Monitoring and Evaluation, Medical Informatics, Information Technology and Research Department, Partners in Health, Neno, Malawi.
Pardee RAND Graduate School, RAND Corporation, Santa Monica, CA, USA.
Glob Health Action. 2023 Dec 31;16(1):2241808. doi: 10.1080/16549716.2023.2241808.
Globally, an estimated five percent of adults have major depressive disorder. However, little is known about the relationship between these individuals' depressive symptoms and their household members' mental health and well-being.
We aimed to investigate the prevalence and predictors of depressive symptoms among adult household members of patients living with major depressive disorder in Neno District, Malawi.
As part of a cluster randomized controlled trial providing depression care to adults with major depressive disorder, we conducted surveys with patients' household members ( = 236) and inquired about their overall health, depressive symptoms, disability, and social support. We calculated prevalence rates of depressive disorder and conducted multivariable linear regression and multivariable logistic regression analyses to assess correlates of depressive symptom severity and predictors of having depressive disorder (PHQ-9), respectively, among household members.
We observed that roughly one in five household members (19%) screened positive for a depressive disorder (PHQ-9 > 9). More than half of household members endorsed six or more of the nine symptoms, with 68% reporting feeling 'down, depressed, or hopeless' in the prior two weeks. Elevated depression symptom severity was associated with greater disability (β = 0.17, < 0.001), less social support (β = -0.04, = 0.016), and lower self-reported overall health (β = 0.54, = 0.001). Having depressive disorder was also associated with greater disability (adjusted Odds Ratio [aOR] = 1.12, = 0.001) and less social support (aOR = 0.97, = 0.024).
In the Malawian context, we find that depressive disorder and depression symptoms are shared attributes among household members. This has implications for both screening and treatment, and it suggests that mental health should be approached from the vantage point of the broader social ecology of the household and family unit.
ClinicalTrials.gov (NCT04777006) - March 2, 2021.
据估计，全球有 5%的成年人患有重度抑郁症。然而，人们对这些人抑郁症状与他们家庭成员的心理健康和幸福感之间的关系知之甚少。
我们旨在调查马拉维内诺区患有重度抑郁症患者的成年家庭成员中抑郁症状的患病率和预测因素。
作为一项为患有重度抑郁症的成年人提供抑郁症护理的整群随机对照试验的一部分，我们对患者的家庭成员（=236）进行了调查，并询问了他们的整体健康状况、抑郁症状、残疾和社会支持情况。我们计算了抑郁障碍的患病率，并进行了多变量线性回归和多变量逻辑回归分析，分别评估家庭成员中抑郁症状严重程度的相关因素和抑郁障碍（PHQ-9）的预测因素。
我们发现，大约五分之一的家庭成员（19%）筛查出患有抑郁障碍（PHQ-9>9）。超过一半的家庭成员有六个或更多的九个症状，其中 68%的人在过去两周内报告感到“沮丧、抑郁或绝望”。抑郁症状严重程度升高与残疾程度较高（β=0.17，<0.001）、社会支持较少（β=-0.04，=0.016）和自我报告的整体健康状况较差（β=0.54，=0.001）相关。患有抑郁障碍也与残疾程度较高（调整后的优势比[aOR]=1.12，=0.001）和社会支持较少（aOR=0.97，=0.024）相关。
在马拉维的背景下，我们发现抑郁障碍和抑郁症状是家庭成员共有的特征。这对筛查和治疗都有影响，这表明应该从家庭和家庭单位更广泛的社会生态角度来考虑心理健康。
ClinicalTrials.gov（NCT04777006）-2021 年 3 月 2 日。
