Prevalence and Correlates of Likely Major Depressive Disorder among the Adult Population in Ghana during the COVID-19 Pandemic

Abstract

Background: Emerging research suggests that the novel coronavirus disease (COVID-19) pandemic and associated public health restrictions have caused psychological distress in many contexts. In order for public health authorities and policy makers to effectively address the psychological distress associated with the pandemic, it is important to determine the prevalence and correlates of mental disorders, including depression. Objectives: We aimed to determine the prevalence, and demographic, social, clinical and other COVID-19 related correlates of major depressive disorder symptoms among the general population in Ghana during the COVID-19 pandemic. Method: The study was a cross-sectional survey using online data collection methods. The survey assessed demographic, social and clinical variables as well as COVID-19 related variables. Major depressive disorder symptoms were assessed using the Patient Health Questionnaire-9. The survey link was distributed primarily through WhatsApp-based platforms. Data were analyzed using descriptive and inferential statistics. Results: The overall prevalence of likely MDD symptoms among the sample population was 12.3%. Variables such as employment, loss of jobs during the pandemic and rate of exposure to COVID-related news were independently and significantly associated with the likelihood that respondents had likely MDD. Variables such as gender, relationship, housing status and having a family member or friend who was sick from COVID-19 were not independently significantly associated with the likelihood that respondents had likely MDD, when all other factors in the model were controlled. Conclusion: This study has identified the prevalence and correlates of depression symptoms in Ghana during the COVID-19 pandemic. There is the urgent need for mental health policy makers and the government of Ghana to have policies in place to alleviate the potential threat to the mental health of the population.

First-onset major depression during the COVID-19 pandemic: A predictive machine learning model

“…Therefore, the higher depression rates identified in previous Italian studies may have included depressive conditions before the pandemic, were secondary to other current psychiatric disorders, or were recurrent depression in previously remitted people. Similar factors, in addition to social and cultural differences, may explain the higher rates of self-reported depression that were found in most other studies worldwide ( Adu et al, 2021 ; Cénat et al, 2021 ; Ettman et al, 2020 ; Hao et al, 2020 ; Lakhan et al, 2020 ; Liu et al, 2020a , Liu et al, 2020b ; Luo et al, 2020 ; Salari et al, 2020 ; Solomou and Constantinidou, 2020 ; Wu et al, 2021 ).…”

“…These rates differ greatly across countries, likely due to differences in psychometric tools, phase of the pandemic, and cultural or social context. However, they were higher than pre-pandemic rates ( Adu et al, 2021 ; Cénat et al, 2021 ; Ettman et al, 2020 ; Hao et al, 2020 ; Lakhan et al, 2020 ; Liu et al, 2020a , Liu et al, 2020b ; Luo et al, 2020 ; Salari et al, 2020 ; Solomou and Constantinidou, 2020 ; Wu et al, 2021 ). A recent estimate of the global prevalence and burden of major depressive disorder (MDD) in 204 countries and territories found an increase of 27.6% in 2020 due to the COVID-19 pandemic ( Santomauro et al, 2021 ).…”

“…Several possible predictors of self-reported depression in the general population during the pandemic have been recognized, including sociodemographic factors, such as being female; employment status, such as job loss; pandemic-related stressful experiences; low social support; and personal characteristics such as having a lower level of coping mechanisms with stressors ( Adu et al, 2021 ; Arpino and Pasqualini, 2021 ; Bruno et al, 2020 ; Liu et al, 2020b ; Prout et al, 2020 ; Rossi et al, 2020 ; Solomou and Constantinidou, 2020 ; Vindegaard and Benros, 2020 ). However, most results came from traditional statistical analyses, which were insufficient for identifying the most relevant predictors of depression in large sets of interrelated variables.…”

The potential impact of Covid-19 on CNS and psychiatric sequels

“…As a result, it promotes hyper-activation of the HPA axis, resulting in raised levels of cortisol and corticotropin-releasing hormone, both of which have been proven to rise in depression patients in studies. According to reports, patients treated with interferon- show evidence of depression due to HPA axis activation ( Adu et al, 2021 , Dhrisya et al, 2020 ). As a consequence, COVID-19 infection causes hyperinflation, which inhibits serotonin biosynthesis and causes hyperactivation of the HPA axis, resulting in MDD.…”

“…In another way for COVID-19 to cause hyperinflammation, the virus can attach with its spike to the ACE2 receptor and enter the alveoli cells with the receptors; as a result, the levels of ACE2 receptors are reduced, causing high levels of angiotensin II (which has anti-inflammatory properties), and inflammation is increased as a result of these events. Hyperinflammation can arise in various organs, notably the CNS, because ACE2 receptors are expressed in the gastrointestinal system, heart, kidney, endothelium, and CNS ( Adu et al, 2021 , Harrison et al, 2020 ). Therefore, the entry of COVID-19 into the CNS via the ACE2 pathway and subsequent inflammation can play a significant role in the development of MDD.…”