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.
Highlights
Child or early marriage–defined as marriage under the age of 18 –is a harmful practice that occurs globally and can limit the developmental outcomes of girls, and children born into these unions [1]
We present a narrative review of literature published on the mental health Child Marriage (CM) relationship in the past 20 years, with the aim of exploring the following research question: What are the mental health impacts associated to child and early marriage described in literature?
Though both groups suffered from depression, sexually abused girls had a higher prevalence of Major Depressive Disorder (MDD) and Post-Traumatic Stress Disorder (PTSD)
Summary
Child or early marriage–defined as marriage under the age of 18 –is a harmful practice that occurs globally and can limit the developmental outcomes of girls, and children born into these unions [1]. South Asia and sub-Saharan Africa bear the largest burdens of child marriages. In Sub-Saharan Africa, 40% of women are married as children [2], and 18 of the top 20 countries with the highest prevalence are found in the continent. Though most prevalent in low income regions, Child Marriage (CM) occurs in high income settings, such as Canada and the US where prevalence is higher among rural and minority populations who are more exposed to poverty and social inequalities [5]
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