Food insecurity and common mental disorders in perinatal women living in low socio-economic settings in Cape Town, South Africa during the COVID-19 pandemic: a cohort study

Household Food ◽

Abstract Objective: Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with food insecurity, domestic violence and lack of social support. This study explores the relationship between household food insecurity, mental health status and several adverse social and economic factors experienced by perinatal women during the COVID-19 pandemic.Design: Cohort study, using telephonic interviews at two time-points, three months apart. Logistic regression analysis was used to model the associations of several baseline risk factors with the occurrence of household food insecurity at follow-up as the outcome.Setting: Midwife obstetric units or basic antenatal care units in Cape Town, South Africa.Participants: The sample comprised of 880 perinatal women at baseline and 660 women at follow-up. Results: At baseline 23% were pregnant, 54% were unemployed, 13% had a probable CMD, 43% were severely food insecure and 21% experienced domestic abuse in the past year. Of the 660 women interviewed at follow-up, 71% were unemployment, 3.5% were pregnant, 7% had a probable CMD, and 32% were severely food insecure. In the multivariate regression model, after controlling for ethnicity, number of children, being HIV-infected, and having a planned pregnancy, the odds of being food insecure were greater in women who were unemployed (OR=1.88; p=0.001) or had probable CMD (OR=2.20; p=0.019) at baseline. Conclusions: This study highlights a range of socio-demographic and mental health related variables that predict food insecurity among perinatal women during the COVID-19 pandemic.

Food insecurity and common mental disorders in perinatal women living in low socio-economic settings in Cape Town, South Africa during the COVID-19 pandemic: a cohort study

10.21203/rs.3.rs-692244/v2 ◽

2021 ◽

Author(s):

Zulfa Abrahams ◽

Crick Lund

Keyword(s):

Mental Health ◽

South Africa ◽

Mental Disorders ◽

Food Insecurity ◽

Common Mental Disorders ◽

Cape Town ◽

Baseline Risk ◽

Multivariable Logistic Regression Analysis ◽

Abstract Background Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with poverty, food insecurity and domestic violence. We used data collected from perinatal women at two time-points during the COVID-19 pandemic to test the hypotheses that (1) socio-economic adversities at baseline would be associated with higher CMD prevalence at follow-up and (2) worse mental health at baseline would be associated with higher food insecurity prevalence at follow-up. Methods Telephonic interviews were conducted with perinatal women attending healthcare facilities in Cape Town, South Africa. Multivariable logistic regression analysis was used to model the associations of baseline risk factors with the prevalence of household food insecurity and CMD at 3 months follow-up. Results At baseline 859 women were recruited, of whom 217 (25%) were pregnant, 106 (12%) had probable CMD, and 375 (44%) were severely food insecure. At follow-up (n=634), 22 (4%) were still pregnant, 44 (7%) had probable CMD, and 207 (33%) were severely food insecure. In the multivariable regression model, after controlling for confounders, the odds of being food insecure at follow-up were greater in women who were unemployed [OR=2.05 (1.46-2.87); p<0.001] or had probable CMD [OR=2.37 (1.35-4.18); p=0.003] at baseline; and the odds of probable CMD at follow-up were greater in women with psychological distress [OR=2.81 (1.47-5.39); p=0.002] and abuse [OR=2.47 (1.47-4.39); p=0.007] at baseline. Conclusions This study highlights the complex bidirectional relationship between mental health and socioeconomic adversity among perinatal women during the COVID-19 pandemic.

Impact of Common Mental Disorders on Food Insecurity among Women in Butajira, Ethiopia: A Cohort Study

10.21203/rs.3.rs-26474/v1 ◽

2020 ◽

Author(s):

bilal shikur endris ◽

Seifu Hagos Gebreyesus ◽

Girmay Medhin ◽

Martin Prince ◽

Atalay Alem ◽

...

Keyword(s):

Cohort Study ◽

Mental Disorders ◽

Food Insecurity ◽

Common Mental Disorders ◽

Time Points ◽

South Central ◽

Household Food ◽

Increased Risk ◽

Self Reporting Questionnaire

Abstract Background: There is a growing body of evidence for an association between common mental disorders and food insecurity. However, since most studies have been cross-sectional, it has not been possible to differentiate the direction of the association. The aim of this study was to determine the effect of common mental disorders on food insecurity using a prospective cohort study design. Methods: The study was carried out in Butajira, south-central Ethiopia among mothers who were enrolled in the CMaMiE cohort. A total of 1815 enrolled women were evaluated for symptoms of CMD using the Self-Reporting Questionnaire-20 (SRQ-20) at two time points; August 2012 (time 1, T1) and in August 2014 (time 2, T2). Probable CMD was defined when mothers reported six or more affirmative (yes) responses to the SRQ-20. Household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS) in December 2017 (time 3, T3). Zero inflated negative binomial regression was used to determine the independent effects of CMDs at T1 and T2 on food insecurity score at T3. A Poisson working model was used to determine the risk of being severely food insecure associated with CMD. Results : About two thirds of women (67.0%) were living in food insecure households.The prevalence of CMD was 4.8% at T1 and 10.0% at T2 and only 1.2 % (n=22) women had CMD at both time points. After controlling for potential confounders, women with CMD at T2 only (RR=1.14; 95%CI: 1.02, 1,29) had higher HFIAS scores at T3; Women with CMD at T1 only were not significantly associated with HFIAS score at T3. Women with CMD at T1 only had 4 times higher risk of severe food insecurity (RR=3.96, 95% CI: 2.15-7.27) and women with CMD at T2 only had 2.2 times higher risk of severe food insecurity (RR=2.24, 95% CI: 1.27-3.95) at follow-up. Conclusion : Common mental disorders among mothers were prospectively associated with increased risk of household food insecurity in this rural Ethiopian population. Possible mechanisms such as increased cost for health care, lost productivity and decreased self-efficacy warrant further investigation for their potential to prevent future food insecurity.

Child Dietary Diversity, Household Food Insecurity, Child Stunting and Maternal Mental Health Symptoms in Vakinankaratra, Madagascar

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_146 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 295-295

Author(s):

Christine Walters ◽

Joel Komakech ◽

Hasina Rakotomanana ◽

Barbara Stoecker

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Food Insecurity ◽

Dietary Diversity ◽

Common Mental Disorders ◽

Maternal Mental Health ◽

Child Stunting ◽

Household Food ◽

Adjusted Model

Abstract Objectives This study aimed to determine the association between child dietary diversity, household food insecurity, child stunting, and maternal mental health symptoms in the Vakinankaratra region of Madagascar. Methods This cross-sectional study included 391 mother-child dyads. The World Health Organization (WHO) standards were used for defining child dietary diversity and child stunting and the Household Food Insecurity Access Scale (HFIAS) was used for food insecurity scores. Maternal symptoms of common mental disorders were assessed using the WHO Self-Reporting Questionnaire (SRQ), which was translated into Malagasy and pre-tested; a cutoff of seven was used to indicate the occurrence of symptoms of common mental disorders. Multivariate linear and logistic regression models adjusted for strata, cluster, and confounding variables were conducted with statistical significance set at P < 0.05. Results More than half (56.8%) of the mothers reported symptoms of common mental disorders and more than half of the children (69.4%) were stunted. The mean HFIAS score was 10.3 (±5.6) and mean child dietary diversity score was 3.0 (±1.31). Symptoms of common mental disorders were significantly associated with child dietary diversity score in the bivariate analysis but became nonsignificant in the final adjusted model (β = –0.22, P = 0.06, R2 = 0.07). In the adjusted model, having symptoms of common mental disorders was significantly associated with higher HFIAS score (β = 3.45, P < 0.0001, R2 = 0.13) and HFIAS scores were significantly associated with having symptoms of common mental disorders (AOR = 1.31 [1.09–1.17], P < 0.0001). Maternal symptoms of common mental disorders were significantly associated with stunting (AOR = 1.68 [1.02–2.78], P < 0.05). Conclusions Maternal mental health and household food insecurity were significantly associated in this rural area of the Vakinankaratra region in Madagascar. Furthermore, assessing maternal symptoms of common mental disorders and referring mothers for mental health care appears to be an important consideration for improving child stunting in the region. Funding Sources Oklahoma State University.

The association of household food insecurity and HIV infection with common mental disorders among newly diagnosed tuberculosis patients in Botswana

Public Health Nutrition ◽

10.1017/s1368980020004139 ◽

2020 ◽

pp. 1-9

Author(s):

Qiao Wang ◽

Mbatshi Dima ◽

Ari Ho-Foster ◽

Keneilwe Molebatsi ◽

Chawangwa Modongo ◽

...

Keyword(s):

Mental Disorders ◽

Hiv Infection ◽

Food Insecurity ◽

Common Mental Disorders ◽

Depression And Anxiety ◽

Newly Diagnosed ◽

Cross Sectional ◽

Household Food ◽

Prevalence Of Depression

Abstract Objective: To determine the association between food insecurity and HIV infection with depression and anxiety among new tuberculosis (TB) patients. Design: Our cross-sectional study assessed depression, anxiety and food insecurity with Patient Health Questionnaire (PHQ-9), Zung Anxiety Self-Assessment Scale (ZUNG) and Household Food Insecurity Access Scale, respectively. Poisson regression models with robust variance were used to examine correlates of depression (PHQ-9 ≥ 10) and anxiety (ZUNG ≥ 36). Setting: Gaborone, Botswana. Participants: Patients who were newly diagnosed with TB. Results: Between January and December 2019, we enrolled 180 TB patients from primary health clinics in Botswana. Overall, 99 (55·0 %) were HIV positive, 47 (26·1 %), 85 (47·2 %) and 69 (38·5 %) indicated depression, anxiety and moderate to severe food insecurity, respectively. After adjusting for potential confounders, food insecurity was associated with a higher prevalence of depression (adjusted prevalence ratio (aPR) = 2·30; 95 % CI 1·40, 3·78) and anxiety (aPR = 1·41; 95 % CI 1·05, 1·91). Prevalence of depression and anxiety was similar between HIV-infected and HIV-uninfected participants. Estimates remained comparable when restricted to HIV-infected participants. Conclusions: Mental disorders may be affected by food insecurity among new TB patients, regardless of HIV status.

Intimate partner violence, common mental disorders and household food insecurity: an analysis using path analysis

Public Health Nutrition ◽

10.1017/s1368980016001178 ◽

2016 ◽

Vol 19 (16) ◽

pp. 2965-2974 ◽

Cited By ~ 10

Author(s):

Claudia Leite de Moraes ◽

Emanuele Souza Marques ◽

Michael Eduardo Reichenheim ◽

Marcela de Freitas Ferreira ◽

Rosana Salles-Costa

Keyword(s):

Intimate Partner Violence ◽

Mental Disorders ◽

Food Insecurity ◽

Path Analysis ◽

Partner Violence ◽

Physical Violence ◽

Common Mental Disorders ◽

Intimate Partner ◽

Household Food

AbstractObjectiveTo investigate the direct and indirect associations between psychological and physical intimate partner violence and the occurrence of common mental disorders (CMD) and how they relate to the occurrence of household food insecurity (HFI).DesignThis was a population-based cross-sectional study. Intimate partner violence was assessed using the Brazilian version of the Revised Conflict Tactics Scale (CTS2) and HFI was assessed using the Brazilian Food Insecurity Scale. The propositional analytical model was based on a review of the literature and was tested using path analysis.SettingDuque de Caxias, Greater Rio de Janeiro, Brazil (April–December 2010).SubjectsWomen (n 849) who had been in a relationship in the 12 months preceding the interview.ResultsBoth psychological and physical violence were found to be major risk factors of HFI. Psychological violence was associated with HFI indirectly via physical violence and CMD, and directly by an unidentified path. The effects of physical violence seemed to be manifested exclusively through CMD. Most of the variables in the propositional model related to socio-economic position, demographic characteristics, degree of women’s social support and partner alcohol misuse were retained in the ‘final’ model, indicating that these factors contribute significantly to the increased likelihood of HFI.ConclusionsThe results reinforce the importance of considering domestic violence and other psychosocial aspects of family life when implementing interventions designed to reduce/eradicate HFI.

Domestic violence, food insecurity and mental health of pregnant women in the COVID-19 lockdown in Cape Town, South Africa

10.21203/rs.3.rs-102205/v1 ◽

2020 ◽

Author(s):

Zulfa Abrahams ◽

Sonet Boisits ◽

Marguerite Schneider ◽

Martin Prince ◽

Crick Lund

Keyword(s):

Mental Health ◽

Risk Factors ◽

South Africa ◽

Psychological Distress ◽

Food Insecurity ◽

Pregnant Women ◽

Poisson Regression ◽

Common Mental Disorders ◽

Cape Town ◽

Abstract Introduction Common mental disorders (CMD) such as depression and anxiety are associated with low household income, food insecurity and intimate partner violence in perinatal women. The national COVID-19 lockdown in South Africa resulted in increased levels of poverty and food insecurity. We aimed to explore the relationship between CMDs, food insecurity and experiences of violence among pregnant women during the COVID-19 lockdown.Methods Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data was collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of abuse. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs.Results Of the 2149 women enrolled in the ASSET study, 885 consented to the telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. The strength of the association between key risk factors measured during the lockdown and psychological distress increased during the COVID-19 lockdown. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was almost three times more likely in women who were severely food insecure or who experienced psychological or sexual abuse. Conclusions This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low resource settings in Cape Town, and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.

The association of household food insecurity and HIV infection with common mental disorders among newly diagnosed tuberculosis patients in Botswana

10.1101/2020.08.15.20175315 ◽

2020 ◽

Author(s):

Qiao Wang ◽

Mbatshi Dima ◽

Ari Ho-Foster ◽

Keneilwe Molebatsi ◽

Chawangwa Modongo ◽

...

Keyword(s):

Mental Disorders ◽

Hiv Infection ◽

Food Insecurity ◽

Common Mental Disorders ◽

Depression And Anxiety ◽

Newly Diagnosed ◽

Tuberculosis Patients ◽

Household Food ◽

Prevalence Of Depression

Objective: To determine the association between food insecurity and HIV-infection with depression and anxiety among new tuberculosis patients. Design: Our cross-sectional study assessed depression, anxiety, and food insecurity with Patient Health Questionnaire (PHQ9), Zung Anxiety Self-Assessment Scale (ZUNG), and Household Food Insecurity Access Scale, respectively. Poisson regression models with robust variance were used to examine correlates of depression (PHQ9 ≥ 10) and anxiety (ZUNG ≥ 36). Setting: Gaborone, Botswana. Participants: Patients who were newly diagnosed with tuberculosis. Results: Between January and December 2019, we enrolled 180 TB patients from primary health clinics in Botswana. Overall, 99 (55.0%) were HIV-positive, 47 (26.1%), 85 (47.2%), and 69 (38.5%) indicated depression, anxiety, and moderate to severe food insecurity, respectively. After adjusting for potential confounders, food insecurity was associated with a higher prevalence of depression (adjusted prevalence ratio [aPR] = 2.30; 95% confidence interval [CI] = 1.40, 3.78) and anxiety (aPR = 1.41; 95% CI = 1.05, 1.91). Prevalence of depression and anxiety were similar between HIV-infected and -uninfected participants. Estimates remained comparable when restricted to HIV-infected participants. Conclusions: Mental disorders may be affected by food insecurity among new tuberculosis patients, regardless of HIV status.

The relationship between common mental disorders (CMDs), food insecurity and domestic violence in pregnant women during the COVID-19 lockdown in Cape Town, South Africa

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02140-7 ◽

2021 ◽

Author(s):

Zulfa Abrahams ◽

Sonet Boisits ◽

Marguerite Schneider ◽

Martin Prince ◽

Crick Lund

Keyword(s):

Mental Health ◽

Risk Factors ◽

Domestic Violence ◽

Mental Disorders ◽

Food Insecurity ◽

Poisson Regression ◽

Common Mental Disorders ◽

Cape Town ◽

The Relationship ◽

Abstract Purpose We aimed to explore the relationship between common mental disorders (CMDs), food insecurity and experiences of domestic violence among pregnant women attending public sector midwife obstetric units and basic antenatal care clinics in Cape Town during the COVID-19 lockdown. Methods Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data were collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of domestic violence. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs. Results Of the 2149 women enrolled in the ASSET study, 885 consented to telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was increased in women who were severely food insecure or who experienced psychological or sexual abuse. Conclusions This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low-resource settings in Cape Town and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.

Impact of COVID-19 on child malnutrition, obesity in women and household food insecurity in underserved urban settlements in Sri Lanka: a prospective follow up study

Public Health Nutrition ◽

10.1017/s1368980021001841 ◽

2021 ◽

pp. 1-24

Author(s):

Renuka Jayatissa ◽

Himali Herath ◽

Amila Gayan Perera ◽

Thulasika Thejani Dayaratne ◽

Nawmali Dhanuska De Alwis ◽

...

Keyword(s):

Sri Lanka ◽

Food Insecurity ◽

Child Malnutrition ◽

Nutrition Status ◽

Follow Up Study ◽

Household Food ◽

Before And After ◽

Urban Settlements

Abstract Objectives: To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic. Design: A prospective follow up study. Setting: In 2019, the baseline Urban Health and Nutrition Study (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35% of households from the UHNS-2019 cohort were randomly selected for repeat interviews, one year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer administered questionnaires. Differences in measurements at baseline and follow-up studies were compared. Participants: A total of 207 households, comprising 127 women and 109 children were included. Results: The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18.3%vs13.7%;p=0.26 and 8.3%vs3.7%;p=0.12 respectively). There was a decrease in prevalence of child stunting (14.7%vs11.9%;p=0.37). A change was not observed in overall obesity in women, which was around 30.7%. Repeated lockdown was associated with a significant reduction in food security from 57% in UHNS-2019 to 30% in the current study (p<0.001). Conclusions: There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.

Preconception prediction of expectant fathers' mental health: 20-year cohort study from adolescence

BJPsych Open ◽

10.1192/bjo.2017.10 ◽

2018 ◽

Vol 4 (2) ◽

pp. 58-60 ◽

Cited By ~ 8

Author(s):

Elizabeth Spry ◽

Rebecca Giallo ◽

Margarita Moreno-Betancur ◽

Jacqui Macdonald ◽

Denise Becker ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Mental Disorders ◽

Mental Health Problems ◽

Common Mental Disorders ◽

Common Mental Disorder ◽

Health Problems ◽

Adolescent And Young Adult ◽

Future Research ◽

Expectant Fathers

We examined prospective associations between men's common mental disorders in the decades prior to offspring conception and subsequent paternal antenatal mental health problems. Data came from a prospective intergenerational cohort study which assessed common mental disorder nine times from age 14 to 29 years, and in the third trimester of subsequent pregnancies to age 35 years (N = 295 pregnancies to 214 men). Men with histories of adolescent and young adult common mental disorders were over four times more likely to experience antenatal mental health problems. Future research identifying modifiable perinatal factors that counteract preconception risk would provide further targets for intervention.Declaration of interestNone.