Postpartum Depression

One research assistant of the mental health unit was awarded a 30- month fellowship to study for an MSc. in Psychiatric Research Methods in the Institute of Psychiatry, King’s College- University of London,UK. The Wellcome Trust awarded this Fellowship, which covers the MSc. and project work.

For the project component of the fellowship the principal investigator would study prospectively, the risks factors for and effects of postpartum depression among women in the Kintampo district. Before the prospective cohort study comes on board, a validation of the study instruments would be conducted. The validation component of the project would be executed in April 2005.

The study would make an important contribution to the research portfolio in KHRC as it bridges three of the core research areas; demographic surveillance, maternal health and mental health. Postpartum depression is an area of major public health importance, which has been largely neglected by the research community in Sub-Saharan Africa.

i) Hypotheses to be tested;

Sociodemographic and socioeconomic factors will be risk factors for the development of postpartum depression.

ii) Aims of the project;

The research offers the opportunity to study some of the health consequences of population change. The study population is largely rural, however the district capital is becoming increasingly urbanised. Substantial migration is occurring from the villages to the district capital, Kintampo Town . This has been intensified by the war in neighbouring Cote D'Ivoire because Kintampo lies on what has now become the major trading route into Burkina Faso . This has resulted in many additional opportunities in these towns, particularly for traders and food sellers, those providing services and commercial sex workers. The study population is clearly undergoing rapid change. The proposed study will therefore enable us to examine the effects of the changing sociodemographic and socioeconomic variables, which are a consequence of population migration, on the incidence and consequences of postpartum depression.

The specific objectives of the project are as follows:

1. To establish the validity and reliability of the Twi versions of the Edinburgh Postnatal depression Scale (EPDS) and the Patient Health Questionnaire (PHQ) in a sample of pregnant and postpartum women in Kintampo district.
2. To determine the prevalence and incidence of postpartum depression among women living in Kintampo district after delivery of a live or stillbirth.
3. To assess risk factors for incident postnatal depression, and the maintenance of antenatal depression into the pueperium.

The study is a prospective cohort study nested within a larger field trial studying maternal and infant mortality, called the ObaapaVitA study.

The cohort study will recruit all women in the Kintampo District and who go on to deliver a live or stillbirth within the ObaapaVitA study. The study is in two phases; the validity study and the prevalence/incidence study.

The validity study would involve recruiting 150 women 6-10 weeks postpartum. The prevalence/incidence study would recruit 320 in their final trimester of pregnancy

•  To integrate mental health component into the demographic surveillance activities at the Kintampo Health Research Centre for longitudinal studies of people with mental illness.

•  Provide leadership in the formation of a mental health interest group with the INDEPTH network.

•  To develop a neuro-cognitive study of cases with a diagnosis of schizophrenia

•  To develop a protocol to study risk factors for cases of epilepsy identified on the psychiatric case register.

•  To study the epidemiology of eating disorders with Collaborators from Hospital for Sick Kids in Canada .

•  Conduct Dementia studies.

Contact: Ben.weobong@ghana-khrc.org