The household economic costs associated with depression symptoms: A cross-sectional household study conducted in the North West province of South Africa

Depressive disorder at the household level: prevalence and correlates of depressive symptoms among household members

BACKGROUND

Globally, an estimated five percent of adults have major depressive disorder. However, little is known about the relationship between these individuals' depressive symptoms and their household members' mental health and well-being.

OBJECTIVES

We aimed to investigate the prevalence and predictors of depressive symptoms among adult household members of patients living with major depressive disorder in Neno District, Malawi.

METHODS

As part of a cluster randomized controlled trial providing depression care to adults with major depressive disorder, we conducted surveys with patients' household members (n = 236) and inquired about their overall health, depressive symptoms, disability, and social support. We calculated prevalence rates of depressive disorder and conducted multivariable linear regression and multivariable logistic regression analyses to assess correlates of depressive symptom severity and predictors of having depressive disorder (PHQ-9), respectively, among household members.

RESULTS

We observed that roughly one in five household members (19%) screened positive for a depressive disorder (PHQ-9 > 9). More than half of household members endorsed six or more of the nine symptoms, with 68% reporting feeling 'down, depressed, or hopeless' in the prior two weeks. Elevated depression symptom severity was associated with greater disability (β = 0.17, p < 0.001), less social support (β = -0.04, p = 0.016), and lower self-reported overall health (β = 0.54, p = 0.001). Having depressive disorder was also associated with greater disability (adjusted Odds Ratio [aOR] = 1.12, p = 0.001) and less social support (aOR = 0.97, p = 0.024).

CONCLUSIONS

In the Malawian context, we find that depressive disorder and depression symptoms are shared attributes among household members. This has implications for both screening and treatment, and it suggests that mental health should be approached from the vantage point of the broader social ecology of the household and family unit.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT04777006) - March 2, 2021.

Prevalence of depressive symptoms and its association with social support among older adults: The Brazilian National Health Survey

BACKGROUND

The study aimed to assess the association between depressive symptoms and social support measures among non-institutionalized Brazilian older adults.

METHODS

A cross-sectional study was carried out with data from the last National Health Survey, conducted in 2019. A descriptive analysis of the study variables was performed, followed by a multiple regression analysis to teste the association between the dependent variable (depressive symptoms, assessed by the Patient Health Questionnaire (PHQ-9) and independent variables (household arrangement, marital relationship, leisure activities, voluntary activity, religious activity, activities in associations/leaderships, work and receiving social support (friends and family).

RESULTS

The sample comprised 22,723 older adults and 13.1 % had depressive symptoms. There was a positive relationship between the number of people in the household and the prevalence of depressive symptoms. Individuals with support from family members only (PR 0.69; 95 % CI 0.51; 0.92) and those with support from family and friends (PR 0.53 95 % CI 0.40; 0.70) had a lower prevalence of depressive symptoms than those without support. Participation in leisure and religious activities was inversely associated with depressive symptoms. A negative association was found between work and the presence of depressive symptoms (PR 0.83; 95 % CI 0.70; 0.99).

LIMITATIONS

The cross-sectional design limits causal inferences and the survey did not include institutionalized individuals.

CONCLUSIONS

The lower prevalence of the outcome among older adults with social support highlights the importance of evaluating these measures and practicing activities that allow personal and social interactions among this age group.

One in Five Street Traditional Coffee Vendors Suffered from Depression During the COVID-19 Pandemic in Harar Town, Ethiopia

BACKGROUND

The COVID-19 crisis has already resulted in an economic and labor market shock and a rise of informal work sectors. Being an informal job, traditional coffee vending can predispose women to a myriad of mental disorders. Therefore, this study was aimed to assess depressive symptoms during the COVID-19 pandemic and associated factors among street traditional coffee vendors in Harar town, Eastern Ethiopia.

METHODS

A cross-sectional study was employed on 180 women engaged in street traditional coffee vending business in Harar town. Data were collected through a face-to-face interview using a Public Health Questionnaire and analyzed using SPSS version 20. Binary logistic regression was executed to identify factors associated with depression at a cut-off point of P < 0.05.

RESULTS

The mean age of the study participants was 31.83 (±10) years. The majority of the participants were currently married (n = 77, 42.8%), attended primary education (n = 68, 37.8%), had a family member of four or more (n = 60, 33.3%), and had two years or less work experience (n = 123, 68.3%). Most of the study participants obtained COVID-19-related information from television (n = 125, 69.4%). The prevalence of depression was found to be 18.9%. Attending primary education (AOR: 0.34; 95% CI: 0.12, 0.98), attending secondary education or higher (AOR: 0.23; 95% CI: 0.07, 0.69), and having four or more family members (AOR: 2.81; 95% CI: 1.14, 6.92) were significantly associated with depression.

CONCLUSION

One in five street traditional coffee vendors suffered from depression during the COVID-19 pandemic. Lower odds of being depressed were observed in those who attended a minimum of primary education. On the contrary, having a greater family size was associated with higher odds of being depressed. This finding will direct the government and other concerned bodies to be involved in the provision of psychological and material support for such informal workers during COVID-19.