Seasonal variation of depression among male and female adults and their mental health perception of extreme heat in Niamatpur, Naogaon: A mixed-methods study

Abstract

Background: Extreme heat has an effect on mental health. However, the seasonality of depression among adults and their perceptions of mental health effects are yet to be explored in the Barind area of Bangladesh. Furthermore, targeted intervention requires exploration of mental health program implementation barriers and facilitators.

Objectives: The study aims to compare the seasonality of depression by gender and occupation, explore perceptions and coping strategies of mental health effects during extreme heat, and identify barriers and facilitators of implementing the BHP mental health program in Niamatpur, Naogaon.

Methods: A mixed-method study was conducted among adults in Niamatpur, Naogaon, Bangladesh. Round-wise secondary data of the BHP surveillance project was used to observe seasonal depression patterns. Qualitative exploration is based on purposive sampling of 12 In-Depth Interviews (IDIs) and 5 Key Informant Interviews (KIIs). Quantitative data was analyzed using StataNow/BE 18.5 and descriptive statistics was used to present frequency and percentage. Thematic analysis of qualitative data was done using both inductive and deductive coding.

Results: Depression of adults increased from 8.1% in winter to 12.5% in summer. Females had higher prevalence in both rounds and almost doubled (16%) than males (8.3%) in summer. For all occupations depression notably increased in summer. Extreme heat is mostly normalized although it significantly affects the mental health of outdoor workers (farmers, day labourers) and women for their working environment and gendered role.

Conclusions: Heat is a mental health concern for the vulnerable adults and women and outdoor workers bear the disproportionate burden. The findings have notable implications for public health policy, mental health programme design, and future research in the contexts of heat-vulnerable adult populations.