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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa</title>
<author><name sortKey="Dewing, Sarah" sort="Dewing, Sarah" uniqKey="Dewing S" first="Sarah" last="Dewing">Sarah Dewing</name>
<affiliation><nlm:aff id="A1">Health Systems Research Unit, Medical Research Council of South Africa, Tygerberg, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tomlinson, Mark" sort="Tomlinson, Mark" uniqKey="Tomlinson M" first="Mark" last="Tomlinson">Mark Tomlinson</name>
<affiliation><nlm:aff id="A2">Department of Psychology, Stellenbosch University, Stellenbosch, South Africa</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Le Roux, Ingrid M" sort="Le Roux, Ingrid M" uniqKey="Le Roux I" first="Ingrid M." last="Le Roux">Ingrid M. Le Roux</name>
<affiliation><nlm:aff id="A4">Philani Child Health and Nutrition Project, Khayelitsha, Elonwabeni, Cape Town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chopra, Mickey" sort="Chopra, Mickey" uniqKey="Chopra M" first="Mickey" last="Chopra">Mickey Chopra</name>
<affiliation><nlm:aff id="A5">Health Section, United Nations Children's Fund, NY, United States</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tsai, Alexander C" sort="Tsai, Alexander C" uniqKey="Tsai A" first="Alexander C." last="Tsai">Alexander C. Tsai</name>
<affiliation><nlm:aff id="A6">Center for Global Health and Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, United States</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Harvard Medical School, Boston, MA, United States</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23707034</idno>
<idno type="pmc">3762324</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762324</idno>
<idno type="RBID">PMC:3762324</idno>
<idno type="doi">10.1016/j.jad.2013.04.040</idno>
<date when="2013">2013</date>
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<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C20</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa</title>
<author><name sortKey="Dewing, Sarah" sort="Dewing, Sarah" uniqKey="Dewing S" first="Sarah" last="Dewing">Sarah Dewing</name>
<affiliation><nlm:aff id="A1">Health Systems Research Unit, Medical Research Council of South Africa, Tygerberg, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tomlinson, Mark" sort="Tomlinson, Mark" uniqKey="Tomlinson M" first="Mark" last="Tomlinson">Mark Tomlinson</name>
<affiliation><nlm:aff id="A2">Department of Psychology, Stellenbosch University, Stellenbosch, South Africa</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Le Roux, Ingrid M" sort="Le Roux, Ingrid M" uniqKey="Le Roux I" first="Ingrid M." last="Le Roux">Ingrid M. Le Roux</name>
<affiliation><nlm:aff id="A4">Philani Child Health and Nutrition Project, Khayelitsha, Elonwabeni, Cape Town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chopra, Mickey" sort="Chopra, Mickey" uniqKey="Chopra M" first="Mickey" last="Chopra">Mickey Chopra</name>
<affiliation><nlm:aff id="A5">Health Section, United Nations Children's Fund, NY, United States</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tsai, Alexander C" sort="Tsai, Alexander C" uniqKey="Tsai A" first="Alexander C." last="Tsai">Alexander C. Tsai</name>
<affiliation><nlm:aff id="A6">Center for Global Health and Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, United States</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Harvard Medical School, Boston, MA, United States</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of affective disorders</title>
<idno type="ISSN">0165-0327</idno>
<idno type="eISSN">1573-2517</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 id="S1"><title>Background</title>
<p id="P1">Although the public health impacts of food insecurity and depression on both maternal and child health are extensive, no studies have investigated the associations between food insecurity and postnatal depression or suicidality.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We interviewed 249 women three months after they had given birth and assessed food insecurity, postnatal depression symptom severity, suicide risk, and hazardous drinking. Multivariable Poisson regression models with robust standard errors were used to estimate the impact of food insecurity on psychosocial outcomes.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Food insecurity, probable depression, and hazardous drinking were highly prevalent and co-occurring. More than half of the women (149 [59.8%]) were severely food insecure, 79 (31.7%) women met screening criteria for probable depression, and 39 (15.7%) women met screening criteria for hazardous drinking. Nineteen (7.6%) women had significant suicidality, of whom 7 (2.8%) were classified as high risk. Each additional point on the food insecurity scale was associated with increased risks of probable depression (adjusted risk ratio [ARR], 1.05; 95% CI, 1.02–1.07), hazardous drinking (ARR, 1.04; 95% CI, 1.00–1.09), and suicidality (ARR, 1.12; 95% CI, 1.02–1.23). Evaluated at the means of the covariates, these estimated associations were large in magnitude.</p>
</sec>
<sec id="S4"><title>Limitations</title>
<p id="P4">The study is limited by lack of data on formal DSM-IV diagnoses of major depressive disorder, potential sample selection bias, and inability to assess the causal impact of food insecurity.</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">Food insecurity is strongly associated with postnatal depression, hazardous drinking, and suicidality. Programmes promoting food security for new may enhance overall psychological well-being in addition to improving nutritional status.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7906073</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4424</journal-id>
<journal-id journal-id-type="nlm-ta">J Affect Disord</journal-id>
<journal-id journal-id-type="iso-abbrev">J Affect Disord</journal-id>
<journal-title-group><journal-title>Journal of affective disorders</journal-title>
</journal-title-group>
<issn pub-type="ppub">0165-0327</issn>
<issn pub-type="epub">1573-2517</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23707034</article-id>
<article-id pub-id-type="pmc">3762324</article-id>
<article-id pub-id-type="doi">10.1016/j.jad.2013.04.040</article-id>
<article-id pub-id-type="manuscript">NIHMS477278</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Dewing</surname>
<given-names>Sarah</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tomlinson</surname>
<given-names>Mark</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>le Roux</surname>
<given-names>Ingrid M.</given-names>
</name>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chopra</surname>
<given-names>Mickey</given-names>
</name>
<xref ref-type="aff" rid="A5">e</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tsai</surname>
<given-names>Alexander C.</given-names>
</name>
<xref ref-type="aff" rid="A6">f</xref>
<xref ref-type="aff" rid="A7">g</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Health Systems Research Unit, Medical Research Council of South Africa, Tygerberg, South Africa</aff>
<aff id="A2"><label>b</label>
Department of Psychology, Stellenbosch University, Stellenbosch, South Africa</aff>
<aff id="A3"><label>c</label>
Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa</aff>
<aff id="A4"><label>d</label>
Philani Child Health and Nutrition Project, Khayelitsha, Elonwabeni, Cape Town, South Africa</aff>
<aff id="A5"><label>e</label>
Health Section, United Nations Children's Fund, NY, United States</aff>
<aff id="A6"><label>f</label>
Center for Global Health and Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, United States</aff>
<aff id="A7"><label>g</label>
Harvard Medical School, Boston, MA, United States</aff>
<author-notes><corresp id="FN1"><label>*</label>
Corresponding author at: MGH Center for Global Health, 100 Cambridge Str., 15th floor, Boston, MA 02114, United States. Tel.: +1 617 724 1120. <email>actsai@partners.org</email>
(A.C. Tsai)</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>19</day>
<month>8</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>23</day>
<month>5</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><day>5</day>
<month>9</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>05</day>
<month>9</month>
<year>2014</year>
</pub-date>
<volume>150</volume>
<issue>2</issue>
<fpage>460</fpage>
<lpage>465</lpage>
<permissions><copyright-statement>© 2013 Elsevier B.V. All rights reserved.</copyright-statement>
<copyright-year>2013</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Although the public health impacts of food insecurity and depression on both maternal and child health are extensive, no studies have investigated the associations between food insecurity and postnatal depression or suicidality.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We interviewed 249 women three months after they had given birth and assessed food insecurity, postnatal depression symptom severity, suicide risk, and hazardous drinking. Multivariable Poisson regression models with robust standard errors were used to estimate the impact of food insecurity on psychosocial outcomes.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Food insecurity, probable depression, and hazardous drinking were highly prevalent and co-occurring. More than half of the women (149 [59.8%]) were severely food insecure, 79 (31.7%) women met screening criteria for probable depression, and 39 (15.7%) women met screening criteria for hazardous drinking. Nineteen (7.6%) women had significant suicidality, of whom 7 (2.8%) were classified as high risk. Each additional point on the food insecurity scale was associated with increased risks of probable depression (adjusted risk ratio [ARR], 1.05; 95% CI, 1.02–1.07), hazardous drinking (ARR, 1.04; 95% CI, 1.00–1.09), and suicidality (ARR, 1.12; 95% CI, 1.02–1.23). Evaluated at the means of the covariates, these estimated associations were large in magnitude.</p>
</sec>
<sec id="S4"><title>Limitations</title>
<p id="P4">The study is limited by lack of data on formal DSM-IV diagnoses of major depressive disorder, potential sample selection bias, and inability to assess the causal impact of food insecurity.</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">Food insecurity is strongly associated with postnatal depression, hazardous drinking, and suicidality. Programmes promoting food security for new may enhance overall psychological well-being in addition to improving nutritional status.</p>
</sec>
</abstract>
<kwd-group><kwd>Food insecurity</kwd>
<kwd>Postnatal depression</kwd>
<kwd>Suicide</kwd>
<kwd>South Africa</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source>
<award-id>R25 MH060482 || MH</award-id>
</award-group>
<award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source>
<award-id>K23 MH096620 || MH</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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