Prevalence and correlates of depression during the COVID-19 pandemic and the major role of stigmatization in low- and middle-income countries: A multinational cross-sectional study

Psychiatry Res. 2021 Mar:297:113714. doi: 10.1016/j.psychres.2021.113714. Epub 2021 Jan 8.

Abstract

Objectives: Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs.

Methods: Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2.

Results: The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries.

Conclusions: The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.

Keywords: COVID-19; DR Congo, Haiti, Rwanda and Togo; Depression; Resilience; Stigmatization.

MeSH terms

  • Adult
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • COVID-19 / epidemiology
  • COVID-19 / psychology*
  • Cross-Sectional Studies
  • Democratic Republic of the Congo / epidemiology
  • Depression / epidemiology*
  • Educational Status
  • Female
  • Haiti / epidemiology
  • Humans
  • Income
  • Male
  • Mental Health
  • Middle Aged
  • Pandemics
  • Poverty
  • Prevalence
  • Rwanda / epidemiology
  • SARS-CoV-2*
  • Social Stigma*
  • Stereotyping
  • Togo
  • Young Adult