Prevalence and Correlates of Prenatal Depression, Anxiety and Suicidal Behaviours in the Volta Region of Ghana

Abstract

Pregnancy is associated with several physical and psychosocial challenges that influence women’s health and wellbeing. However, prenatal mental health has received little attention. Therefore, this study examined the prevalence and correlates of prenatal depression, anxiety and current suicidal behaviors among pregnant women in the Volta Region of Ghana. Two hundred and fourteen (n = 214) pregnant women recruited from two hospitals responded to the hospital depression and anxiety scale (HADS), the insomnia severity index, and a set of psycho-behavioral, socioenvironmental and demographic characteristic questions. Chi-squared, bivariate and multivariate logistic regression were used for data analysis. Prevalence of prenatal depression, anxiety and current suicidal behaviors was 50.5%, 35.5% and 3.3%, respectively. After controlling for other variables, average monthly income, insomnia, non-nutritious food consumption (pica), and body image satisfaction were significantly associated with depression. Marital status, insomnia, lifetime suicidal behavior and partner support were significantly associated with anxiety. Current partner abuse was the only factor significantly associated with current suicidal behavior. The high prevalence rates of anxiety and depression among pregnant women and intimate partner violence remain important maternal health issues in the region. Therefore, brief mental health screening and counseling services should be integrated into prenatal healthcare services.

Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors

“…Taken together, the studies ( 41 – 52 , 54 , 56 – 58 ) demonstrate that experiences of abuse, particularly physical abuse, are significantly associated with ideation and attempts when measured separately and collectively, and therefore may be involved in enabling a woman to transition from having suicidal thoughts alone to then act on those thoughts. Furthermore, the findings suggest a persistent psychological effect of abuse (e.g., lifetime IPV and childhood abuse) which can manifest during the perinatal period.…”

“…However, the authors did not find experiences of abuse to be more or less associated with suicidal ideation, nor more or less associated with suicide attempt. Current IPV was also associated with a sixfold increase in likelihood of suicidal ideation and attempts (a combined measure) in 214 pregnant women ( 54 ), and IPV experienced at any point during a woman’s lifetime was also found to be associated with increased odds of suicidal ideation, planning and attempts in a larger sample of 2062 pregnant women ( 45 ). According to Supraja et al’s ( 55 ) bivariate analyses, any form of IPV (psychological, sexual, or physical) was strongly correlated with ideation during pregnancy, but IPV did not emerge as a significant predictor of ideation in their multivariate analysis.…”

“…Twenty-four studies ( 28 , 40 , 43 , 44 , 46 , 48 , 54 – 56 , 59 – 61 , 65 , 67 , 75 , 77 – 85 ) assessed social support, yet the types of social support (e.g., material, emotional, informational, affective, and social interaction) and sources of support (e.g., partner, family, friends, and neighbours) varied across these studies. With regards to the 16 studies that measured social support and suicide/self-harm ideation alone, seven studies found no association ( 48 , 67 , 80 – 82 , 84 , 85 ), six ( 40 , 43 , 44 , 59 – 61 ) reported a significant association (i.e., poor social support increased the odds), and three ( 75 , 78 , 79 ) found a significant protective effect of social support (i.e., good-quality support reduced the odds).…”

“…Seven studies investigated social support and suicidal ideation and behaviour ( 46 , 54 – 56 , 65 , 77 , 83 ) with mixed findings, although it should be noted that most of these studies used a different self-report measure of social support. Only Belete and Misgan ( 56 ) and Belete et al ( 77 ) used the same measure of social support, namely, the Oslo-3 Social Support Scale ( 87 ) which asks: “ how many people are you so close to that you can count on them if you have great personal problems?…”

“…One study assessed loneliness: Kugbey et al ( 54 ) failed to find a bivariate or multivariate association between loneliness and current suicidal behaviour (i.e., a composite score of suicidal ideation, suicide plans, and suicide attempts) in 214 pregnant women. However, they used just one item to measure loneliness without providing any more information on this item.…”