Household food insufficiency and mental health in South Africa.
BACKGROUND
Both mental illness and food insufficiency are common in low and middle income countries. However, there are limited data on the relation between food insufficiency and mental disorders, despite the potential relevance of such data for the development of policy-level interventions. The relationship between food insufficiency and mental disorders within a nationally representative sample of South African adults was examined.


METHODS
A national survey of 4185 South African adults was conducted using the WHO Composite International Diagnostic Interview to generate psychiatric diagnoses. The survey included a widely used single-item measure of household food insufficiency. The independent effects of food insufficiency and demographic characteristics on 12-month and lifetime DSM-IV diagnosis were assessed using logistic regression.


RESULTS
29% of respondents reported that their household 'sometimes' did not have enough to eat while 9% reported that they 'often' did not have enough to eat. After controlling for conventional socioeconomic and sociodemographic variables, food insufficiency was associated with having any 12-month (OR 1.44, 95% CI 1.1 to 1.9) and lifetime (OR 1.35, 95% CI 1.1 to 1.7) DSM-IV disorder.


CONCLUSIONS
In South Africa the prevalence of household food insufficiency is very high compared with studies conducted in the developed world, and is independently associated with having a 12-month and lifetime DSM-IV diagnosis. The relationship between food insufficiency and mental health has implications for reducing the burden of common mental disorders in South Africa since, unlike a number of major risk factors for mental illness, food insufficiency may be relatively amenable to intervention.
Sorsdahl
Katherine
K
J-Block Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa. katherine.sorsdahl@uct.ac.za
Slopen
Natalie
N
Siefert
Kristine
K
Seedat
Soraya
S
Stein
Dan J
DJ
Williams
David R
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000523:psychology; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008603:Mental Health; D008875:Middle Aged; D009752:Nutritional Status; D011594:Psychometrics; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult