Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review
Jane Fisher, Meena Cabral de Mello, Vikram Patel, Atif Rahman, Thach Tran, Sara Holton & Wendy Holmes
Volume 90, Number 2, February 2012, 139-149H
Table 2. Methods of investigating common perinatal mental disorders in pregnant women in low- and lower-middle-income countries, as per World Bank country income classification
Study | Study type | Setting | Quality | Sample | Gestational age | Assessment instrument | Prevalence (%) | SANCa (%) |
---|---|---|---|---|---|---|---|---|
Tertiary hospitals | ||||||||
Abiodun et al., 1993 |
Cross-sectional survey Validation of GHQ-30 | University of Ilorin Teaching Hospital, Nigeria | 7 | 240/250 consecutive attendees at antenatal clinics fluent in English or Yoruba | Trimester 1 (20.8%) Trimester 2 (33.3%) Trimester 3 (45.95%) | GHQ 30b > 4 | 19.1 | 58 |
PSE | 12.5 | |||||||
Aderibigbe et al., 1993 |
Prospective cohort Validation of GHQ-28 | University College Hospital, Ibadan, Nigeria | 6 | 277/300 consecutive attendees at antenatal clinics | Trimester 2 | C-GHQ-28b > 7 | 27.1 | 58 |
PAS | 14.4 CMD | |||||||
Karmaliani et al., 2006 |
Cross-sectional survey | Civil Hospital, Hyderabad, Pakistan | 8 | 1000 first recruited women 20–26 weeks pregnant and living locally, identified during routine household visits of 1368/1879 in larger study | Trimester 2 | AKUADSb > 31.5 | 11.5 | 64 |
How I feel scale > 83.5 | 13.5 | |||||||
Limlomwongse and Liabsuetrakul, 2006 |
Prospective cohort | Antenatal clinics Songlanagarind University Hospital, Thailand | 8 | 612/833 women, consecutive attendees at antenatal clinics | Trimester 3 | EPDS > 10 | 20.5 | 98 |
EPDS > 12 | 5.2 | |||||||
Fisher, Tran & Tran, 2007 |
Cross-sectional survey | National Obstetric Hospital, Hanoi, Viet Nam | 6 | Convenience sample of 61/74 women attending antenatal clinics | Trimester 3 | EPDS 10–12 | 13.1 | 91 |
EPDS > 12 | 1.6 | |||||||
Provincial or district health services | ||||||||
Cox et al., 1979 |
Cross-sectional | Antenatal clinics at semi-rural teaching health centres, Uganda | 6 | 263 antenatal clinic attendees | SISb | 16 CMD | 94 | |
Nhiwatiwa et al., 1998 |
Prospective cohort | Periurban primary care clinics, Zimbabwe | 5 | 500/500 consecutive attendees ≥ 32 weeks pregnant at antenatal and primary-health-care clinics | Trimester 3 | SSQb | 19.0 high risk | 94 |
CIS-R | ||||||||
Chandran et al., 2002 |
Prospective cohort | Christian Medical College, Vellore community health service, India | 5 | 384/991 consecutive attendees at antenatal clinics intending to live locally after giving birth | Trimester 3 | CIS-Rb | 16.2 depression | 74 |
Adewuya et al., 2007 |
Cross-sectional survey Validation of EPDS | Semi-urban health centres in Ilesa, Nigeria | 5 | 180 consecutive attendees at antenatal clinics who were well and could speak English or Yoruba | Trimester 3 | EPDSb > 5 | 41.6 | 58 |
MINI (DSM-IV) | 8.3 depression | |||||||
Fisher et al., 2010 |
Cross-sectional clinical and structured interviews | Randomly selected urban and rural commune health centres, Viet Nam | 8 | 65/70 women > 28 weeks pregnant registered with the CHC in Hanoi (urban) | Trimester 3 | SCIDb (DSM-IV) | 21.5 CMD | 91 |
134/148 > 28 weeks pregnant registered with the CHC in Hanam (rural) | SCIDb (DSM-IV) | 32.9 CMD | ||||||
Community | ||||||||
Rahman et al., 2003 |
Prospective cohort | Kaller Syedan QH and Choha Khalsa QH, a rural low-income subdistrict, Pakistan | 8 | 632/701 women > 28 weeks pregnant in households visited by Lady Health Workers or identified by vaccinators or TBAs who did not have psychotic or chronic illness or intellectual disability | Trimester 3 | SCANb (ICD-10) | 25.0 depression | 64 |
Gausia et al., 2009 |
Prospective cohort | Demographic Surveillance Site, Matlab, Bangladesh | 6 | 361/410 women > 33 weeks pregnant registered with MCH programme | Trimester 3 | EPDS-Bb > 9 | 33.0 | 60 |
Hanlon et al., 2009 |
Prospective cohort | Demographic Surveillance Site Butajira Rural Health Program, Ethiopia | 8 | 1065/1234 women > 28 weeks pregnant, residing in DHSS and identified by Butajira Rural Health Program enumerators in household visits | Trimester 3 | SRQ-20b 1–5 “low symptoms” | 59.5 | 28 |
SRQ-20b > 5 “high symptoms” | 12.0 |
AKUADS, Aga Khan University Anxiety Depression Scale; CHC, commune health centre; CIS-R Clinical Interview Schedule-Revised; C-GHQ, conventional scoring method; CMD, common mental disorder; DHSS, Demographic and Health Surveillance System; DSM-IV, Diagnostic and statistical manual of mental disorders, 4th edition; EPDS, Edinburgh Postnatal Depression Scale; GHQ, General Health Questionnaire; ICD-10, International Classification of Diseases, tenth revision; MCH, Maternal and Child Health; MINI, Mini-International Neuropsychiatric Interview; PAS, Psychiatric Assessment Schedule; PSE, Present State Examination; QH, Qanungo Halqa (an administrative subdistrict); SANC, skilled antenatal care; SCAN, Schedule for Clinical Assessment in Neuropsychiatry; SCID, Structured Clinical Interview for DSM-IV; SIS, Standardised Interview Schedule; SRQ-20, World Health Organization Self Reporting Questionnaire; SSQ, Shona Symptom Questionnaire; TBA, traditional birth attendant.
a Proportion of pregnant women given skilled antenatal care.
b Instrument locally validated.