S'pore single mothers at higher risk of mood disorders: Study

SINGAPORE - Single mothers have more than five times the risk of developing mood disorders in their lifetime, compared with married mothers.

This was even after controlling for socio-demographic factors such as age, education and employment status, research here has found.

These mood disorders include major depressive disorder, dysthymia (mild but long-term depression) and bipolar disorder.

Published in March in the local medical journal Annals Academy Of Medicine, this is the first such study examining the association of single mothers and psychiatric disorders in a multi-ethnic Asian country.

Previous research, mainly focused on the Western population, showed that single mothers have an increased risk of both physical and mental health disorders, but it was unclear if Asian societies have the same trend.

The latest study involved 128 single mothers and 1,510 married mothers - culled from the nationwide Singapore Mental Health Study. It grouped unmarried mothers, women who were divorced, separated or widowed with children aged 21 years and below as "single mothers", because of the small numbers of these groups.

The study found that 27 per cent of single mothers had mood disorders, compared with 7 per cent of married mothers. When the socio-demographic background of the mothers - which could influence their risk of mood disorders - were accounted for statistically, the odds of a single mother developing mood disorders was even higher, at 5.28 times that of a married mother.

What this showed is that a woman's single or married status is an independent risk factor for mood disorders, underlying the need to pay attention to mood problems among single mothers.

The prevalence of anxiety and alcohol disorders were also relatively more common among single mothers than married ones. But there were no significant differences in the prevalence or odds of having any physical illness between the two groups.

Adjunct Assistant Professor Mythily Subramaniam, director of the research division at the Institute of Mental Health (IMH), said: "Motherhood is a challenging experience by itself, but being a single mother does impose additional stressors, so the finding was not surprising."

A vulnerable group

According to the researchers from IMH and Saw Swee Hock School of Public Health, "it is reasonable to assume that sole-parenting responsibilities and the associated potential lack of resources (social and economic) would have a role to play" in single motherhood and mood disorders.

They found that married mothers were more likely to be highly educated and economically inactive than single mothers. The economically inactive women were also likely to be housewives, rather than retirees, given that their children were below 21 years old, said Prof Mythily.

Single mothers also reported fewer days, in a year, that they were unable to work or carry out normal activities, compared with married mothers. Researchers think it is because single mothers needed to remain economically and functionally active in spite of serious health problems.

But there were no significant differences in the two groups in terms of social support.

The face-to-face interviews with respondents from December 2009 to December 2010 asked about the mother's social network and her perceived social support and included questions such as how often the mother spoke on the phone or got together with relatives/friends who do not live with her.

Prof Mythily said the study results emphasised the need for early diagnosis and treatment of psychiatric conditions in the "vulnerable group" of single mothers.

She said: "Clinicians following up on single mothers during any stage - from pregnancy to post-natal and beyond - must be alert to symptoms and should consider referral to suitable services."

A 41-year-old administrative assistant, who wanted to be known only as Ms G L, has been a single mother for four years since her husband's death from brain cancer.

She took his death so badly that she lost sleep and appetite and cried incessantly at first.

Eventually, she turned to Wicare and Help Family Service Centre (FSC). Wicare provides support for widows and children without fathers, while Help FSC provides counselling and casework services for single parents and their children.

This year, she made the painful decision to leave her 11-year-old daughter alone at home when she is at work.

Her elderly parents used to be her child's caregivers, but her father died two years ago and her 67-year-old mother now has to care for her sister's newborn baby.

She also has health issues but chose not to undergo surgery for degeneration of the joints in her neck, in order to save money. The numbness in her hands was so bad two years ago that it stopped her from doing housework. She now goes for weekly physiotherapy sessions at Tan Tock Seng Hospital.

Despite her difficulties, she wants other single mothers to know that they are not alone and should not feel embarrassed to ask for help.

"Even without a husband, turn to your family members who can give you love," she said.

joanchew@sph.com.sg

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