Major depressive disorder in sub-Saharan Africa: findings from the Neuro-GAP-Psychosis study

Major depressive disorder (MDD) is a significant contributor to the burden of mental disorders in Africa, necessitating an understanding of its prevalence and risk factors across diverse socio-cultural contexts to address health disparities and improve care. This cross-sectional study analyzed 7,073 adult participants from hospital settings in Uganda, Kenya, Ethiopia, and South Africa within the NeuroGAP-Psychosis study. Prevalence estimates, calculated with 95% confidence intervals, revealed overall rates of 0.9% for current MDD and 5.1% for lifetime MDD, with South Africa reporting the highest prevalence (2.1% current, 8.4% lifetime). Multilevel logistic regression identified significant associations between current MDD and negative life events, alcohol use, and Kessler psychological distress scores, while lifetime MDD was linked to age, female sex, chronic pain, frequent headaches, and positive psychosis screening. These findings underscore the need for targeted mental health interventions tailored to the identified risk factors to reduce the burden of MDD in the studied populations.