Poor mental health in Ghana: who is at risk?
Identifieur interne : 000574 ( Main/Exploration ); précédent : 000573; suivant : 000575Poor mental health in Ghana: who is at risk?
Auteurs : Heather Sipsma [États-Unis] ; Angela Ofori-Atta [Ghana] ; Maureen Canavan [États-Unis] ; Isaac Osei-Akoto [Ghana] ; Christopher Udry [États-Unis] ; Elizabeth H. Bradley [États-Unis]Source :
- BMC Public Health [ 1471-2458 ] ; 2013.
Abstract
Poor mental health is a leading cause of disability worldwide with considerable negative impacts, particularly in low-income countries. Nevertheless, empirical evidence on its national prevalence in low-income countries, particularly in Africa, is limited. Additionally, researchers and policy makers are now calling for empirical investigations of the association between empowerment and poor mental health among women. We therefore sought to estimate the national prevalence of poor mental health in Ghana, explore its correlates on a national level, and examine associations between empowerment and poor mental health among women.
We conducted a cross-sectional analysis using data from a nationally representative survey conducted in Ghana in 2009–2010. Interviews were conducted face-to-face with participants (N = 9,524 for overall sample; n = 3,007 for women in relationships). We used the Kessler Psychological Distress Scale (K10) to measure psychological distress and assessed women’s attitudes about their roles in decision-making, attitudes towards intimate partner violence, partner control, and partner abuse. We used weighted multivariable multinomial regression models to determine the factors independently associated with experiencing psychological distress for our overall sample and for women in relationships.
Overall, 18.7% of the sample reported either moderate (11.7%) or severe (7.0%) psychological distress. The prevalence of psychological distress was higher among women than men. Overall, the prevalence of psychological distress differed by gender, marital status, education, wealth, region, health and religion, but not by age or urban/rural location. Women who reported having experienced physical abuse, increased partner control, and who were more accepting of women’s disempowerment had greater likelihoods of psychological distress (P-values < 0.05).
Psychological distress is substantial among both men and women in Ghana, with nearly 20% having moderate or severe psychological distress, an estimate higher than those found among South African (16%) or Australian (11%) adults. Women who are disempowered in the context of intimate relationships may be particularly vulnerable to psychological distress. Results identify populations to be targeted by interventions aiming to improve mental health.
Url:
DOI: 10.1186/1471-2458-13-288
PubMed: 23547846
PubMed Central: 3620375
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Poor mental health in Ghana: who is at risk?</title><author><name sortKey="Sipsma, Heather" sort="Sipsma, Heather" uniqKey="Sipsma H" first="Heather" last="Sipsma">Heather Sipsma</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Ofori Atta, Angela" sort="Ofori Atta, Angela" uniqKey="Ofori Atta A" first="Angela" last="Ofori-Atta">Angela Ofori-Atta</name><affiliation wicri:level="3"><nlm:aff id="I2">Department of Psychiatry, University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Psychiatry, University of Ghana Medical School, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Canavan, Maureen" sort="Canavan, Maureen" uniqKey="Canavan M" first="Maureen" last="Canavan">Maureen Canavan</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Osei Akoto, Isaac" sort="Osei Akoto, Isaac" uniqKey="Osei Akoto I" first="Isaac" last="Osei-Akoto">Isaac Osei-Akoto</name><affiliation wicri:level="4"><nlm:aff id="I3">Institute of Statistical, Social and Economic Research, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Institute of Statistical, Social and Economic Research, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Udry, Christopher" sort="Udry, Christopher" uniqKey="Udry C" first="Christopher" last="Udry">Christopher Udry</name><affiliation wicri:level="2"><nlm:aff id="I4">Department of Economics, Yale University, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Economics, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Bradley, Elizabeth H" sort="Bradley, Elizabeth H" uniqKey="Bradley E" first="Elizabeth H" last="Bradley">Elizabeth H. Bradley</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23547846</idno><idno type="pmc">3620375</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620375</idno><idno type="RBID">PMC:3620375</idno><idno type="doi">10.1186/1471-2458-13-288</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000276</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000276</idno><idno type="wicri:Area/Pmc/Curation">000275</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000275</idno><idno type="wicri:Area/Pmc/Checkpoint">000287</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000287</idno><idno type="wicri:Area/Ncbi/Merge">000553</idno><idno type="wicri:Area/Ncbi/Curation">000553</idno><idno type="wicri:Area/Ncbi/Checkpoint">000553</idno><idno type="wicri:Area/Main/Merge">000575</idno><idno type="wicri:Area/Main/Curation">000574</idno><idno type="wicri:Area/Main/Exploration">000574</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Poor mental health in Ghana: who is at risk?</title><author><name sortKey="Sipsma, Heather" sort="Sipsma, Heather" uniqKey="Sipsma H" first="Heather" last="Sipsma">Heather Sipsma</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Ofori Atta, Angela" sort="Ofori Atta, Angela" uniqKey="Ofori Atta A" first="Angela" last="Ofori-Atta">Angela Ofori-Atta</name><affiliation wicri:level="3"><nlm:aff id="I2">Department of Psychiatry, University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Psychiatry, University of Ghana Medical School, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Canavan, Maureen" sort="Canavan, Maureen" uniqKey="Canavan M" first="Maureen" last="Canavan">Maureen Canavan</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Osei Akoto, Isaac" sort="Osei Akoto, Isaac" uniqKey="Osei Akoto I" first="Isaac" last="Osei-Akoto">Isaac Osei-Akoto</name><affiliation wicri:level="4"><nlm:aff id="I3">Institute of Statistical, Social and Economic Research, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Institute of Statistical, Social and Economic Research, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Udry, Christopher" sort="Udry, Christopher" uniqKey="Udry C" first="Christopher" last="Udry">Christopher Udry</name><affiliation wicri:level="2"><nlm:aff id="I4">Department of Economics, Yale University, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Economics, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Bradley, Elizabeth H" sort="Bradley, Elizabeth H" uniqKey="Bradley E" first="Elizabeth H" last="Bradley">Elizabeth H. Bradley</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Poor mental health is a leading cause of disability worldwide with considerable negative impacts, particularly in low-income countries. Nevertheless, empirical evidence on its national prevalence in low-income countries, particularly in Africa, is limited. Additionally, researchers and policy makers are now calling for empirical investigations of the association between empowerment and poor mental health among women. We therefore sought to estimate the national prevalence of poor mental health in Ghana, explore its correlates on a national level, and examine associations between empowerment and poor mental health among women.</p></sec><sec><title>Methods</title><p>We conducted a cross-sectional analysis using data from a nationally representative survey conducted in Ghana in 2009–2010. Interviews were conducted face-to-face with participants (N = 9,524 for overall sample; n = 3,007 for women in relationships). We used the Kessler Psychological Distress Scale (K10) to measure psychological distress and assessed women’s attitudes about their roles in decision-making, attitudes towards intimate partner violence, partner control, and partner abuse. We used weighted multivariable multinomial regression models to determine the factors independently associated with experiencing psychological distress for our overall sample and for women in relationships.</p></sec><sec><title>Results</title><p>Overall, 18.7% of the sample reported either moderate (11.7%) or severe (7.0%) psychological distress. The prevalence of psychological distress was higher among women than men. Overall, the prevalence of psychological distress differed by gender, marital status, education, wealth, region, health and religion, but not by age or urban/rural location. Women who reported having experienced physical abuse, increased partner control, and who were more accepting of women’s disempowerment had greater likelihoods of psychological distress (P-values < 0.05).</p></sec><sec><title>Conclusions</title><p>Psychological distress is substantial among both men and women in Ghana, with nearly 20% having moderate or severe psychological distress, an estimate higher than those found among South African (16%) or Australian (11%) adults. Women who are disempowered in the context of intimate relationships may be particularly vulnerable to psychological distress. Results identify populations to be targeted by interventions aiming to improve mental health.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Prince, M" uniqKey="Prince M">M Prince</name></author><author><name sortKey="Patel, V" uniqKey="Patel V">V Patel</name></author><author><name sortKey="Saxena, S" uniqKey="Saxena S">S Saxena</name></author><author><name sortKey="Maj, M" uniqKey="Maj M">M Maj</name></author><author><name sortKey="Maselko, J" uniqKey="Maselko J">J Maselko</name></author><author><name sortKey="Philllips, M" uniqKey="Philllips M">M Philllips</name></author><author><name sortKey="Rahman, A" uniqKey="Rahman A">A Rahman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Siddiqi, K" uniqKey="Siddiqi K">K Siddiqi</name></author><author><name sortKey="Siddiqi, N" uniqKey="Siddiqi N">N 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Mann</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Connecticut</li><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li></orgName></list><tree><country name="États-Unis"><region name="Connecticut"><name sortKey="Sipsma, Heather" sort="Sipsma, Heather" uniqKey="Sipsma H" first="Heather" last="Sipsma">Heather Sipsma</name></region><name sortKey="Bradley, Elizabeth H" sort="Bradley, Elizabeth H" uniqKey="Bradley E" first="Elizabeth H" last="Bradley">Elizabeth H. Bradley</name><name sortKey="Canavan, Maureen" sort="Canavan, Maureen" uniqKey="Canavan M" first="Maureen" last="Canavan">Maureen Canavan</name><name sortKey="Udry, Christopher" sort="Udry, Christopher" uniqKey="Udry C" first="Christopher" last="Udry">Christopher Udry</name></country><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Ofori Atta, Angela" sort="Ofori Atta, Angela" uniqKey="Ofori Atta A" first="Angela" last="Ofori-Atta">Angela Ofori-Atta</name></region><name sortKey="Osei Akoto, Isaac" sort="Osei Akoto, Isaac" uniqKey="Osei Akoto I" first="Isaac" last="Osei-Akoto">Isaac Osei-Akoto</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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