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Objective: To estimate the level of low-self esteem in index depressed patients and compare them with
their first-degree relatives to determine low self esteem as a risk factor for depression.
Material and Methods: This case control study (150 cases and 150 controls) was conducted on adult
depressed patients (cases) and their healthy first-degree relatives (controls) attending psychiatric out
patients' clinic of the Aga Khan University Hospital from April 1, 2005 to September 1, 2005. We used
convenient method of sampling. Self-esteem was measured by Urdu version of Rosenberg Self-esteem Scale.
Logistic regression was applied for multivariate analysis.
Results: Out of 300 (169 males, 131 females) participants, 216(75%) were married. Cases and controls
were fairly matched on socio demographic variables except on marital status, educational level and
monthly income that showed significant difference. Main logistic regression shows that depressed patients
had significantly lower self esteem than non depressed population (OR= 8.05, 95%CI -3.5-14; p=0.001).
Male gender had lower self-esteem. (OR=3.50, p=0.005). Self-esteem increased with advancing age. Age
group 55-65 had the highest level of self-esteem (OR, .45.CI, 3-4.2, p=0.005). Undergraduates had
significantly lower level of self-esteem. (OR 2, CI.03-1.18, p =0.005). Depressed patients, having the
illness for more than one year, were 2.75 times more likely to have lower self-esteem. (OR, 2.75, CI, .97-
2.5, p= 0.001).
Conclusion: Association of depression and low self esteem as a state was replicated. Duration of illness
and male gender were significantly associated with low self-esteem.
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