Family Support as a Determinant of Major Depression among Pregnant Women in a Low-resource Setting
Published: 2023-07-20
Page: 121-132
Issue: 2023 - Volume 6 [Issue 1]
Ada Nkemagu Okocha
Department of Family Medicine, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Mkpe Abbey *
Department of Obstetrics and Gynaecology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Simeon Chijioke Amadi
Department of Obstetrics and Gynaecology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Chidiebere Nwakamma Ononuju
Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria.
Oluwagbemiga Adewale
Ultimate Specialist Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Mental wellbeing of the expectant mother, with particular reference to depression may be improved with a strong and effective family support. This study thus aimed to determine the relationship between major depression with perceived family support among pregnant women attending antenatal clinic in the Rivers State University Teaching Hospital.
Methods: This was a cross-sectional study carried out among 163 participants recruited via systematic random sampling at the antenatal clinic of RSUTH. Data on socio-demographic, obstetrics and medical information were obtained with the aid of semi-structured interviewer-administered questionnaire. Screening for depression was done using the Edinburgh Postnatal Depression Scale (EPDS) while perceived social support-family scale (PSS-Fa) was used to assess the perceived family support among the participants. Data was analyzed with SPSS version 23. A p-value of less than 0.05 was considered significant.
Results: The mean age of the subjects was 29.1±4.53years with an age range of 20 - 40 years. The highest proportion (43.6%) of the participants was within the age group of 26-30 years. Majority of the subjects were married (87.1%) from monogamous families (73.6%) and had tertiary level of education (67.5%), Majority were within high social class (56.4%), and did not experience intimate partner violence (92.6%). The prevalence of depression was 44.8%. The majority had a strong family support (82.8%). Equal number 14 (8.6%) of participants had no family support and weak family support respectively. All 14(100%) of the participants who had no family support developed antepartum depression; then, out of the 14 participants who had weak family support, 7 (50%) had antepartum depression and 52(38%) of the 135 participants who had strong family support developed antepartum depression (X=19.558; p=0.0001).
Conclusions: Family support during pregnancy was inversely related to the prevalence of major antepartum depression. This finding thus highlights the need for Family Physicians to utilize the role of family support in achieving better mental wellbeing in pregnant women and reduction of the prevalence of antepartum depression and its sequelae.
Keywords: Family support, major depression, determinant, low-resource setting
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References
Manderscheid RW, Ryff CD, Freeman EJ, McKnight-Eily LR, Dhingra S, Strine TW. Peer reviewed: Evolving definitions of mental illness and wellness. Preventing Chronic Disease. 2010;7
Di Florio A, Forty L, Gordon-Smith K, Heron J, Jones L, Craddock N, et al. Perinatal episodes across the mood disorder spectrum. JAMA psychiatry. 2013; 70:168-175
Jenkins C, Shestak A, Laux J, Jancsin J. As a diagnostic category, trauma-and stress or-related disorders represent a new grouping in the diagnostic and statistical manual of mental disorders ; American psychiatric association [Apa]. DSM-5. Family Systems. 2017; 2:159
Lépine J-P, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat. 2011;7:3.
Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, De Girolamo G, et al. Cross-national epidemiology of DSM -iv major depressive episode. BMC Medicine. 2011;9:90
World Health Organization. Mental health aspects of women's reproductive health: A global review of the literature. Geneva. World Health Organization; 2009.
Adachi Y, Aleksic B, Nobata R, Suzuki T, Yoshida K, Ono Y, et al. Combination use of beck depression inventory and two-question case-finding instrument as a screening tool for depression in the workplace. BMJ open. 2012;2: e000596
Rochat TJ, Tomlinson M, Bärnighausen T, Newell ML, Stein A. The prevalence and clinical presentation of antenatal depression in rural South Africa. J Affect Disord. 2011;135
Muzik M, Marcus SM, Flynn H, Rosenblum KL. Depression during pregnancy: Detection, comorbidity and treatment. Asia‐Pac Psychiat. 2010;2:7-18
Al-Krenawi A. A study of psychological symptoms, family function, marital and life satisfactions of polygamous and monogamous women: The Palestinian case. Int J Soc Psychiatry 2012;58: 79-86.
World Health Organization. Mental health: facing the challenges, building solutions. Report from the WHO European Ministerial Conference on Mental Health, Helsinki, Finland; 2005.
Rait G, Walters K, Griffin M, Buszewicz M, Petersen I, Nazareth I. Recent trends in the incidence of recorded depression in primary care. Br J Psychiatry. 2009; 195:520-524.
Bird P, Omar M, Doku V, Lund C, Nsereko JR, Mwanza J. Increasing the priority of mental health in Africa: Findings from qualitative research in Ghana, South africa, Uganda and Zambia. Health Policy Plan. 2010;26:357-365
Rachel R. The agony of pre-natal depression: It strikes one in eight pregnant women, but many of us don't even know it exists. Mail (London); 2012
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: A systematic review. Am J obstet gynecol. 2010;202:5-14
Barker ED, Kirkham N, Ng J, Jensen SK. Prenatal maternal depression symptoms and nutrition, and child cognitive function. Br J Psychiatry. 2013;203:417-421
Chatillon O, Even C. Antepartum depression: Prevalence, diagnosis and treatment. L'Encéphale. 2010;36: 443-451.
Adewuya AO, Ola BA, Aloba OO, Dada AO, Fasoto OO. Prevalence and correlates of depression in late pregnancy among Nigerian women. Depress. Anxiety. 2007;24:15-21
Marcus SM. Depression during pregnancy: Rates, risks and consequences. Can J Clin Pharmacol. 2009;16:15-22.
Breedlove G, Fryzelka D. Depression screening during pregnancy. J Midwifery Womens Health. 2011;56:18-25.
Ugochukwu OC, Donald CC, Chukwuemeka SP. Comorbidity of alcohol use disorder and depression among patients attending a tertiary hospital in the Niger Delta region of Nigeria. Neuroscience. 2016;4: 38-42.
Qiu C, Williams MA, Calderon-Margalit R, Cripe SM, Sorensen TK. Preeclampsia risk in relation to maternal mood and anxiety disorders diagnosed before or during early pregnancy. Am Journal Hypertens. 2009; 22:397-402.
Bernstein IH, Rush AJ, Yonkers K, Carmody TJ, Woo A, McConnell K, et al. Symptom features of postpartum depression: Are they distinct? Depress Anxiety. 2008;25:20-26.
Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen H-U. Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Human Development. 2010;86:305-310.
Manber R, Blasey C, Allen J. Depression symptoms during pregnancy. Arch Womens Ment Health. 2008;11:43-48.
Hoertel N, López S, Peyre H, Wall MM, González‐Pinto A, Limosin F, et al. Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using item response theory (irt). Depress Anxiety. 2015;32:129-140.
Wakefield JC. Diagnostic issues and controversies in dsm-5: Return of the false positives problem. Annu Rev Clin Psychol. 2016;12:105-132.
Afolabi MO, Abioye-Kuteyi EA, Fatoye FO, Bello IS, Adewuya AO. Pattern of depression among patients in a Nigerian family practice population. S Afr Fam Pract 2008;50:1.
Obadeji A, Oluwole LO, Dada MU, Ajiboye AS, Kumolalo BF, Solomon OA. Assessment of depression in a primary care setting in Nigeria using the phq-9. J Family Med Prim care. 2015;4:30.
Richmond CA, Ross NA. Social support, material circumstance and health behaviour: Influences on health in first nation and inuit communities of Canada. Soc Sci Med. 2008;67:1423-1433.
Hutchings J, Bywater T, Williams ME, Lane E, Whitaker CJ. Improvements in maternal depression as a mediator of child behaviour change. Psychol. 2012;3:795.
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: A systematic review. Am J obstet gynecol. 2010;202:5-14.
Health Nccfm. Antenatal and postnatal mental health: The NICE guideline on clinical management and service guidance; 2007.
Aktas S, Calik KY. Factors affecting depression during pregnancy and the correlation between social support and pregnancy depression. Iran Red Crescent Med J. 2015;17.
Bird P, Omar M, Doku V, Lund C, Nsereko JR, Mwanza J. Increasing the priority of mental health in Africa: Findings from qualitative research in Ghana, South africa, Uganda and Zambia. Health Policy Plan. 2010;26:357-365.
Wang PS, Aguilar-Gaxiola S, Alonso J, Lee S, Schoenbaum M, Üstün TB, et al. Assessing mental disorders and service use across countries. The Conceptual Evolution of DSM-5. 2010;231.
Bener A, Ghuloum S, Abou-Saleh MT. Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar. Soc Psychiatry Psychiatr Epidemiol. 2012; 47:439-446.
Tselebis A, Anagnostopoulou T, Bratis D, Moulou A, Maria A, Sikaras C, et al. The 13 item family support scale: Reliability and validity of the greek translation in a sample of greek health care professionals. Asia Pac Fam Med. 2011;10:3.
Dunst CJ, Espe-Sherwindt M. Family-centered practices in early childhood intervention. Handbook of early childhood special education. Springer. 2016;37-55.
Rochat TJ, Tomlinson M, Newell M-L, Stein A. Detection of antenatal depression in rural hiv-affected populations with short and ultrashort versions of the Edinburgh postnatal depression scale (epds). Arch Womens Mental Health. 2013;16: 401-410
Bindt C, Appiah-Poku J, Te Bonle M, Schoppen S, Feldt T, Barkmann C, et al. Antepartum depression and anxiety associated with disability in African women: Cross-sectional results from the cds study in Ghana and Côte d'ivoire. PloS one. 2012;7:e48396.
Asad N, Karmaliani R, Sullaiman N, Bann CM, McClure EM, Pasha O, et al. Prevalence of suicidal thoughts and attempts among pregnant pakistani women. Acta Obstet Gynecol Scand. 2010;89:1545-1551.
Stewart RC, Umar E, Tomenson B, Creed F. A cross-sectional study of antenatal depression and associated factors in Malawi. Archives of Women's Mental Health. 2014;17:145-154.
Amiya RM, Poudel KC, Poudel-Tandukar K, Pandey BD, Jimba M. Perceived family support, depression, and suicidal ideation among people living with HIV/AIDS: A cross-sectional study in the Kathmandu valley, Nepal. PLoS One. 2014;9:e90959.