journal article Open Access Jan 12, 2022

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

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Abstract
Child Marriage (before the age of 18) affects over 12 million young women globally, annually. Despite acknowledgement of the negative impacts of the practice on reproductive health, mental health consequences are largely overlooked. Given the ability for poor mental health to intensify other health and social challenges, understanding the mental health consequences linked to child marriage is vital. Our study is the first to examine how mental health is approached in current literature on child marriage. Our conceptual framework was informed by a rapid assessment of key issues in the field. Systematic searches of papers published between 2000–2020 were completed on four electronic databases with no language restrictions. Our protocol was registered on Prospero (CRD42019139685). Articles were assessed using PRISMA guidelines, and their quality assessed using the Joanna Briggs Institute Critical Appraisal Tools. Of the 4,457 records identified, 21 papers meeting inclusion criteria were analysed using narrative synthesis. The final sample included 5 qualitative, 1 mixed-methods and 15 quantitative studies (14 cross-sectional and 1 longitudinal study) reporting on data from 12 countries, largely in the global south. Intimate partner violence, poverty, challenges in childbirth and isolation were identified as social factors linked to emotional distress by those married as children. Depression was the most reported mental disorder. Anxiety, phobias, psychological distress, substance misuse, negative well-being and anti-social personality disorder were reported less frequently. Findings highlight that while significant emotional distress and specific mental health conditions are linked to child marriage, gaps in our understanding remain. Future studies are needed to; clarify directionality in these relationships; understand the mental health needs of young men, LGBTQI communities and those in humanitarian settings. Given the well documented cyclical relationship between social determinants and mental health conditions, we outline a series of community-oriented interventions which blend psychological, social and structural support to promote mental health and wellbeing in the contexts of child marriage.
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References
98
[1]
Y Efevbera "Girl child marriage as a risk factor for early childhood development and stunting" Soc Sci Med (2017) 10.1016/j.socscimed.2017.05.027
[2]
Girls Not Brides. Child Marriage Around the World [Internet]. Child Marriage Around the World; 2017. Available from: https://www.girlsnotbrides.org/where-does-it-happen/
[3]
UNICEF. Child marriage: Latest trends and future prospects. New York; 2017.
[4]
B Rasmussen "Evaluating interventions to reduce child marriage in India." J Glob Heal Reports (2021)
[5]
M Zaman "Child marriage in Canada: A systematic review." PLoS One (2020) 10.1371/journal.pone.0229676
[6]
AM Kalamar "Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature." J Adolesc Heal (2016) 10.1016/j.jadohealth.2016.06.015
[7]
Henderson R. Ending child marriage by 2030: Tracking progress and identifying gap. [online] World Vision UK [Internet]. Girls Not Brides. 2016. Available from: https://www.girlsnotbrides.org/documents/464/Ending_Child_Marriage_by_2030.pdf
[8]
Q Wodon "Child Marriage, Education, and Agency in Uganda." Fem Econ (2016) 10.1080/13545701.2015.1102020
[9]
S Ashraf "Domestic Violence against Women: Empirical Evidence from Pakistan." Pertanika J Soc Sci (2017)
[10]
D Godha "Association between child marriage and reproductive health outcomes and service utilization: A multi-country study from south asia." J Adolesc Heal (2013) 10.1016/j.jadohealth.2013.01.021
[11]
A Raj "Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries." Violence Against Women (2013) 10.1177/1077801213487747
[12]
MA Magadi "Multilevel determinants of teenage childbearing in sub-Saharan Africa in the context of HIV/AIDS" Health Place (2017) 10.1016/j.healthplace.2017.04.006
[13]
J Svanemyr "Research priorities on ending child marriage and supporting married girls." Reprod Health (2015) 10.1186/s12978-015-0060-5
[14]
SAT "Age of Consent: Global Legal Review." (2017)
[15]
MN Nour "Child Marriage: A Silent Health and Human Rights Issue." Rev Obstet Gynecol (2009)
[16]
P. Paul "Effects of education and poverty on the prevalence of girl child marriage in India: A district—level analysis" Child Youth Serv Rev (2019) 10.1016/j.childyouth.2019.02.033
[17]
S Petroni "New Findings on Child Marriage in Sub-Saharan Africa." Ann Glob Heal (2017) 10.1016/j.aogh.2017.09.001
[18]
UNICEF "Child marriage, adolescent pregnancy and school dropout in South Asia." (2019)
[19]
J. Roest "Child Marriage and Early Child-bearing in India: Risk Factors and Policy Implications" Young Lives Policy Pap (2016)
[20]
Resources, Agency, Achievements: Reflections on the Measurement of Women's Empowerment

Naila Kabeer

Development and Change 1999 10.1111/1467-7660.00125
[21]
Q Wodon (2017)
[22]
A. Raj (2010)
[23]
[24]
HRW (2012)
[25]
J Das "Mental health and poverty in developing countries: Revisiting the relationship." Soc Sci Med (2007) 10.1016/j.socscimed.2007.02.037
[26]
C Lund "Poverty and mental disorders: Breaking the cycle in low-income and middle-income countries" Lancet (2011) 10.1016/s0140-6736(11)60754-x
[27]
A Gibbs "Associations between poverty, mental health and substance use, gender power, and intimate partner violence amongst young (18–30) women and men in urban informal settlements in South Africa: A cross-sectional study and structural equation model." PLoS One (2018)
[28]
The Lancet Commission on global mental health and sustainable development

Vikram Patel, Shekhar Saxena, Crick Lund et al.

The Lancet 2018 10.1016/s0140-6736(18)31612-x
[29]
K Trevillion "Experiences of domestic violence and mental disorders: a systematic review and meta-analysis." PLoS One (2012) 10.1371/journal.pone.0051740
[30]
LJ Bacchus "Recent intimate partner violence against women and health: a systematic review and meta-analysis of cohort studies" BMJ Open (2018) 10.1136/bmjopen-2017-019995
[31]
A Gibbs "Emotional and economic intimate partner violence as key drivers of depression and suicidal ideation: A cross-sectional study among young women in informal settlements in South Africa." PLoS One (2018)
[32]
F Cohen "Intimate partner violence and mental health: sex-disaggregated associations among adolescents and young adults in Uganda." J Interpers violence (2020)
[33]
R Burgess "Contextualising women’s mental distress and coping strategies in the time of AIDS: A rural South African case study" Transcult Psychiatry (2014) 10.1177/1363461514526925
[34]
RS Siegel "Adolescents, pregnancy, and mental health" J Pediatr Adolesc Gynecol (2014) 10.1016/j.jpag.2013.09.008
[35]
MR Kabir "Causes of Early Marriage and Its Effect on Reproductive Health of Young Mothers in Bangladesh." Am J Appl Sci (2019) 10.3844/ajassp.2019.289.297
[36]
SK Brar "The relationship between intimate partner violence and probable depression among adolescent girls and young women in Lilongwe, Malawi." Glob Public Heal (2020)
[37]
Connectedness to family, school, peers, and community in socially vulnerable adolescents

Cynthia Ewell Foster, Adam Horwitz, Alvin Thomas et al.

Children and Youth Services Review 2017 10.1016/j.childyouth.2017.08.011
[38]
MH Watt "Development of an intervention to improve mental health for obstetric fistula patients in Tanzania." Eval Program Plann (2015) 10.1016/j.evalprogplan.2015.01.007
[39]
CDC "Strategic direction for the prevention of suicidal behavior: Promoting individual, family, and community connectedness to prevent suicidal behavior." (2013)
[40]
P McGorry "Redeeming diagnosis in psychiatry: timing versus specificity" Lancet (2013) 10.1016/s0140-6736(12)61268-9
[41]
M Ouattara "Forced marriage, forced sex: the perils of childhood for girls." Gend Dev (1998) 10.1080/741922829
[42]
WHO (2001)
[43]
D Moher "Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement" BMJ (2009)
[44]
The Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses (2017)
[45]
J O’Donovan "The use of participatory visual methods with community health workers: A systematic scoping review of the literature." Glob Public Heal (2019) 10.1080/17441692.2018.1536156
[46]
J Popay "Guidance on the Conduct of Narrative Synthesis in Systematic Reviews" (2006)
[47]
NA John "Child marriage and psychological well-being in Niger and Ethiopia." BMC Public Health (2019) 10.1186/s12889-019-7314-z
[48]
Y Le Strat "Child marriage in the United States and its association with mental health in women" Pediatrics (2011) 10.1542/peds.2011-0961
[49]
A e. a Fakhari "Early Marriage and Negative Life Events Affect on Depression in Young Adults and Adolescents." Arch Iran Med (2020)
[50]
N Soylu "Early-married and sexually abused girls differ in their psychiatric outcomes." Child Abus Negl (2014) 10.1016/j.chiabu.2014.05.017

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Details
Published
Jan 12, 2022
Vol/Issue
2(1)
Pages
e0000131
License
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Funding
UCL Institute for Global Health, University College London Award: Grand Challenges Award
Cite This Article
Rochelle A. Burgess, Mairi Jeffery, Sabina Adhiambo Odero, et al. (2022). Overlooked and unaddressed: A narrative review of mental health consequences of child marriages. PLOS Global Public Health, 2(1), e0000131. https://doi.org/10.1371/journal.pgph.0000131