Mental health in Malawi

Lilford, Philippa

doi:10.1192/bji.2019.28

Cited by 6 publications

(2 citation statements)

References 2 publications

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“…Philippa Lilford describes, in vivid terms, her experiences as a junior psychiatrist in Malawi, which has but one mental hospital, in Zomba. 4 The asylum's origins lie in the local prison, where it was established in 1910; it has existed in its current form since 1953. Criticism of the in-patient system, in the context of Malawian society, was made by a senior government psychiatrist at the hospital nearly 30 years ago.…”

Section: Malawimentioning

confidence: 99%

Reflections on community mental healthcare around the world

Skuse

2020

BJPsych Int.

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Section: Malawimentioning

confidence: 99%

Reflections on community mental healthcare around the world

Skuse

2020

BJPsych Int.

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“…To date, several facility-based studies in Malawi have reported a high burden of mental health disorders [ 27 , 28 ]. Nonetheless, most mental health conditions remain under diagnosed in the community due to limited availability of mental health services in primary care, and a lack of mental health funding and trained mental health professionals [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Association between physical multimorbidity and common mental health disorders in rural and urban Malawian settings: Preliminary findings from Healthy Lives Malawi long-term conditions survey

Nkoka,

Munthali-Mkandawire,

Mwandira

et al. 2024

PLOS Glob Public Health

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In low-income Africa, the epidemiology of physical multimorbidity and associated mental health conditions is not well described. We investigated the multimorbidity burden, disease combinations, and relationship between physical multimorbidity and common mental health disorders in rural and urban Malawi using early data from 9,849 adults recruited to an on-going large cross-sectional study on long-term conditions, initiated in 2021. Multimorbidity was defined as having two or more measured (diabetes, hypertension) or self-reported (diabetes, hypertension, disability, chronic pain, HIV, asthma, stroke, heart disease, and epilepsy) conditions. Depression and anxiety symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder scale (GAD-7) and defined by the total score (range 0–27 and 0–21, respectively). We determined age-standardized multimorbidity prevalence and condition combinations. Additionally, we used multiple linear regression models to examine the association between physical multimorbidity and depression and anxiety symptom scores. Of participants, 81% were rural dwelling, 56% were female, and the median age was 30 years (Inter Quartile Range 21–43). The age-standardized urban and rural prevalence of multimorbidity was 14.1% (95% CI, 12.5–15.8%) and 12.2% (95% CI, 11.6–12.9%), respectively. In adults with two conditions, hypertension, and disability co-occurred most frequently (18%), and in those with three conditions, hypertension, disability, and chronic pain were the most common combination (23%). Compared to adults without physical conditions, having one (B-Coefficient (B) 0.79; 95% C1 0.63–0.94%), two- (B 1.36; 95% CI 1.14–1.58%), and three- or more- physical conditions (B 2.23; 95% CI 1.86–2.59%) were associated with increasing depression score, p-trend <0.001. A comparable ‘dose-response’ relationship was observed between physical multimorbidity and anxiety symptom scores. While the direction of observed associations cannot be determined with these cross-sectional data, our findings highlight the burden of multimorbidity and the need to integrate mental and physical health service delivery in Malawi.

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