Anxiety and depression symptoms and associated care seeking behaviors among ever- married women of reproductive age in Bangladesh: Assessing the role of women’s empowerment

Abstract Purpose To examine the association of women’s empowerment with anxiety, depression and associated care-seeking behaviors among ever-married women of reproductive age in Bangladesh. Methods We analyzed nationally representative Bangladesh Demographic and Health Survey data collected in 2022. Survey-based Women’s Empowerment (SWPER) Index was used to define women’s empowerment in three domains: “Attitude towards violence”, “Social independence” and “Decision-making”. Mental health disorders include symptoms of anxiety and depression, measured respectively using the Generalized Anxiety Disorder-7 scale and the Patient Health Questionnaire. Multivariable binary logistic regression analysis was performed to explore the association. Results Of 19987 women, 19.5% had anxiety, 4.9% depression, 21.1% any symptom, 4.2% concurrent symptoms, and 11.9% sought mental health care. Women with low empowerment had significantly greater prevalence of mental health disorders than their counterparts. Compared to women with high empowerment, women’s low empowerment in “Attitude towards violence” was associated with greater odds of anxiety (AOR 1.69, 95% CI 1.36–2.09), depression (1.59, 1.07–2.31), any mental health symptoms (1.64, 1.32–2.03), their co-occurrences (1.73, 1.19–2.51), and associated care-seeking (2.44, 1.92–3.1). Low empowered women in “Social independence” domain were significantly more likely to experience anxiety (1.27, 1.12–1.44), any symptoms (1.2, 1.07–1.35), and their co-occurrences (1.34, 1.01–1.79). Conversely, empowerment in “decision-making” domain did not exhibit a statistically significant relationship with either mental health symptoms but with care-seeking behaviors. Conclusions Mental health disorders are high among women in Bangladesh and is linked with their low empowerment. Targeted interventions covering women with low empowerment might help address mental health burden in Bangladesh.