Previous studies have found no female predominance in irritable bowel syndrome (IBS) in non-Western countries. The aim of the study was to assess the prevalence and correlates of Rome II (IBS) in both sexes in Pakistan. A Population-based survey in a low-income inner city area using questionnaires to diagnose Rome II IBS and assess distress, disability and stressful life events. Data were collected from 880/938 (93%) randomly selected residents. 13.4% of women and 13.1% men met criteria for Rome II IBS; 34 (3.9%) had diarrhoea-predominant, 59 (6.7%) had constipation-predominant IBS and 24 (2.7%) had 'mixed IBS'. In logistic regression analysis, IBS was associated in men with high income (OR = 1.56; 95% CI: 1.05-2.3) and few years of education (OR = 2.17; 95% CI: 1.2-3.9) and in women with being married (OR = 3.6; 95% CI: 1.1-11.9) and stressful life events score (OR = 1.14; 95% CI: 1.01-1.3). Disability was associated with constipation-predominant IBS (OR = 1.99; 95% CI: 1.1-3.6), distress (OR = 1.19; 95% CI: 1.14-1.23) and stressful life events (OR = 1.19; 95% CI: 1.1-1.3). Investigations were more likely in men (54%) than in women (27%) (P = 0.003). These findings suggest that the equal sex ratio of IBS in urban Pakistan could result from a close association between marked distress and IBS in men similar to that found in women in western studies.

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Depression around childbirth is common in low income countries. The aim of this study was to examine the factors associated with persistence of depression from the antenatal to the postnatal period in urban Pakistan. A total of 1,357 pregnant women in their third trimester attending the antenatal clinic were included in the study. From these, 763 mothers who delivered at the study maternity home were reassessed after 3 months of childbirth. Edinburgh Postnatal Depression Scale (EPDS) was administered to measure depression in both the antenatal and the postnatal periods. Psychological distress, disability and life events experienced by mothers were also measured by using the Self-Reporting Questionnaire (SRQ-20), Brief Disability Questionnaire (BDQ), and Life Events Checklist, respectively. We found 25.8% prevalence rate of antenatal depression and 38.3% persistent depression in a private clinic. Persistently depressed mothers had significantly high psychological distress, more disability, and experienced more stressful life events than the resolved group. Our findings confirm the high rates of depression during pregnancy but we found low rates of persistent depression in this urban population as compared to the previous report. There is a need for further investigation of factors associated with persistent depression in order to develop appropriate interventions.

Background: Low-birth weight (LBW) (<2500 g) is considered to be a leading cause of cognitive impairment and physical disabilities in children. Incidence of LBW in South Asia has been reported to be as high as 33%. We investigated the association between antenatal depression and LBW in an urban community, in Karachi, Pakistan.Methods: A total of 1357 pregnant women in their third trimester were recruited into the study. They were screened for antenatal depression with Edinburgh postnatal depression scale. Self-reporting questionnaire was also used to measure psychological distress. Birth weights of 763 newborns were obtained from the hospital records.Results: We did not find a significant association between antenatal depression and LBW (odds ratio 0.881, 95%CI 0.732–1.060) in mothers attending a charity run hospital in an urban setting in Pakistan.Conclusion: Antenatal depression is not associated with LBW in this urban population in Pakistan. However, the prevalence of depression is high during pregnancy. There is a need to develop culturally adapted psychosocial interventions to address the high rates of depression for this population group.