Objectives: Adults in South Africa demonstrate rates of mental illness at or above levels elsewhere in the developing world. Yet there is a research gap regarding the social context surrounding mental health in this region. The objective of this analysis was to characterize the prevalence and correlates of depressive symptoms and perceived stress among a heterogeneous South African population.
Methods: Low-income adults (n = 257) in Capetown, Port Elizabeth and Durban were interviewed regarding demographics, income, subjective social status, life events and decision-making. The Center for Epidemiologic Studies Depression Scale (CES-D) and Cohen’s Perceived Stress Scale (PSS) were used.
Results: CES-D scores were 18.8 (SD 11.7), with 50.4% of men and 64.5% of women exceeding the cut-off at which professional care is recommended (p = 0.03). PSS scores were 18.6 (SD 6.7), with a mean of 17.5 among men and 19.6 among women (p = 0.02). In multivariate regressions, increased CES-D scores were associated with more household members (p<0.1), lower educational attainment (p = 0.07), less income stability (p<0.07), lower subjective social status (p<0.01) and independent decision-making (p = 0.04). Increased PSS scores were associated with female gender (p<0.05), multiracial race (p<0.02), more household members (p<0.1), lower subjective social status (p<0.02) and recent birth or catastrophe (p<0.01).
Conclusions: Depressive symptoms and perceived stress are public health concerns in this sample, with more symptoms among those with fewer resources. The prevention of mental illness is critical, especially in vulnerable populations.
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Funding: This study was funded by the National Science Foundation (SES-0424067 and CAREER SES-0547898), BASIS/USAID (CRSP), the Princeton University Center for Migration, the Social Science Research Council Program in Applied Economics and the Federal Reserve Bank of New York.
Competing interests: None.
Ethics approval: Ethics approval for this research was obtained from the Princeton University Institutional Review Panel and the research proposal was reviewed and approved by the legal department of the South African lending organisation with whom the authors worked.
The views expressed in this paper are not necessarily shared by any of the funders or the Federal Reserve System.