{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:14:35Z","timestamp":1789496075953,"version":"build-2803163510"},"reference-count":103,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosmentalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Ment Health"],"abstract":"<jats:p>Online mental health services (MH) are playing a pivotal role by increasing MH literacy, enabling accessibility, and reducing logistical barriers, especially for women from developing nations like Bangladesh. However, the psychological burden and service needs of women using online MH platforms remain understudied despite their heightened vulnerability. Therefore, this study investigated the prevalence and determinants of anxiety and depression among women who received counseling from the online MH service platform,Women Support Initiative Forum (WSIF)through a cross-sectional study conducted between 5th September 2023 and 26th August, 2024. Data were collected by WSIF psychologists using a structured client information form covering socio-demographics, history of MH condition, health conditions, and presenting MH symptoms. Anxiety and depression levels were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Multivariate logistic regression was used to identify associated factors. Out of 375 women, 59.2% and 58.1% had experienced mild to severe anxiety and depression, respectively, with 25.6% having both conditions. Women with graduate-level education had 66% lower, and those with one or more siblings had 50\u201354% lower likelihoods of anxiety compared with women without graduate-level education and siblings. In contrast, women with graduate-level or postgraduate-level education and reporting hormonal conditions had 3.41 times, 2.63 times and over 10 times higher likelihoods of depression, respectively, compared with women who were not graduates and without a hormonal condition. Conversely, women with a history of MH and reported migraine, headache and allergic conditions had 52% and 65% lower odds compared with women without these conditions. Distress, negative thinking, and feelings of worry were highly prevalent among women with anxiety and among those with depression. Our findings highlight a significant MH burden among women who accessed online psychological counseling, indicating the importance of targeted actions in designing MH interventions by relevant stakeholders and policymakers.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000715","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:52:32Z","timestamp":1789494752000},"page":"e0000715","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and associated factors of anxiety and depression among women seeking digital mental health services in Bangladesh"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2466-8139","authenticated-orcid":true,"given":"Kamrun Nahar","family":"Koly","sequence":"first","affiliation":[{"name":"Women Support Initiative Forum-WSIF","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jobaida","family":"Saba","sequence":"additional","affiliation":[{"name":"Women Support Initiative Forum-WSIF","place":["Dhaka, Bangladesh"]},{"name":"Jahangirnagar University","place":["Dhaka, Bangladesh"],"department":["Department of Public Health and Informatics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0021-6164","authenticated-orcid":true,"given":"Fahmida","family":"Sarker","sequence":"additional","affiliation":[{"name":"Women Support Initiative Forum-WSIF","place":["Dhaka, Bangladesh"]},{"name":"University of Oulu","place":["Oulu, Finland"],"department":["Research Unit of Population Health, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elma","family":"Rudhsarah","sequence":"additional","affiliation":[{"name":"Women Support Initiative Forum-WSIF","place":["Dhaka, Bangladesh"]},{"name":"Asian University for Women","place":["Chittagong, Bangladesh"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Arif","family":"Billah","sequence":"additional","affiliation":[{"name":"icddr, b","place":["Dhaka, Bangladesh"],"department":["Urban Health Systems and Population Studies Division"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4409-6692","authenticated-orcid":true,"given":"Rasma","family":"Muzaffar","sequence":"additional","affiliation":[{"name":"Women Support Initiative Forum-WSIF","place":["Dhaka, Bangladesh"]},{"name":"North South University","place":["Dhaka, Bangladesh"],"department":["Department of Public Health, School of Health & Life Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafisa","family":"Mosaddek","sequence":"additional","affiliation":[{"name":"Bangladesh University of Professionals","place":["Dhaka, Bangladesh"],"department":["Department of Environmental Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Syed Md.","family":"Mosaddek","sequence":"additional","affiliation":[{"name":"Uttara Adhunik Medical College","place":["Dhaka, Bangladesh"],"department":["Department of Pharmacology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel D.","family":"Reidpath","sequence":"additional","affiliation":[{"name":"Queen Margaret University","place":["Edinburgh, Scotland, United Kingdom"],"department":["Institute for Global Health and Development Division"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"pmen.0000715.ref001","volume-title":"Mental health strengthening our response","author":"Organization WH","year":"2022"},{"issue":"10440","key":"pmen.0000715.ref002","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"AJ Ferrari","year":"2024","journal-title":"The Lancet"},{"key":"pmen.0000715.ref003","article-title":"Prevalence of mental disorders in South Asia: A systematic review of reviews","volume":"10","author":"AL Vidyasagaran","year":"2023","journal-title":"Glob Ment Health (Camb)"},{"key":"pmen.0000715.ref004","doi-asserted-by":"crossref","first-page":"573150","DOI":"10.3389\/fpsyt.2020.573150","article-title":"Prevalence of Common Mental Disorders in South Asia: A Systematic Review and Meta-Regression Analysis","volume":"11","author":"S Naveed","year":"2020","journal-title":"Frontiers in Psychiatry"},{"key":"pmen.0000715.ref005","doi-asserted-by":"crossref","first-page":"103897","DOI":"10.1016\/j.ajp.2023.103897","article-title":"Community prevalence of psychiatric disorders: Findings from a nationwide survey in Bangladesh","volume":"92","author":"MF Alam","year":"2024","journal-title":"Asian J Psychiatr"},{"issue":"5","key":"pmen.0000715.ref006","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s00737-025-01564-3","article-title":"Anxiety and depression among reproductive-aged women in Bangladesh: burden, determinants, and care-seeking practices based on a nationally representative demographic and health survey","volume":"28","author":"S Raza","year":"2025","journal-title":"Arch Womens Ment Health"},{"issue":"1","key":"pmen.0000715.ref007","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1186\/s12939-024-02275-4","article-title":"Gender disparity in prevalence of mental health issues in Kerala: a systematic review and meta-analysis","volume":"23","author":"K Rahna","year":"2024","journal-title":"Int J Equity Health"},{"issue":"5","key":"pmen.0000715.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0176211","article-title":"Intimate partner violence around the time of pregnancy and postpartum depression: The experience of women of Bangladesh","volume":"12","author":"MJ Islam","year":"2017","journal-title":"PLoS One"},{"key":"pmen.0000715.ref009","author":"NIMH","year":"2019"},{"issue":"4","key":"pmen.0000715.ref010","doi-asserted-by":"crossref","first-page":"576","DOI":"10.4103\/2249-4863.174297","article-title":"Depression and anxiety among middle-aged women: A community-based study","volume":"4","author":"P Bansal","year":"2015","journal-title":"J Family Med Prim Care"},{"key":"pmen.0000715.ref011","doi-asserted-by":"crossref","first-page":"64","DOI":"10.22159\/ajpcr.2022.v15i5.44308","article-title":"Anxiety among the urban working women and homemakers: a questionnaire-based survey","author":"N Jana","year":"2022","journal-title":"Asian J Pharm Clin Res"},{"key":"pmen.0000715.ref012","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.ajp.2017.05.016","article-title":"Prevalence of depression among middle aged women in the rural area of Kerala","volume":"29","author":"A Ps","year":"2017","journal-title":"Asian J Psychiatr"},{"issue":"12","key":"pmen.0000715.ref013","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.3390\/ijerph21121566","article-title":"Paid Domestic Work and Depressive Symptoms in Mexico: Results of a National Health Survey","volume":"21","author":"G Guerra","year":"2024","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"pmen.0000715.ref014","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/j.1440-1584.2006.00794.x","article-title":"Prevalence of depression among adults in Oyo State, Nigeria: a comparative study of rural and urban communities","volume":"15","author":"O Amoran","year":"2007","journal-title":"Aust J Rural Health"},{"issue":"01","key":"pmen.0000715.ref015","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4236\/ojepi.2016.61008","article-title":"Factors Affecting Depression among Married Women Living in Urban Squatter Settlements of Karachi, Pakistan","volume":"06","author":"SS Bhamani","year":"2016","journal-title":"OJEpi"},{"issue":"8","key":"pmen.0000715.ref016","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.3390\/ijerph22081217","article-title":"Current Status of Mental Health in Mexico City","volume":"22","author":"E Sanchez","year":"2025","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pmen.0000715.ref017","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/s12888-024-05794-0","article-title":"Prevalence of depression and associated symptoms among patients attending primary healthcare facilities: a cross-sectional study in Nepal","volume":"24","author":"NP Luitel","year":"2024","journal-title":"BMC Psychiatry"},{"issue":"1","key":"pmen.0000715.ref018","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2022.613","article-title":"Prevalence and associated factors of common mental disorders in primary care settings in Sofala Province, Mozambique","volume":"9","author":"A Muanido","year":"2023","journal-title":"BJPsych Open"},{"issue":"1","key":"pmen.0000715.ref019","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12888-019-2064-0","article-title":"Prevalence of mental disorders and epidemiological associations in post-conflict primary care attendees: a cross-sectional study in the Northern Province of Sri Lanka","volume":"19","author":"S Doherty","year":"2019","journal-title":"BMC Psychiatry"},{"issue":"4","key":"pmen.0000715.ref020","doi-asserted-by":"crossref","first-page":"57","DOI":"10.11648\/j.ajpn.20150304.11","article-title":"Mental Health and the Health System in Bangladesh: Situation Analysis of a Neglected Domain","volume":"3","author":"A Islam","year":"2015","journal-title":"AJPN"},{"issue":"1","key":"pmen.0000715.ref021","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1186\/s12913-022-07678-z","article-title":"Mental healthcare-seeking behavior during the perinatal period among women in rural Bangladesh","volume":"22","author":"GK Dutta","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"pmen.0000715.ref022","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1089\/jwh.1997.6.543","article-title":"Symptoms of post-traumatic stress disorder in abused women in a primary care setting","volume":"6","author":"C Silva","year":"1997","journal-title":"J Womens Health"},{"issue":"1","key":"pmen.0000715.ref023","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1186\/s12889-022-13116-w","article-title":"Barriers to help-seeking from healthcare professionals amongst women who experience domestic violence - a qualitative study in Sri Lanka","volume":"22","author":"T Silva","year":"2022","journal-title":"BMC Public Health"},{"issue":"11","key":"pmen.0000715.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0293295","article-title":"Factors and consequences associated with intimate partner violence against women in low- and middle-income countries: A systematic review","volume":"18","author":"L Gunarathne","year":"2023","journal-title":"PLoS One"},{"key":"pmen.0000715.ref025","article-title":"Stakeholder perspectives of mental healthcare services in Bangladesh, its challenges and opportunities: a qualitative study","volume":"11","author":"KN Koly","year":"2024","journal-title":"Glob Ment Health (Camb)"},{"issue":"1","key":"pmen.0000715.ref026","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1186\/s12888-022-04414-z","article-title":"Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform","volume":"22","author":"KN Koly","year":"2022","journal-title":"BMC Psychiatry"},{"issue":"1","key":"pmen.0000715.ref027","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12888-018-1979-1","article-title":"A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems","volume":"19","author":"N Berry","year":"2019","journal-title":"BMC Psychiatry"},{"key":"pmen.0000715.ref028","doi-asserted-by":"crossref","first-page":"5046","DOI":"10.18535\/sshj.v8i09.1330","article-title":"Socio-Economic Status and Living Condition of Widows in Rural Bangladesh","volume":"8","author":"M Sarker","year":"2024","journal-title":"Social Science and Humanities Journal"},{"key":"pmen.0000715.ref029","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13033-018-0218-y","article-title":"Pathways to care of patients with mental health problems in Bangladesh","volume":"12","author":"NN Nuri","year":"2018","journal-title":"Int J Ment Health Syst"},{"issue":"12","key":"pmen.0000715.ref030","article-title":"Employing telepsychiatry services to assess the prevalence and identify mental health disorders using the PHQ-9 and GAD-7 in resource-constrained regions of Dadar Mansehra, Pakistan: an observational cross-sectional study","volume":"13","author":"IZ Aga","year":"2023","journal-title":"BMJ Open"},{"issue":"5","key":"pmen.0000715.ref031","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3109\/09638237.2015.1019054","article-title":"Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature","volume":"24","author":"JA Naslund","year":"2015","journal-title":"J Ment Health"},{"issue":"6","key":"pmen.0000715.ref032","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/S2215-0366(17)30096-2","article-title":"Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature","volume":"4","author":"JA Naslund","year":"2017","journal-title":"Lancet Psychiatry"},{"issue":"2","key":"pmen.0000715.ref033","doi-asserted-by":"crossref","DOI":"10.1111\/ajr.70032","article-title":"Characteristics and Treatment Outcomes for Patients of a Digital Psychology Service in Regional and Remote Parts of Australia","volume":"33","author":"LG Staples","year":"2025","journal-title":"Aust J Rural Health"},{"issue":"9","key":"pmen.0000715.ref034","article-title":"Online and social networking interventions for the treatment of depression in young people: a systematic review","volume":"16","author":"SM Rice","year":"2014","journal-title":"J Med Internet Res"},{"key":"pmen.0000715.ref035","author":"WSIF","year":"2018"},{"key":"pmen.0000715.ref036","doi-asserted-by":"crossref","first-page":"20503121221086372","DOI":"10.1177\/20503121221086372","article-title":"A promising future for tele-mental health in Oman: A qualitative exploration of clients and therapists\u2019 experiences","volume":"10","author":"T Al-Mahrouqi","year":"2022","journal-title":"SAGE Open Med"},{"issue":"2","key":"pmen.0000715.ref037","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s44159-021-00003-1","article-title":"An overview of and recommendations for more accessible digital mental health services","volume":"1","author":"EG Lattie","year":"2022","journal-title":"Nat Rev Psychol"},{"key":"pmen.0000715.ref038","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1475-9276-12-25","article-title":"The impact of socioeconomic status on changes in the general and mental health of women over time: evidence from a longitudinal study of Australian women","volume":"12","author":"JS Williams","year":"2013","journal-title":"Int J Equity Health"},{"issue":"2","key":"pmen.0000715.ref039","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1176\/appi.ajp.157.2.229","article-title":"Multiple recurrences of major depressive disorder","volume":"157","author":"DA Solomon","year":"2000","journal-title":"Am J Psychiatry"},{"issue":"1","key":"pmen.0000715.ref040","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1002\/ijop.12950","article-title":"Factors associated with perceived helpfulness and use of mental health websites by Australian young adults with a family history of mental illness","volume":"59","author":"T Perich","year":"2024","journal-title":"Int J Psychol"},{"key":"pmen.0000715.ref041","article-title":"Quality of sibling relationship and psychological well-being in adults: Impact of sibling dyad","volume":"6","author":"J D\u2019Silva","year":"2023","journal-title":"Journal for ReAttach Therapy and Developmental Diversities"},{"issue":"1","key":"pmen.0000715.ref042","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s11764-014-0392-0","article-title":"Mental health services utilization and expenditures associated with cancer survivorship in the United States","volume":"9","author":"C Li","year":"2015","journal-title":"J Cancer Surviv"},{"key":"pmen.0000715.ref043","volume-title":"Diagnostic and statistical manual of mental disorders","author":"DSM I","year":"1994"},{"issue":"1","key":"pmen.0000715.ref044","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s44192-022-00005-2","article-title":"Generalized anxiety disorder among Bangladeshi university students during COVID-19 pandemic: gender specific findings from a cross-sectional study","volume":"2","author":"R Muzaffar","year":"2022","journal-title":"Discov Ment Health"},{"issue":"4","key":"pmen.0000715.ref045","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002924","article-title":"Social support, distress, stress, anxiety, and depression as predictors of suicidal thoughts among selected university students in Bangladesh","volume":"4","author":"S Howlader","year":"2024","journal-title":"PLOS Glob Public Health"},{"issue":"2","key":"pmen.0000715.ref046","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s41347-021-00239-x","article-title":"Seeking and sharing mental health information on social media during COVID-19: role of depression and anxiety, peer support, and health benefits","volume":"7","author":"N Akhther","year":"2022","journal-title":"J Technol Behav Sci"},{"issue":"1","key":"pmen.0000715.ref047","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1186\/s12888-021-03243-w","article-title":"Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh","volume":"21","author":"R Tasnim","year":"2021","journal-title":"BMC Psychiatry"},{"issue":"1","key":"pmen.0000715.ref048","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1186\/s12889-025-22228-y","article-title":"Prevalence and correlates of anxiety and depression among ever-married reproductive-aged women in Bangladesh: national-level insights from the 2022 Bangladesh Demographic and Health Survey","volume":"25","author":"MT Amin","year":"2025","journal-title":"BMC Public Health"},{"issue":"1","key":"pmen.0000715.ref049","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s40359-023-01224-0","article-title":"Depressive symptoms and anxiety among women with a history of abortion living in urban slums of Bangladesh","volume":"11","author":"KN Koly","year":"2023","journal-title":"BMC Psychol"},{"issue":"3","key":"pmen.0000715.ref050","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-097745","article-title":"Factors influencing mental health outcomes among university students: a cross-sectional study in Bangladesh","volume":"15","author":"M Al-Amin","year":"2025","journal-title":"BMJ Open"},{"key":"pmen.0000715.ref051","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.psychres.2018.12.039","article-title":"The association between Facebook addiction and depression: A pilot survey study among Bangladeshi students","volume":"271","author":"MAA Mamun","year":"2019","journal-title":"Psychiatry Res"},{"issue":"2","key":"pmen.0000715.ref052","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3171\/2016.7.SPINE16472","article-title":"Preoperative mental health status may not be predictive of improvements in patient-reported outcomes following an anterior cervical discectomy and fusion","volume":"26","author":"BC Mayo","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"pmen.0000715.ref053","first-page":"1","article-title":"Prevalence of depression and anxiety among general population in Pakistan during COVID-19 lockdown: An online-survey","author":"I Ullah","year":"2022","journal-title":"Curr Psychol"},{"key":"pmen.0000715.ref054","doi-asserted-by":"crossref","DOI":"10.3389\/fdgth.2021.742196","article-title":"Accessibility and digital mental health: considerations for more accessible and equitable mental health apps","volume":"3","author":"J Bunyi","year":"2021","journal-title":"Frontiers in Digital Health"},{"issue":"3","key":"pmen.0000715.ref055","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s41347-020-00134-x","article-title":"Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice","volume":"5","author":"JA Naslund","year":"2020","journal-title":"J Technol Behav Sci"},{"key":"pmen.0000715.ref056","article-title":"Gender differences in the prevalence of anxiety and depression and care seeking for mental health problems in Nepal: Analysis of nationally representative survey data","volume":"11","author":"MSR Shawon","year":"2024","journal-title":"Glob Ment Health (Camb)"},{"issue":"1","key":"pmen.0000715.ref057","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1055\/s-0039-1700595","article-title":"Depression, Anxiety, and Stress among Rural South Indian Women-Prevalence and Correlates: A Community-Based Study","volume":"11","author":"M Srinivasan","year":"2020","journal-title":"J Neurosci Rural Pract"},{"key":"pmen.0000715.ref058","doi-asserted-by":"crossref","first-page":"21501319241258658","DOI":"10.1177\/21501319241258658","article-title":"Prevalence of Mental Disorders Among Patients with Multimorbidity Visiting Primary Care Settings in Slums of Karachi, Pakistan","volume":"15","author":"H Sharif","year":"2024","journal-title":"J Prim Care Community Health"},{"issue":"5","key":"pmen.0000715.ref059","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3390\/socsci9050087","article-title":"Covid-19 and Women\u2019s Triple Burden: Vignettes from Sri Lanka, Malaysia, Vietnam and Australia","volume":"9","author":"HJ McLaren","year":"2020","journal-title":"Social Sciences"},{"key":"pmen.0000715.ref060","article-title":"Gender differences in the prevalence of anxiety and depression and care seeking for mental health problems in Nepal: Analysis of nationally representative survey data","volume":"11","author":"MSR Shawon","year":"2024","journal-title":"Glob Ment Health (Camb)"},{"issue":"10","key":"pmen.0000715.ref061","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1017\/S0033291711000407","article-title":"Co-morbidity between major depressive disorder and anxiety disorders: shared etiology or direct causation?","volume":"41","author":"AR Mathew","year":"2011","journal-title":"Psychol Med"},{"issue":"6","key":"pmen.0000715.ref062","first-page":"244","article-title":"The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care","volume":"3","author":"RMA Hirschfeld","year":"2001","journal-title":"Prim Care Companion J Clin Psychiatry"},{"key":"pmen.0000715.ref063","doi-asserted-by":"crossref","first-page":"117339","DOI":"10.1016\/j.socscimed.2024.117339","article-title":"Which comes first? Comorbidity of depression and anxiety symptoms: A cross-lagged network analysis","volume":"360","author":"H Zou","year":"2024","journal-title":"Soc Sci Med"},{"issue":"10","key":"pmen.0000715.ref064","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1017\/S104161021200107X","article-title":"Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years","volume":"24","author":"OP Almeida","year":"2012","journal-title":"Int Psychogeriatr"},{"key":"pmen.0000715.ref065","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jad.2011.12.008","article-title":"Clinical relevance of comorbidity in anxiety disorders: a report from the Netherlands Study of Depression and Anxiety (NESDA)","volume":"137","author":"MK Hofmeijer-Sevink","year":"2012","journal-title":"J Affect Disord"},{"issue":"3","key":"pmen.0000715.ref066","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1002\/da.23113","article-title":"Co-morbidity between mood and anxiety disorders: A systematic review and meta-analysis","volume":"38","author":"S Saha","year":"2021","journal-title":"Depress Anxiety"},{"key":"pmen.0000715.ref067","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.maturitas.2020.06.010","article-title":"Insomnia symptoms in relation to menopause among middle-aged Chinese women: Findings from a longitudinal cohort study","volume":"141","author":"M Luo","year":"2020","journal-title":"Maturitas"},{"issue":"6","key":"pmen.0000715.ref068","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1001\/archpsyc.62.6.593","article-title":"Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication","volume":"62","author":"RC Kessler","year":"2005","journal-title":"Arch Gen Psychiatry"},{"issue":"3","key":"pmen.0000715.ref069","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/s10942-009-0098-9","article-title":"Depressive Rumination and Co-Morbidity: Evidence for Brooding as a Transdiagnostic Process","volume":"27","author":"ER Watkins","year":"2009","journal-title":"J Ration Emot Cogn Behav Ther"},{"issue":"5","key":"pmen.0000715.ref070","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/j.adolescence.2011.02.005","article-title":"A closer look at co-rumination: gender, coping, peer functioning and internalizing\/externalizing problems","volume":"34","author":"TL Tompkins","year":"2011","journal-title":"J Adolesc"},{"issue":"4","key":"pmen.0000715.ref071","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1353\/cpr.2013.0046","article-title":"\u201cTension\u201d in South Asian women: developing a measure of common mental disorder using participatory methods","volume":"7","author":"A Karasz","year":"2013","journal-title":"Prog Community Health Partnersh"},{"key":"pmen.0000715.ref072","doi-asserted-by":"crossref","first-page":"100092","DOI":"10.1016\/j.ssmmh.2022.100092","article-title":"\u201cTension\u201d and distress in South Asia: A systematic literature review","volume":"2","author":"LJ Weaver","year":"2022","journal-title":"SSM - Mental Health"},{"issue":"9","key":"pmen.0000715.ref073","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1037\/hea0000985","article-title":"Health effects of psychological interventions for worry and rumination: A meta-analysis","volume":"40","author":"D McCarrick","year":"2021","journal-title":"Health Psychol"},{"key":"pmen.0000715.ref074","article-title":"A systematic review of the effects of rumination-focused cognitive behavioral therapy in reducing depressive symptoms","volume":"15","author":"Y Li","year":"2024","journal-title":"Frontiers in Psychology"},{"key":"pmen.0000715.ref075","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13034-019-0275-2","article-title":"Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group","volume":"13","author":"T Tschan","year":"2019","journal-title":"Child Adolesc Psychiatry Ment Health"},{"issue":"5","key":"pmen.0000715.ref076","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/j.1741-3737.2011.00857.x","article-title":"Life Events, Sibling Warmth, and Youths\u2019 Adjustment","volume":"73","author":"EB Waite","year":"2011","journal-title":"J Marriage Fam"},{"key":"pmen.0000715.ref077","doi-asserted-by":"crossref","first-page":"1330720","DOI":"10.3389\/fpsyg.2024.1330720","article-title":"Social support and mental health: the mediating role of perceived stress","volume":"15","author":"EF Acoba","year":"2024","journal-title":"Front Psychol"},{"key":"pmen.0000715.ref078","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jad.2022.04.036","article-title":"Social support coping styles and psychological distress during the COVID-19 pandemic: The moderating role of sex","volume":"308","author":"CL McLean","year":"2022","journal-title":"J Affect Disord"},{"issue":"3","key":"pmen.0000715.ref079","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s41347-020-00134-x","article-title":"Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice","volume":"5","author":"JA Naslund","year":"2020","journal-title":"J Technol Behav Sci"},{"key":"pmen.0000715.ref080","unstructured":"Effects of previous exposure to psychotherapeutic strategies on depression and anxiety symptoms during the COVID-19 pandemic. 2021."},{"issue":"5","key":"pmen.0000715.ref081","doi-asserted-by":"crossref","first-page":"777","DOI":"10.2105\/AJPH.2012.301056","article-title":"Mental illness stigma, help seeking, and public health programs","volume":"103","author":"C Henderson","year":"2013","journal-title":"Am J Public Health"},{"issue":"3","key":"pmen.0000715.ref082","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1037\/a0025957","article-title":"Mental health literacy: empowering the community to take action for better mental health","volume":"67","author":"AF Jorm","year":"2012","journal-title":"Am Psychol"},{"issue":"3","key":"pmen.0000715.ref083","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/0706743715616609","article-title":"Mental Health Literacy: Past, Present, and Future","volume":"61","author":"S Kutcher","year":"2016","journal-title":"Can J Psychiatry"},{"issue":"1","key":"pmen.0000715.ref084","doi-asserted-by":"crossref","DOI":"10.1155\/2023\/3001191","article-title":"Mental Health Literacy among the Palestinian\u2010Arab Minority in Israel and Its Correlates with Mental Health Service Use","volume":"2023","author":"F Abo-Rass","year":"2023","journal-title":"Perspectives in Psychiatric Care"},{"key":"pmen.0000715.ref085","doi-asserted-by":"crossref","DOI":"10.1503\/jpn.150205","volume-title":"Why is depression more prevalent in women?","author":"PR Albert","year":"2015"},{"key":"pmen.0000715.ref086","doi-asserted-by":"crossref","first-page":"103686","DOI":"10.1016\/j.midw.2023.103686","article-title":"Barriers and facilitators of psychological help-seeking behaviors for perinatal women with depressive symptoms: A qualitative systematic review based on the Consolidated Framework for Implementation Research","volume":"122","author":"Y Hu","year":"2023","journal-title":"Midwifery"},{"key":"pmen.0000715.ref087","doi-asserted-by":"crossref","unstructured":"Holt R. Clinical characterisation of the co-occurrence of mental and physical disorders. 2025. 127\u201360.","DOI":"10.1007\/978-3-031-81802-8_6"},{"issue":"3","key":"pmen.0000715.ref088","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/wps.21110","article-title":"Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management","volume":"22","author":"M Berk","year":"2023","journal-title":"World Psychiatry"},{"key":"pmen.0000715.ref089","article-title":"Allergic rhinitis and depression: profile and proposal","volume":"12","author":"YK Mou","year":"2022","journal-title":"Frontiers in Psychiatry"},{"issue":"6","key":"pmen.0000715.ref090","article-title":"Migraine With Comorbid Depression: Pathogenesis, Clinical Implications, and Treatment","volume":"14","author":"N Asif","year":"2022","journal-title":"Cureus"},{"issue":"6","key":"pmen.0000715.ref091","article-title":"Is There an Association Between Migraine and Major Depressive Disorder? A Narrative Review","volume":"12","author":"S Jahangir","year":"2020","journal-title":"Cureus"},{"key":"pmen.0000715.ref092","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2023.1241800","article-title":"Anxiety and depression and health-related quality of life among adults with migraine: a national population-based study","volume":"11","author":"M Alwhaibi","year":"2023","journal-title":"Frontiers in Public Health"},{"issue":"11","key":"pmen.0000715.ref093","article-title":"Migraine headache and the risk of depression","volume":"14","author":"HA Al Ghadeer","year":"2022","journal-title":"Cureus"},{"issue":"6","key":"pmen.0000715.ref094","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1001\/jamaneurol.2025.0806","article-title":"Fremanezumab for the Treatment of Patients With Migraine and Comorbid Major Depressive Disorder: The UNITE Randomized Clinical Trial","volume":"82","author":"RB Lipton","year":"2025","journal-title":"JAMA Neurol"},{"issue":"2","key":"pmen.0000715.ref095","doi-asserted-by":"crossref","first-page":"3331024231222923","DOI":"10.1177\/03331024231222923","article-title":"Improvement of migraine depressive symptoms is not related to headache frequency: exploring the impact of anti-CGRP therapies","volume":"44","author":"M Torres-Ferr\u00fas","year":"2024","journal-title":"Cephalalgia"},{"issue":"1","key":"pmen.0000715.ref096","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40359-023-01053-1","article-title":"The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy","volume":"11","author":"M Yousefi Afrashteh","year":"2023","journal-title":"BMC Psychol"},{"issue":"10171","key":"pmen.0000715.ref097","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/S0140-6736(18)33135-0","article-title":"Gender equality in science, medicine, and global health: where are we at and why does it matter?","volume":"393","author":"G Shannon","year":"2019","journal-title":"Lancet"},{"issue":"11","key":"pmen.0000715.ref098","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1002\/da.22515","article-title":"Educational attainment as a protective factor for psychiatric disorders: findings from a nationally representative longitudinal study","volume":"33","author":"J Erickson","year":"2016","journal-title":"Depress Anxiety"},{"issue":"1","key":"pmen.0000715.ref099","doi-asserted-by":"crossref","first-page":"1496887","DOI":"10.1080\/16549716.2018.1496887","article-title":"Health systems readiness for adopting mhealth interventions for addressing non-communicable diseases in low- and middle-income countries: a current debate","volume":"11","author":"A Feroz","year":"2018","journal-title":"Glob Health Action"},{"issue":"3","key":"pmen.0000715.ref100","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3390\/women3030033","article-title":"Reproductive hormones and female mental wellbeing","volume":"3","author":"K Wieczorek","year":"2023","journal-title":"Women"},{"issue":"03","key":"pmen.0000715.ref101","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4236\/ojd.2017.63005","article-title":"Relation between Depression and Hormonal Dysregulation","volume":"06","author":"N de Souza Duarte","year":"2017","journal-title":"OJD"},{"key":"pmen.0000715.ref102","first-page":"590648","article-title":"The Link between Thyroid Function and Depression","volume":"2012","author":"MP Hage","year":"2012","journal-title":"J Thyroid Res"},{"issue":"1","key":"pmen.0000715.ref103","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12888-025-06490-3","article-title":"Prevalence and associated factors of anxiety and depression among patients with hypothyroidism in Southern Iran","volume":"25","author":"T Dehesh","year":"2025","journal-title":"BMC Psychiatry"}],"container-title":["PLOS Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmen.0000715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:52:46Z","timestamp":1789494766000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmen.0000715"}},"subtitle":[],"editor":[{"given":"Ariel Soares","family":"Teles","sequence":"first","affiliation":[{"name":"Instituto Federal do Maranh\u00e3o: Instituto Federal de Educacao Ciencia e Tecnologia do Maranh\u00e3o","place":["BRAZIL"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":103,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmen.0000715","relation":{},"ISSN":["2837-8156"],"issn-type":[{"value":"2837-8156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]}}}