title: Social and economic correlates of depressive symptoms and perceived stress in South African adults.
abstract: OBJECTIVE
  Adults in South Africa demonstrate rates of mental illness at or above levels elsewhere in the developing world. Yet there is a research gap regarding the social context surrounding mental health in this region. The objective of this analysis was to characterize the prevalence and correlates of depressive symptoms and perceived stress among a heterogeneous South African population.
  
  
  METHODS
  Low-income adults (n = 257) in Capetown, Port Elizabeth and Durban were interviewed regarding demographics, income, subjective social status, life events and decision-making. The Center for Epidemiologic Studies Depression Scale (CES-D) and Cohen's Perceived Stress Scale (PSS) were used.
  
  
  RESULTS
  CES-D scores were 18.8 (SD 11.7), with 50.4% of men and 64.5% of women exceeding the cut-off at which professional care is recommended (p = 0.03). PSS scores were 18.6 (SD 6.7), with a mean of 17.5 among men and 19.6 among women (p = 0.02). In multivariate regressions, increased CES-D scores were associated with more household members (p<0.1), lower educational attainment (p = 0.07), less income stability (p<0.07), lower subjective social status (p<0.01) and independent decision-making (p = 0.04). Increased PSS scores were associated with female gender (p<0.05), multiracial race (p<0.02), more household members (p<0.1), lower subjective social status (p<0.02) and recent birth or catastrophe (p<0.01).
  
  
  CONCLUSIONS
  Depressive symptoms and perceived stress are public health concerns in this sample, with more symptoms among those with fewer resources. The prevention of mental illness is critical, especially in vulnerable populations.
authors.affiliation: University of California Berkeley, Berkeley, CA 94720, USA. hamad@post.harvard.edu
authors.forename: R
authors.initials: R
authors.lastname: Hamad
authors.forename: L C H
authors.initials: LC
authors.lastname: Fernald
authors.forename: D S
authors.initials: DS
authors.lastname: Karlan
authors.forename: J
authors.initials: J
authors.lastname: Zinman
mesh_terms: D000328:Adult; D003657:Decision Making; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D003906:Developing Countries; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D008016:Life Change Events; D016014:Linear Models; D008297:Male; D017533:Marital Status; D011203:Poverty; D015995:Prevalence; D012111:Residence Characteristics; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology