Mental Health Disorders with Psychosis in Pregnant and Non-Pregnant Women in Sub-Saharan Africa Open Access

Abstract

Maternal mental health is a persisting global maternal child health issue; however, this area remains under-researched, especially pertaining to psychosis disorders in African populations. Using the Neuropsychiatric Genetics in African Populations Psychosis (NeuroGAP-Psychosis) Study data, this exploratory analysis aims to examine the prevalence of mental health disorders with psychosis (MHP), such as schizophrenia and bipolar disorder, among pregnant and non- pregnant women and to characterize covariates that are associated with MHP conditions. The data included female participants from Ethiopia (n = 13,000), Kenya (n = 8,355), Uganda (n = 9,598), and South Africa (n = 12,000). Overall, the prevalence of MHP diagnosis among pregnant and non-pregnant women is 37.7% and 49.7% respectively. Schizophrenia diagnosis ranged from 18.3% to 26.9% and bipolar/mania diagnosis from 19.3% - 22.8%. Three binary logistic regression models were used in this study to examine the association between pregnancy and psychosis. Pregnant women who were married were 60% less likely (OR 0.4; 95% CI: 0.25- 0.63) to experience MHP and non-pregnant women who were married were 51% less likely (OR 0.49, 95% CI 0.46-0.52) to experience MHP compared to their single/divorce/widowed counterparts. Using women with a college level education as the reference group, women with primary or below (Pregnant: OR 1.76, 95% CI 1.05-3.00; Non-Pregnant: OR 1.87, 95% CI 1.72- 2.04) or secondary school education (Pregnant: OR 2.00, 95% CI 1.21-3.37; Non-Pregnant: OR 1.66, 95% CI 1.53-1.79) were more likely to experience MHP. Additional research is needed to identify other potential covariates that are country and population specific and can be used to inform future research that can enact change in care for women.

Table of Contents

Introduction.....................................................................................................1 

Literature Review..............................................................................................2

Methods..........................................................................................................11

Variable Coding Strategy...........................................................................14

Modeling..................................................................................................16

Results............................................................................................................16

Prevalence................................................................................................18 

Statistical Analysis....................................................................................19

Discussion/Conclusion......................................................................................20

Implications/Recommendations........................................................................26

Reference List..................................................................................................27

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health Health Sciences, Mental Health
Keyword	Sub-Saharan Africa Pregnant Women Mental Health Psychosis
Committee Chair / Thesis Advisor	Melissa Fox Young, PhD, Emory University
Committee Members	Rocky E. Stroud II, MPH, MSM, Emory University Rachel Waford, PhD, ABPP, Emory University Johnathan A. Edwards, MSPH, Emory University

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