A cross-sectional study of antenatal depression and associated factors in Malawi

Abstract

Depression, and disabling levels of mixed depressive, anxious and somatic symptoms, termed common mental disorder, occurring in the perinatal period are an important health problem in low- and middle-income countries. In this cross-sectional study, pregnant women were recruited from a district hospital antenatal clinic in Malawi. Symptoms of depression and anxiety, and non-specific somatic symptoms commonly associated with distress, were measured using validated local versions of the Self Reporting Questionnaire (SRQ). In a sub-sample, Diagnostic Statistical Manual (DSM)-IV diagnoses of major and minor depressive disorders were made using the Structured Clinical Interview for DSM-IV. Maternal socio-demographic and health variables were measured, and associations with SRQ score and depression diagnosis were determined. Of 599 eligible women, 583 were included in the analysis. The adjusted weighted prevalence of current major depressive episode and current major or minor depressive episode were 10.7 % (95 % CI 6.9-14.5 %) and 21.1 % (95 % CI 15.5-26.6 %), respectively. On multivariate analysis, SRQ score was significantly associated with lower perceived social support, experience of intimate partner violence, having had a complication in a previous delivery, higher maternal mid-upper arm circumference and more years of schooling. Major depressive episode was associated with lower perceived social support and experience of intimate partner violence. This study demonstrates that antenatal depression/CMD is common in Malawi and is associated with factors that may be amenable to psychosocial interventions.

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

“…Previous data from the Malawi Demographic Health Survey (18) and from trauma registries (47) indicate that women experience a high prevalence of IPV. The high levels of mental health consequences among women are validated by previous studies (35) and gendered power relations create a qualitative difference between IPV against women and against men. Nevertheless male participants also describe experiencing violence and mental ill health and turning to drugs and alcohol as a result of marital disharmony, which in turn may perpetuate cycles of violence perpetration.…”

“…While there are data from Malawi confirming the link between IPV and depression among pregnant women (35), evidence for effective interventions that prevent violence is limited (30), and there have been no studies aimed at methods for mitigating mental health consequences. The effectiveness of mental health interventions are different in the context of violence, where the cycle may start in childhood due to witnessing violence (36) and/or the external mental ill-health trigger of violence may be ongoing.…”

Sintomas depressivos na gestação e fatores associados: estudo longitudinal

“…In Turkey, the prevalence in the first trimester of gestation was 16.8%. (9,10) The prevalence also varies according to gestational age or trimester, on average 7.4% in the first trimester until 12.0% in the last trimester. (7) Depressive symptoms such as altered sleep patterns, sadness with no apparent reason, decreased performance and feelings of guilt, among others, are common in gestation, ranging from 11.9% to 33.8%, and indicate a risk for depression.…”

Malawi Educators Assessment of Student Mental Health Outcomes

“…In young people rates vary between 10 and 20 percent [11][12][13]. While rates for Tanzania are not available they are not expected to significantly differ from those in Malawi as studies from Nigeria and Kenya, other similarly low income Sub-Saharan African countries, have reported in-school youth depression rates as ranging between 21 and 26 percent respectively [9,10,[14][15][16].…”