Peer-reviewed article
Child marriage and the mental health of adolescent girls: a longitudinal cohort study from Uttar Pradesh and Bihar, India
Shilpa Aggarwal, Kate Louise Francis, S. Ghazaleh Dashti, George Patton ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This longitudinal study followed 7,864 adolescent girls in Uttar Pradesh and Bihar, India over three years to examine links between early marriage and mental health. Among girls who married between the two study waves, newly married girls were twice as likely to report depressive symptoms compared to unmarried girls. Girls who experienced abuse after marriage had even higher rates of depression, particularly those who had not yet given birth. The findings show that poor mental health both precedes and follows child marriage.
Key points
- 23% of study participants (1,825 girls) married between waves 1 and 2
- Newly married girls had twice the odds of depressive symptoms compared to unmarried girls (adjusted-OR 2.0)
- Girls with pre-existing depressive symptoms at baseline were more likely to transition into marriage (adjusted-OR 1.5)
- Newly married girls who experienced abuse had 1.6 times higher odds of depression; this increased to 2.2 for those without children
- Poor mental health is both a risk factor for and a consequence of child marriage
Limitations
The study cannot establish causation definitively due to the observational design, though the longitudinal nature strengthens causal inference. The findings are specific to two Indian states and may not generalise to other regions or countries with different social and economic contexts.
Abstract
Background: There has been much speculation about the role of inequitable gender norms and early marriage in mental health and suicide risks in girls and young women, but no prospective study has yet investigated this relationship. Understanding these links has become particularly important in the context of the COVID-19 pandemic which has led to increased risk of child marriage in the most vulnerable girls. Methods: We examined the association between early marriage and mental health in girls using data from Understanding the Lives of Adolescents and Young Adults (UDAYA), a longitudinal study in adolescents in Uttar Pradesh and Bihar, India. The study included girls who were unmarried at wave 1 (2015-2016) and participated at wave 2 data collection (2018-2019). Information on mental health (Patient Health Questionnaire-9 (PHQ-9)), suicidal thoughts, plans and attempts were collected at both waves. Logistic regression with survey weights was used to estimate the association between marrying between the two waves and mental health. Findings: Between waves 1 and 2, 1825 (23%) participants (n = 7864) married. Unmarried girls with depressive symptoms (PHQ score≥9) at wave 1 had greater odds of transitioning into marriage by wave 2 than those without (adjusted-OR 1.5; 95% CI 1.1 to 2.0). The odds of wave 2 depressive symptoms were higher in newly married vs unmarried girls (adjusted-OR 2.0; 95% CI 1.6-2.5). Among newly married girls, the odds of depressive symptoms were higher for those who experienced any abuse than those who did not (adjusted-OR 1.6; 95% CI 1.2-2.2). This effect was larger for girls who had not given birth (adjusted-OR 2.2; 95% CI 1.4-3.3). Interpretation: Our findings show poor mental health preceded and was a consequence of child marriage. Mental health should be considered in policies and programming aimed at reducing early marriage; equally the mental health of young brides should be a focus for community and maternal health services. Funding: Bill and Melinda Gates Foundation and David and Lucile Packard Foundation.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Longitudinal observation of the natural transition into marriage; no intervention was implemented
- Population
- 7,864 unmarried adolescent girls in Uttar Pradesh and Bihar, India, aged approximately 15-17 at baseline
Key finding
1,825 girls (23%) married between waves; newly married girls had adjusted-OR 2.0 (95% CI 1.6-2.5) for depressive symptoms compared to unmarried girls