Mental Health Crisis Among Married Women in Bangladesh: Risk Factors and the Role of Misdiagnosis.

Background: In Bangladesh, women experience common mental health conditions like depression and anxiety at twice the rate of men, yet they are only half as likely to seek treatment. There were instances of misdiagnosis reported among married women. This study aims to assess the prevalence, key determinants and diagnostic accuracy of anxiety and depression among married women in Bangladesh. Methodology: We used the largest cross-sectional nationally representative Bangladesh Demographic and Health Survey (BDHS) 2022 that sampled 18,605 married women, aged 15-49 years. We utilised complex survey-adjusted binary and multinomial logistic regression models to explore the association between mental health diagnoses and sociodemographic factors. Results: One in three women reported symptoms of anxiety and depression without a clinical diagnosis. Significant regional variation was observed, with women in Dhaka, Mymensingh and Rajshahi less likely to be symptomatic but undiagnosed. Protective factors included higher education, internet access, and household wealth, while media exposure, mobile phone ownership, and attitudes accepting violence increased risk. Women accepting violence had 1.18 times (95% CI = 1.07-1.30) higher odds of being symptomatic but undiagnosed. Those involved in household decision-making had 26% (95% CI = 1.14-1.40) higher odds compared to women who were correctly identified. In contrast, women with secondary and higher education had 17% (95% CI = 0.73-0.95) and 20% (95% CI = 0.66-0.97) lower odds, respectively. Conclusion: Targeted interventions through health literacy interventions are needed in regions with higher rates of symptomatic but undiagnosed cases. Awareness campaigns should also address the harmful effects of media exposure, limited digital access and social norms that normalise violence.