title: Antepartum depression and anxiety associated with disability in African women: cross-sectional results from the CDS study in Ghana and Côte d'Ivoire.
abstract: BACKGROUND
  Common mental disorders, particularly unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease. As a major public health concern, antepartum depression and anxiety not only affects the individual woman, but also her offspring. Data on the prevalence of common mental disorders in pregnant women in sub-Saharan Africa are scarce. We provide results from Ghana and Côte d'Ivoire.
  
  
  METHODS
  We subsequently recruited and screened n = 1030 women in the third trimester of their pregnancy for depressed mood, general anxiety, and perceived disability using the Patient Health Questionnaire depression module (PHQ-9), the 7-item Anxiety Scale (GAD-7), and the World Health Organisation Disability Assessment Schedule II (WHO-DAS 2.0, 12-item version). In addition to estimates of means and prevalence, a hierarchical linear regression model was calculated to determine the influence of antepartum depression and anxiety on disability.
  
  
  RESULTS
  In Ghana, 26.6% of women showed substantially depressed mood. In Côte d'Ivoire, this figure was even higher (32.9%). Clear indications for a generalized anxiety disorder were observed in 11.4% and 17.4% of pregnant women, respectively. Comorbidity of both conditions was common, affecting about 7.7% of Ghanaian and 12.6% of Ivorian participants. Pregnant women in both countries reported a high degree of disability regarding everyday activity limitations and participation restrictions. Controlled for country and age, depression and anxiety accounted for 33% of variance in the disability score.
  
  
  CONCLUSIONS
  Antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in sub-Saharan Africa.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Bindt
authors.forename: John
authors.initials: J
authors.lastname: Appiah-Poku
authors.forename: Marguerite
authors.initials: M
authors.lastname: Te Bonle
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schoppen
authors.forename: Torsten
authors.initials: T
authors.lastname: Feldt
authors.forename: Claus
authors.initials: C
authors.lastname: Barkmann
authors.forename: Mathurin
authors.initials: M
authors.lastname: Koffi
authors.forename: Jana
authors.initials: J
authors.lastname: Baum
authors.forename: Samuel Blay
authors.initials: SB
authors.lastname: Nguah
authors.forename: Harry
authors.initials: H
authors.lastname: Tagbor
authors.forename: Nan
authors.initials: N
authors.lastname: Guo
authors.forename: Eliezer
authors.initials: E
authors.lastname: N'Goran
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001007:Anxiety / Q000453:epidemiology*; D007560:Cote d'Ivoire / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D055815:Young Adult