Abstract :
Background: Wives of individuals with substance use disorders (SUDs) in Pakistan constitute a clinically underserved population bearing profound psychological, relational, and social burdens. Research specifically examining their mental health within the Pakistani sociocultural context remains critically sparse despite a national drug-use burden estimated at seven million active users.
Method: A sequential explanatory mixed-method design was employed. In the quantitative phase, 120 married women whose husbands met DSM-5 criteria for SUD were recruited from rehabilitation centres and psychiatric outpatient clinics across Rawalpindi and Lahore. The Beck Depression Inventory-II (BDI-II), Brief COPE Scale, and an adapted Courtesy Stigma Scale were administered. In the qualitative phase, 20 participants were purposively selected for in-depth semi-structured interviews; transcripts were analysed using reflexive thematic analysis.
Key Results: Over 71% of participants reported moderate-to-severe depressive symptoms (M = 24.7, SD = 8.3). Courtesy stigma was a significant positive predictor of depression (? = .39, p < .001), explaining 19% of variance. Self-blame coping correlated strongly with depressive severity (r = .51, p < .001). Four qualitative themes were identified: concealed suffering, shame by association, religious endurance, and helplessness.
Conclusion: Wives of individuals with SUDs in Pakistan experience severe, unaddressed psychological distress compounded by courtesy stigma and constrained coping resources. Culturally sensitive, gender-responsive psychological interventions integrated within existing rehabilitation infrastructure are urgently required for this population.