However, no significant change was observed in anxiety and marital adjustment scores.
CONCLUSIONS: The SM-ART intervention has the potential to boost resilience scores and decrease depressive symptoms in pregnant women and offers a promising intervention to improve maternal psychological health.
BACKGROUND: NCT04694261, Date of first trial registration: 05/01/2021.

UNASSIGNED: The purpose of this phenomenological study is to explore the acceptance of HIV diagnosis of women in stable relationships. Based on eight semistructured interviews with cisgender Portuguese women, thematic analysis identified four interrelated themes that illustrated the emotional and psychosocial dynamics involved in this journey. Following an HIV diagnosis, participants grappled with complex emotions, societal perceptions, and the internalization of stigma. Marital relationships underwent profound changes, with trust breakdown and emotional distancing. Coping mechanisms ranged from seeking support to living in secrecy, which impacted psychological well-being. Acceptance of HIV diagnosis is influenced by self-stigmatization, societal perceptions of HIV, and gender dynamics. The findings contribute to the development of tailored interventions, emphasizing the interconnected nature of physical and psychological well-being in the diagnosis acceptance process.

UNASSIGNED: Marital factor has been associated with dementia and Alzheimer\'s disease, but there is limited evidence on the impact of holistic marital history over time.
UNASSIGNED: This study aimed to examine association of marital history with cognition.
UNASSIGNED: The study included 24,596 dementia-free participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Holistic marital history was collected at baseline, categorizing participants into five groups: widow-single, widow-remarried, divorce-single, divorce-remarried and married based on the first two marriages. Dementia was collected at follow-up through self-report or from a delegate if the participant was deceased. For 15,355 participants, the Chinese Mini-Mental Status Examination (CMMSE) was administered at both baseline and follow-ups. Cognitive impairment was defined as a follow-up CMMSE score below 18, and rate of cognitive change was calculated as the change in CMMSE score between consecutive visits divided by the duration.
UNASSIGNED: Compared with married older adults, widow-single group had significantly higher risk of dementia (HR 1.28, 95% CI 1.05, 1.54), cognitive impairment (HR 1.31, 95% CI 1.17, 1.47) and significantly faster decline of MMSE score (β -0.09, 95% CI -0.17, -0.01). Meanwhile, widow-remarried group had significantly lower risk of dementia, cognitive impairment and slower MMSE score decline than widow-single group, although the differences were only significant among female but not male.
UNASSIGNED: In this prospective cohort, married older adults and those widowed but with a second marriage had significantly better cognition than widowed individuals who did not remarry.

BACKGROUND: Pregnancy is an important period of life for women and their husbands as the couple\'s health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM).
METHODS: This descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier\'s Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker\'s Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM.
RESULTS: The pregnant women\'s marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491-0.998, p < 0.001) and their husbands\' (β = 0.210, 95% Cl: 0.030-0.726, p = 0.048). Pregnant woman\'s depressive symptoms also negatively affected their health-promoting behaviors (β=-0.088, 95% Cl: -0.974-0.074, P = 0.236) and their husbands\' health-promoting behaviors (β=-0.177, 95% Cl: -0.281 - -0.975, P = 0.011). Furthermore, the husband\'s marital adjustment only positively affected his studied behaviors (β = 0.323, 95% Cl: 0.0303-0.895, P < 0.001) but did not affect the pregnant woman\'s health behaviors. The husband\'s depressive symptoms had a negative impact on his studied behaviors (β = 0.219, 95% Cl: -0.122 - -0.917, P = 0.001) and did not affect the pregnant woman\'s depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman\'s marital adjustment scores positively affected her studied behaviors and her husband (β = 0.071, 95% Cl: 0.042-0.278, P = 0.015) by decreasing her depression score. Therefore, the husband\'s marital adjustment score positively affected his studied behaviors by decreasing his depression score (β = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife\'s health-promoting behaviors.
CONCLUSIONS: These findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands\' symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.

BACKGROUND: Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women\'s poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women.
METHODS: This randomized controlled clinical trial was conducted on 64 newly married women aged 15-45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered.
RESULTS: The results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01].
CONCLUSIONS: The results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families.
BACKGROUND: Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597 .

CONCLUSIONS: Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female preponderance. A cross-sectional study was designed to assess the burden of depression among married women in a rural setting in North Kerala and identify its sociodemographic risk factors. The sample size was calculated to be 453 (prevalence = 24.9%; error = 20%; design-effect = 1.5). Systematic random sampling was used to select the participants from the eligible couple register. They were interviewed using MINI and Montgomery-Ashberg Depression Rating Scales. Descriptive analysis showed that 24.2% was suffering from current depression, mostly mild and none severe. Two percent reported past depression and 5.4% experienced spousal violence. Poor family support, experience of domestic violence, morbidity, and older spouses were found to be significant risk factors. The provision of mental health services by trained personnel and strict vigilance against the marriage of girls below the legal age and domestic violence are need of the hour.

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one\'s own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

OBJECTIVE: Sexual satisfaction and attitudes toward marital infidelity are crucial components of marital quality and well-being. This study investigates the impact of social media and entertainment preferences on these aspects among married couples in Iran, acknowledging the sociocultural nuances unique to the region.
METHODS: A cross-sectional survey design was employed, gathering data from 1,756 married participants through an online questionnaire in Iran. Variables included social media and entertainment preferences, sexual satisfaction, attitude toward marital infidelity, and demographic details. Descriptive statistics, non-parametric tests (Mann-Whitney U test, Kruskal-Wallis test), and GLM (Generalized linear model) were used for exploration.
RESULTS: Key results reveal significant associations between demographic factors, social media usage, and attitudes toward marital infidelity. Notable trends include higher sexual satisfaction among younger participants (p < 0.05), those with shorter marital durations (p < 0.01), and those residing outside Tehran (p < 0.001). Attitudes toward marital infidelity were influenced by gender, age, ethnicity, income levels, and social media habits, reflecting a complex interplay of factors. The GLM analysis emphasizes the impact of variables such as marital duration, ethnicity, spouse\'s education, Iranian social media usage, and attitudes toward marital infidelity on sexual satisfaction. Participants with shorter marriages (p < 0.01), higher spouse education (p < 0.05), and more frequent Iranian social media usage (p < 0.001) reported higher sexual satisfaction.
CONCLUSIONS: This study explores the dynamics of marital relationships in Iran, examining the interconnections between demographics, media habits, sexual satisfaction, and attitudes toward infidelity. The findings provide valuable insights into factors influencing marital satisfaction, emphasizing the importance of considering cultural contexts. Robust statistical methods, including Generalized Linear Models, support the reliability of results. The study contributes to understanding non-western marital dynamics, highlighting implications for research and interventions in the digital age.

Child marriage has a significant health impact on young mothers and their offspring. This study aims to compare the effectiveness of the Jalinan Kasih Android-based application, the Marriage Age Maturity (PUP) module, and the lecture method in improving knowledge, attitude, and practice regarding early marriage among high school students. A quasi-experiment with control groups was conducted, involving 72 students selected from three high schools in Bengkulu City, Indonesia who met the inclusion criteria. The participants were divided into three groups: 24 individuals in the application intervention group, 24 individuals in the module intervention group, and 24 individuals in the control group. The Jalinan Kasih application group showed an increase in average scores before and after the intervention, in terms of knowledge (6.46), attitude (6.79) and practice (1.75), with a p-value of 0.000, 0.000 and 0.17, respectively, The Jalinan Kasih application had a greater influence on knowledge, attitude and practice compared to the PUP module and the lecture method with a p-value of 0.000. In other words, the Jalinan Kasih mobile application was effective in improving the knowledge, attitude, and practice of high school students regarding early marriage through the use of its contents and consultation feature. It is recommended that the Jalinan Kasih application be used as an educational medium to prevent early marriage and improves family planning.
Le mariage des enfants a un impact significatif sur la santé des jeunes mères et de leur progéniture. Cette étude vise à comparer l\'efficacité de l\'application basée sur Android Jalinan Kasih, du module Marriage Age Maturity (PUP) et de la méthode magistral pour améliorer les connaissances, l\'attitude et la pratique concernant le mariage précoce chez les lycéens. Une quasi-expérience avec des groupes témoins a été menée, impliquant 72 étudiants sélectionnés dans trois lycées de la ville de Bengkulu, en Indonésie, qui répondaient aux critères d\'inclusion. Les participants ont été divisés en trois groupes : 24 personnes dans le groupe d\'intervention d\'application, 24 personnes dans le groupe d\'intervention du module et 24 personnes dans le groupe témoin. Le groupe d\'application Jalinan Kasih a montré une augmentation des scores moyens avant et après l\'intervention, en termes de connaissances (6,46), d\'attitude (6,79) et de pratique (1,75), avec des valeurs p de 0,000, 0,000 et 0,17, respectivement. L\'application Jalinan Kasih a eu une plus grande influence sur les connaissances, l\'attitude et la pratique par rapport au module PUP et à la méthode magistral avec une valeur p de 0,000. En d’autres termes, l’application mobile Jalinan Kasih a été efficace pour améliorer les connaissances, l’attitude et la pratique des lycéens concernant le mariage précoce grâce à l’utilisation de son contenu et de sa fonction de consultation. Il est recommandé d\'utiliser l\'application Jalinan Kasih comme support pédagogique pour prévenir les mariages précoces et améliorer la planification familiale.