The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: A national survey in South Africa

Abstract

Objective and methodsMental health problems among adults are a growing public health concern, and middle-income countries such as South Africa are disproportionally affected. Using a large scale nationally representative weighted survey, we assessed the prevalence of probable depression, probable anxiety, and adverse childhood experiences (ACEs), and explored associations between probable depression, probable anxiety, ACEs, socio-economic status, and demographic characteristics.ResultsNationally, 25.7, 17.8, and 23.6% of respondents, respectively, reported scores of ≥10 on the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), indicating probable depression or probable anxiety, and an ACE score of ≥4 (high exposure). Overall probable depression prevalence across South Africa varied from 14.7 to 38.8%. Both probable depression and probable anxiety were more frequently reported among adults who were: retired and older (>65 years of age), and widowed, divorced, or separated; living in metropolitan areas; and only had primary school education. In a multivariable adjusted logistic regression, the likelihood of reporting probable depression or probable anxiety was also found to increase with each standard deviation increase in the ACE score (p < 0.001), independent of other socio-demographic determinants.ConclusionThe prevalence of probable depression among respondents in South Africa varies significantly across the nine provinces. Furthermore, higher ACE score and several socio-demographic determinants were associated with a higher likelihood of probable depression and probable anxiety. Adult mental health services are urgently needed to identify groups of the population vulnerable to mental health problems for better targeting of interventions. Given the range of probable depression prevalence across the country, provincial level plans and resources should also reflect the burden of mental health problems in that province.

Association between socio-economic status and non-communicable disease risk in young adults from Kenya, South Africa, and the United Kingdom

“…Specifically, our findings show that mental health conditions are still more common in HICs and that they are rapidly increasing in LMICs, where more than a quarter of respondents reported a diagnosis of a mental health problem. These findings are in accordance with previous reports 38 , 39 . We recently conducted a national survey with weighted data representing approximately 39.6 million South African households and showed that 25.7% and 17.8% of the South African population reported moderate to severe symptoms of probable depression and anxiety, respectively 39 .…”

“…These findings are in accordance with previous reports 38 , 39 . We recently conducted a national survey with weighted data representing approximately 39.6 million South African households and showed that 25.7% and 17.8% of the South African population reported moderate to severe symptoms of probable depression and anxiety, respectively 39 . Furthermore, the findings that hypertension and related cardiovascular disorders (e.g., heart attack) was more prevalent in SA and Kenya than in the UK sample agrees with previous studies 40 , 41 .…”

Impact of a free medication intervention on seizure recurrence and anxious and depressive symptoms in people living with epilepsy in the Republic of Guinea

“…The average seizure frequency over the 30 days prior to follow up was 1.5 (95%CI [0.5, 2.6]) and significantly lower than at baseline (p = 0.002). 66% of participants were No to mild depressive symptoms (0-9 points), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), severe (20)(21)(22)(23)(24)(25)(26)(27) No to mild anxious symptoms (0-4 points), moderate (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19)(20)(21) F I G U R E 2 Distribution of scores on the PHQ-9 (a) and GAD-7 (b) at baseline and 90-day follow up.…”

“…Cross-sectional studies from multiple Sub-Saharan African countries have shown that the prevalence of depressive symptoms is high in PLWE, ranging from 40% (Ethiopia) to 86% (East Nigeria) [2]. Anxiety is also disproportionately high in PLWE and posited to be higher in Sub-Saharan African countries compared to other geographies [1,[5][6][7]. Whether these higher burdens result from a lack of access to diagnosis and treatment is not yet established.…”

The framing of depression in the South African print media over a 13-year period (2004-2016): a retrospective study.

“…However, some evidence shows that an estimated 9.8% of the adult population experience major (clinical) depression at some point in their life [6]. A recent large-scale, nationally representative study, assessing the prevalence of mental health problems among South African adults found that overall probable depression prevalence across South Africa varied from 14.7 to 38.8% [7].…”