Title: Prevalence of Depression and Anxiety among Working Women in Saudi Arabia:
Psychosocial and Perinatal Correlates
Version: 0 Date: 11 Jun 2024
Reviewer's report:
Title: Mental Health of Working Women in Saudi Arabia: Prevalence with Psychosocial and
Perinatal Correlates
Dear Authors,
Thank you for studying such an important topic among Saudi working women. Please consider
the following feedback:
General comments:
1. The paper title did not reflect the study aim stated in the abstract” Objectives: To explore
the prevalence of depression and anxiety among working women in Saudi Arabia and its
psychosocial and perinatal correlations”. Kindly revise the paper title. In addition, based on your
study participants be careful of using Saudi working women because I think you involved non-
Saudi women as well.
Abstract:
1. Results are quite confusing. It needs to be summarized to be concise.
2. The conclusion needs rewriting to reflect the study's aim and results.
Keywords:
1. The keywords did not align with the study title or aims. Kindly revise it as there are many
confusing words.
Introduction:
1. The first paragraph is far away from the study's aim and other paragraph are loose. It did not
give information about working women's status in Saudi Arabia, work related to anxiety and
depression, or relation with working women's perinatal aspects. Kindly rewrite the background
with a focus on study variables in each paragraph, then provide a literature review from Saudi,
and Arab studies then you can add some international studies.
2. What is the study framework that is based on the relations between working women, perinatal
issues, and anxiety and depression?
3. The significance of the study is missing.
Subject and Methods:
1. Please add subheadings for example design, setting, participants, recruitment, process, study
instruments, data management, ethical consideration…etc.
2. There is an inconsistency between the abstract and this section. In the abstract, it was
mentioned that “This cross-sectional study involved 580 working women from all over Saudi
Arabia”, while in this section you mentioned, “The study includes all working females in both
private and public sectors in Riyadh, Saudi Arabia”. So, it is a county-based study or based on
one region?
3. Inclusion and exclusion criteria need to be revised. What is the age limit? What do you mean
by “and those not living in Saudi Arabia”? Did you involve non-Saudi women?
4. “In 2021, the General Authority for Statistics in Saudi Arabia reported the total number
of workers to be 13,483,813 persons. The General Authority determined that Saudi females
represent 32% and 38% of the private and public sectors, respectively.” It lacks referencing and
should be moved with the background.
5. Sample size calculation not clear. What is the population size? From which organization did
you reach your participants? How the participants were recruited.
6. I am confused about the variables “smoking status, substance use, and drinking alcohol” Why
were you involved in your study? Please revise.
7. What is the validity of the PHQ-9 and GAD-7. Please mention more information about the
scale, no. of items, response, and Arabic Cronbach alpha.
Result:
1. Please focus on the abstract on the highest percentage of anxiety and depression, not the
percentage of severe and moderate to reflect the actual percentage, not a category (the prevalence
of minimal, mild, and moderate depression was 29.5%, 31.7%, and 18.4%, respectively.
Furthermore, moderately severe and severe depression were 14% and 6.4%, respectively. Figure
2 depicts that minimal and moderate anxiety prevalence was 35.5% and 30.5% each.)
Discussion:
1. The first paragraph seems like a literature review and is not related to the main aim of this
study.
2. The discussion is very long and some parts focus mainly on pregnant women. Please align
the study aim with the finding then link it with discussion. The discussion needs to focus mainly
in each study finding with supportive previous studies and studies that are inconsistent with the
current findings and please add rationale for each result. Please consider revising the discussion
to provide a comprehensive understanding.
3. “The Kingdom of Saudi Arabia has made dramatic changes and implemented policies and..”
Please move it to the background under paragraph status of working women in Saudi Arabia.
Limitation:
1. Please delete this “Multiple work-related factors such as career satisfaction, relationships
with coworkers, and types of relationships with supervisors that could influence psychological
well-being were not included. Personal and familial factors such as family satisfaction,
responsibilities of each spouse, women’s relationship with their spouse and families, and a
family history of depression or childhood trauma that contributed to depression or anxiety were
also not included.”
2. Why did you consider a “small sample size” with limitations?
Implications:
1. Please add practical implications the decrease or eliminate anxiety and depression of working
women and focus on the women's maternity factors.
Conclusion:
1. “This study has shown that employed Saudi women have a high prevalence of depression and
anxiety” Not correct information please reflect the accurate result. Another issue your sample
is made on Saudi and non-Saudi, please be careful with using terms.
2. Needs to be rewritten to align with the study aim, findings, and recommendation.
Tables and Figures:
1. The tables are very long and have many unneeded variables. Please revise.
2. Is smoking considered significant at (0.075)? As well in table 2; Working hours per week
(0.078)?
3.  Please revise the result in the table, make the significance result in bold, or add an asterisk
for easy looking. Then be sure to discuss it.
4. Why did you not find the predictors of depression and anxiety?
5. From the figure I understand that you did simple calculations for each category. Would you
please find out if you can consulate a statistician to make another statistical analysis to take your
results and paper to a higher level?