In spite of high levels of poverty in low and middle income countries (LMIC), and
the high burden posed by common mental disorders (CMD), it is only in the last two
decades that research has emerged that empirically addresses the relationship between
poverty and CMD in these countries. We conducted a systematic review of the epidemiological
literature in LMIC, with the aim of examining this relationship. Of 115 studies that
were reviewed, most reported positive associations between a range of poverty indicators
and CMD. In community-based studies, 73% and 79% of studies reported positive associations
between a variety of poverty measures and CMD, 19% and 15% reported null associations
and 8% and 6% reported negative associations, using bivariate and multivariate analyses
respectively. However, closer examination of specific poverty dimensions revealed
a complex picture, in which there was substantial variation between these dimensions.
While variables such as education, food insecurity, housing, social class, socio-economic
status and financial stress exhibit a relatively consistent and strong association
with CMD, others such as income, employment and particularly consumption are more
equivocal. There are several measurement and population factors that may explain variation
in the strength of the relationship between poverty and CMD. By presenting a systematic
review of the literature, this paper attempts to shift the debate from questions about
whether poverty is associated with CMD in LMIC, to questions about which particular
dimensions of poverty carry the strongest (or weakest) association. The relatively
consistent association between CMD and a variety of poverty dimensions in LMIC serves
to strengthen the case for the inclusion of mental health on the agenda of development
agencies and in international targets such as the millenium development goals.
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