Antepartum Depression and Anxiety Associated with Disability in African Women: Cross-Sectional Results from the CDS Study in Ghana and Côte d'Ivoire

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.

Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study

“…Numerous studies on CPMD have found that a history of mental health disorders increases the risk for current diagnoses and that depression and anxiety are commonly comorbid in the perinatal period (Heron et al 2004; Littleton et al 2007; Teixeira et al 2009; Field et al 2010; Matthey and Ross-Hamid 2012; Bindt et al 2012). Where depression and anxiety disorders occur simultaneously, the deleterious effects on maternal and child well-being may be compounded: symptoms may be more severe, duration of episodes of either disorder may be longer and have a chronic course, there may be worse impairment of maternal functioning, a poorer response to treatment and increased suicidality (Field et al 2010).…”

Paramètres hématologiques au cours de la dépression anténatale

“…Les éléments de mise en oeuvre du projet ont déjà été décrits (Bindt et al, 2012). L'étude s'est déroulée de février 2010 à décembre 2011 à l'Hôpital Général d'Abobo Nord et au Laboratoire de Biologie de l'Institut National de la Santé Publique (INSP) d'Abidjan pour l'analyse des échantillons.…”

“…La thrombopénie a été retrouvée respectivement chez 34,4% de nouveau-nés de mères déprimées et 26,6% de ceux nés de mères non déprimées, ainsi qu'une thrombocytose (3,1 versus 4,7%) (Tableaux 4, 5 et 6). (Bindt et al, 2012 ;Hartley et al, 2011 ;Adewuya et al, 2007). Les études ont également montré l'impact de la dépression maternelle sur le développement de l'enfant ainsi que la santé de la mère.…”

“…Une revue systématique a montré que la prévalence de la dépression dans le troisième trimestre de la grossesse est plus élevée que dans le premier trimestre (Bennett et al, 2004). Des études menées en Côte d'Ivoire et au Ghana ont montré une prévalence de la dépression anténatale respectivement de 33 et 27% (Bindt et al, 2012). L'état de grossesse se caractérise par de grandes modifications physiologiques, qui permettent le développement du foetus et l'adaptation de la mère à l'état de grossesse (Fournier et al, 1999).…”

Effect of Caregiver Training on the Neurodevelopment of HIV-Exposed Uninfected Children and Caregiver Mental Health: A Ugandan Cluster-Randomized Controlled Trial

“…1, 11–13 In western Africa, children of depressed mothers have been found to have elevated risk of morbidity and mortality as compared to those of non-depressed mothers. 21, 22 Despite this, most studies have not evaluated the effects of ECD interventions on the mental health of the child’s mother or caregiver. 6 …”