Prevalence and Stigma of Postpartum Common Mental Disorders in the Gurage Region of Ethiopia: A Mixed-Methods Observational Cohort Study

Abstract

Objectives: Mental disorders are vastly underdiagnosed in low-income countries that disproportionately affect women. We aimed to evaluate the prevalence of common mental disorders in newly postpartum women, and stigma associated with mental health reporting in an Ethiopian community using a validated World Health Organization survey.Methods: The Self Reporting Questionnaire (SRQ) for psychological distress was administered in Amharic by nurses to 118 women aged 18–37 years who had given birth in the prior 3 months in the Glenn C. Olsen Memorial Primary Hospital in Yetebon. Mental health stigma among the four nursing staff was assessed using Link and Phelan's Components of Stigma.Results: Among 118 women surveyed, 18% had a probable common mental disorder using the SRQ 4/5 cutoff and 2% admitted to suicidal thoughts. Presence of stigma in the healthcare staff was verified, including labeling, stereotyping, separating, and status loss and discrimination.Conclusion: Postpartum mental health disorders as well as stigma against such diagnoses are common in the Yetebon community. There is an urgent need for increased availability of properly trained and supervised healthcare staff in the identification and referral of postpartum women with common mental disorders.

Mental illness stigma among perinatal women in low- and middle-income countries: early career psychiatrists' perspective

“…Few studies attempted to investigate stigma toward perinatal mental illness in LMICs ( 9 , 10 ). In our experience, perinatal women with mental illness are frequently stigmatized for seeking treatment, refusing treatment, being on medications, and being associated with a husband or family member (e.g., mother) with a mental illness in LMICs.…”

Maternal suicides, the tip of an iceberg

“…Global statistics report a prevalence of suicidal ideation in the perinatal period ranges from 2 to 5% among women seeking obstetrical care 7,8,9,10,11 . The reported rates are higher among special groups of women: 10% among women veterans between the third trimester and six weeks postpartum 12 , 5 to 14% among perinatal women with depression or in mental health treatment 13,14 , 8% among perinatal women living with HIV 15 , and 9% among those screening positive for postpartum depression among mothers of babies admitted to a neonatal intensive care unit 16 .…”

Suicide and Maternal Mortality

“…Many women had a history of expressing or presenting with suicidal ideation (62%0 or had previously attempted suicide (37%). Antidepressants were the most commonly prescribed medication (29%) at the time of death Monaghan et al [ 31 ] Prevalence and Stigma of Postpartum Common Mental Disorders in the Gurage Region of Ethiopia: A Mixed-Methods Observational Cohort Study Cross-sectional 118 postpartum women who had given birth in the past 3 months 118 pregnant women SRQ SI Of the women surveyed, 18% had a probable common mental disorder, and 2% admitted to suicidal thoughts Moreyra et al [ 36 ] Implementing a standardized screening protocol for parental depression, anxiety, and PTSD symptoms in the Neonatal Intensive Care Unit Cross-sectional NICU parents [120 mothers, 30 fathers] 150 PHQ9 SI 23% of parents (includes both mothers and fathers) scored 10 or above on PHQ9, with 9% of positive screens ( n = 3) scoring above a 0 on item 9 (related to suicidal thoughts) Mota et al [ 51 ] Mental Disorders and Suicide Attempts in the Pregnancy and Postpartum Periods Compared with Non-Pregnancy: A Population-Based Study Retrospective cohort study Perinatal vs non perinatal women in Manitoba 45,362 perinatal women, 139,705 non-perinatal N/A SA Within the perinatal cohort, pregnancy was associated with lower rate of diagnosed mood or anxiety disorder, substance use disorder, and suicide attempt compared to pre-pregnancy. Compared with non-perinatal women, pregnancy was associated with lower rate of all outcomes.…”