Dimensionality and differential item endorsement of depressive symptoms among aging Black populations in South Africa: Findings from the HAALSI study

Children in Southern Africa are exposed to high rates of structural and family adversities. This study tests whether services from Community Based Organisations (CBOs) in South Africa can promote children’s resilience against depression exposed to such adversities. Two linked longitudinal studies were conducted, comprising n = 1848 children aged 9 to 13 years. One group received CBO services, whilst the other (quasi-control) did not. Analyses used interaction terms in regression models to test for potential moderation effects of CBO attendance, and marginal effects models to interpret significant interactions. Two interaction effects were shown, demonstrating moderation effects of CBO attendance on common structural disadvantages. First, children exposed to community violence showed increased depression (contrast = 0.62 [95%CI 0.43, 0.82], p < .001), but this association was removed by CBO access (contrast = 0.07 [95%CI −0.28, 0.43], p = .682). Second, children living in informal housing showed increased depression (contrast = 0.63 [95%CI 0.42, 0.85], p < .001), however, this association was removed by CBO access (contrast = 0.01 [95%CI −0.55, 0.56], p = .977). CBO attendance is associated with fewer depressive symptoms, and can buffer against important structural adversities of poor housing and violence that are common in high HIV-prevalence areas. However, CBO attendance was not able to remove the increased psychosocial distress associated with some family-level vulnerabilities such as orphanhood and abuse. These findings highlight the centrality of CBO-provided psychosocial support for children in Southern Africa, and suggest areas for bolstering provision.

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An overview of trends in depressive symptoms in South Africa

South African Journal of Psychology ◽

10.1177/0081246318823580 ◽

2019 ◽

Vol 49 (4) ◽

pp. 518-535

Author(s):

Kinyanjui Mungai ◽

Amiena Bayat

Keyword(s):

Mental Health ◽

South Africa ◽

Socioeconomic Status ◽

Depressive Symptoms ◽

South African ◽

Emotional Health ◽

National Income ◽

South African Context ◽

Income Dynamics ◽

African Context

The relationship between mental health and socioeconomic status is well established in the literature. The socioeconomic standing of a number of South Africans remains poor and slow changing, while the mental health of the most vulnerable remains both an economic and health problem for government. There is, however, a lack of studies that assess depressive symptoms using panel data. There is also a lack of studies that consider factors that influence transitions of adults into and out of Significant Depressive Symptoms, particularly in the South African context. Panel data from the National Income Dynamics Study were used for this study to assess these transitions. The data included information on various socioeconomic and health variables, as well as a section that assesses the emotional health of adults in South Africa. This emotional health section in National Income Dynamics Study was essentially a 10-item version of the Centre for Epidemiological Studies Depression scale. The study aimed to investigate how socioeconomic status is associated with the risk of adults transitioning into and out of Significant Depressive Symptoms in the South African context. The study found that the prevalence of adults who exhibited Significant Depressive Symptoms declined significantly in South Africa, despite the recent increase. Moreover, adults with a lower socioeconomic standing were identified as being particularly vulnerable to depression and struggled to transition out of Significant Depressive Symptoms.

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Use of short messaging services to assess depressive symptoms among refugees in South Africa: Implications for social services providing mental health care in resource-poor settings

Journal of Telemedicine and Telecare ◽

10.1177/1357633x15605406 ◽

2016 ◽

Vol 22 (6) ◽

pp. 369-377 ◽

Cited By ~ 15

Author(s):

Andrew Tomita ◽

Ka Muzombo Kandolo ◽

Ezra Susser ◽

Jonathan K Burns

Keyword(s):

Mental Health ◽

South Africa ◽

Health Care ◽

Depressive Symptoms ◽

Mental Health Care ◽

Social Services ◽

Resource Poor ◽

Short Messaging Services

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Prevalence and factors associated with depressive symptoms among young women and men in the Eastern Cape Province, South Africa

Journal of Child and Adolescent Mental Health ◽

10.2989/17280583.2012.731410 ◽

2013 ◽

Vol 25 (1) ◽

pp. 43-54 ◽

Cited By ~ 15

Author(s):

Mzikazi Nduna ◽

Rachel K Jewkes ◽

Kristin L Dunkle ◽

Nwabisa P Jama Shai ◽

Ian Colman

Keyword(s):

South Africa ◽

Depressive Symptoms ◽

Young Women ◽

Eastern Cape Province ◽

Eastern Cape ◽

Factors Associated

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Patient-level predictors of detection of depressive symptoms, referral, and uptake of depression counseling among chronic care patients in KwaZulu-Natal, South Africa

Global Mental Health ◽

10.1017/gmh.2020.11 ◽

2020 ◽

Vol 7 ◽

Author(s):

Christopher G. Kemp ◽

Ntokozo Mntambo ◽

Max Bachmann ◽

Arvin Bhana ◽

Deepa Rao ◽

...

Keyword(s):

South Africa ◽

Primary Care ◽

Depressive Symptoms ◽

Primary Care Providers ◽

Depression Treatment ◽

Care Providers ◽

Low Resource Settings ◽

Low Resource ◽

Patient Level ◽

Kwazulu Natal

Abstract Background Integration of depression treatment into primary care could improve patient outcomes in low-resource settings. Losses along the depression care cascade limit integrated service effectiveness. This study identified patient-level factors that predicted detection of depressive symptoms by nurses, referral for depression treatment, and uptake of counseling, as part of integrated care in KwaZulu-Natal, South Africa. Methods This was an analysis of baseline data from a prospective cohort. Participants were adult patients with at least moderate depressive symptoms at primary care facilities in Amajuba, KwaZulu-Natal, South Africa. Participants were screened for depressive symptoms prior to routine assessment by a nurse. Generalized linear mixed-effects models were used to estimate associations between patient characteristics and service delivery outcomes. Results Data from 412 participants were analyzed. Nurses successfully detected depressive symptoms in 208 [50.5%, 95% confidence interval (CI) 38.9–62.0] participants; of these, they referred 76 (36.5%, 95% CI 20.3–56.5) for depression treatment; of these, 18 (23.7%, 95% CI 10.7–44.6) attended at least one session of depression counseling. Depressive symptom severity, alcohol use severity, and perceived stress were associated with detection. Similar factors did not drive referral or counseling uptake. Conclusions Nurses detected patients with depressive symptoms at rates comparable to primary care providers in high-resource settings, though gaps in referral and uptake persist. Nurses were more likely to detect symptoms among patients in more severe mental distress. Implementation strategies for integrated mental health care in low-resource settings should target improved rates of detection, referral, and uptake.

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Relationship between depressive symptoms, alcohol use, and antiretroviral therapy adherence among HIV-infected, clinic-attending patients in South Africa

Journal of Health Psychology ◽

10.1177/1359105316628743 ◽

2016 ◽

Vol 22 (11) ◽

pp. 1426-1433 ◽

Cited By ~ 8

Author(s):

Jessica F Magidson ◽

Wylene Saal ◽

Adriaan Nel ◽

Jocelyn E Remmert ◽

Ashraf Kagee

Keyword(s):

South Africa ◽

Depressive Symptoms ◽

Antiretroviral Therapy ◽

Alcohol Use ◽

Sub Saharan Africa ◽

Level Measurement ◽

Antiretroviral Therapy Adherence ◽

Prevalence Of Depression ◽

Sub Saharan ◽

Independent Association

Despite the prevalence of depression and alcohol use among HIV-infected individuals, few studies have examined their association together in relation to nonadherence to antiretroviral therapy in sub-Saharan Africa. This study examined depressive symptoms, alcohol use, and other psychosocial factors (stigma, demographic characteristics) in relation to nonadherence to antiretroviral therapy among clinic-attending, HIV-infected individuals in South Africa ( n = 101). Nonadherence was assessed using event-level measurement (missed doses over the past weekend). Multivariable logistic regression analyses revealed that only alcohol use, over and above depressive symptoms and education level, was associated with antiretroviral therapy nonadherence(AOR = 1.15; 95%CI = 1.02–1.29; p < .05). Findings point to the independent association of alcohol use and nonadherence to antiretroviral therapy above and beyond depressive symptoms.

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