“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town
Identifieur interne : 001F29 ( Pmc/Curation ); précédent : 001F28; suivant : 001F30“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town
Auteurs : Thandi Davies ; Marguerite Schneider ; Memory Nyatsanza ; Crick LundSource :
- Transcultural psychiatry [ 1363-4615 ] ; 2016.
Abstract
This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semistructured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women’s lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.
Url:
DOI: 10.1177/1363461516632389
PubMed: 26905932
PubMed Central: 5582156
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<front><div type="abstract" xml:lang="en"><p id="P1">This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semistructured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women’s lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9708119</journal-id>
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<title-group><article-title>“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Davies</surname>
<given-names>Thandi</given-names>
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<contrib contrib-type="author"><name><surname>Schneider</surname>
<given-names>Marguerite</given-names>
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<contrib contrib-type="author"><name><surname>Nyatsanza</surname>
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<contrib contrib-type="author"><name><surname>Lund</surname>
<given-names>Crick</given-names>
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<aff id="A1">University of Cape Town</aff>
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<author-notes><corresp id="FN1">Corresponding author: Thandi Davies, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa. <email>thandi.davies@uct.ac.za</email>
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<pub-date pub-type="nihms-submitted"><day>10</day>
<month>8</month>
<year>2017</year>
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<pub-date pub-type="epub"><day>23</day>
<month>2</month>
<year>2016</year>
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<pub-date pub-type="ppub"><month>6</month>
<year>2016</year>
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<pub-date pub-type="pmc-release"><day>04</day>
<month>9</month>
<year>2017</year>
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<volume>53</volume>
<issue>3</issue>
<fpage>286</fpage>
<lpage>312</lpage>
<pmc-comment>elocation-id from pubmed: 10.1177/1363461516632389</pmc-comment>
<abstract><p id="P1">This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semistructured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women’s lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.</p>
</abstract>
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<kwd>South Africa</kwd>
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