Abstract
BackgroundCommon mental disorders, particularly unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease. As a major public health concern, antepartum depression and anxiety not only affects the individual woman, but also her offspring. Data on the prevalence of common mental disorders in pregnant women in sub-Saharan Africa are scarce. We provide results from Ghana and Côte d'Ivoire.MethodsWe subsequently recruited and screened n = 1030 women in the third trimester of their pregnancy for depressed mood, general anxiety, and perceived disability using the Patient Health Questionnaire depression module (PHQ-9), the 7-item Anxiety Scale (GAD-7), and the World Health Organisation Disability Assessment Schedule II (WHO-DAS 2.0, 12-item version). In addition to estimates of means and prevalence, a hierarchical linear regression model was calculated to determine the influence of antepartum depression and anxiety on disability.ResultsIn Ghana, 26.6% of women showed substantially depressed mood. In Côte d'Ivoire, this figure was even higher (32.9%). Clear indications for a generalized anxiety disorder were observed in 11.4% and 17.4% of pregnant women, respectively. Comorbidity of both conditions was common, affecting about 7.7% of Ghanaian and 12.6% of Ivorian participants. Pregnant women in both countries reported a high degree of disability regarding everyday activity limitations and participation restrictions. Controlled for country and age, depression and anxiety accounted for 33% of variance in the disability score.ConclusionsAntepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in sub-Saharan Africa.
Highlights
Almost a decade ago, the WHO focused on mental health, and with the slogan ‘‘no health without mental health’’, placed efforts in this field at the top of its agenda [1]
There is a lack of prioritisation of mental health in low- and middle-income countries (LMICs)
With no variance inflation factor (VIF) greater than 10 we found no indication of multi-collinearity
Summary
The WHO focused on mental health, and with the slogan ‘‘no health without mental health’’, placed efforts in this field at the top of its agenda [1]. In Africa, mental health is neglected, a high prevalence of common mental disorders (CMD), like unipolar depression and anxiety, is assumed [3,4]. Data from high-income countries suggest that antepartum CMD disturb biosocial adaptation to pregnancy, and disables women with regard to everyday functioning, family and community life requirements [7]. The concept of disability, as measured by the World Health Organization Disability Assessment Schedule II (WHODAS 2.0) has been developed to quantify self-reported activity limitations and participation restrictions [8]. Unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease.
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