Prevalence and distribution of depression in Ghana: A nationwide survey using Patient Health Questionnaire-9 (PHQ-9)

Depression often runs a chronic course and substantially impairs an individual's occupational potential and quality of life. The incident cases of depression worldwide increased from 17.2 million in 1990 to 25.8 million in 2017, an increase of 49.86%. Studies among the general population have revealed that socio-demographic factors such as older age, marginalization, and female gender, were important risk. This study sought to provide the prevalence and distribution of cases of depression in Ghana using a nationwide cross-sectional methodology. A total of 5202 participants aged 18-69 years were sampled from all regions of Ghana using a multi-stage cluster sampling approach. Probable depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) as part of the WHO STEPWise survey for non-communicable disease (NCD) risk factors. Data was collected face-to-face and electronically using a pre-loaded structured questionnaire translated into Ga, Ewe, Dagbanli and Twi for inclusivity. Among the respondents, 49.5% were females (n = 2,580), and the majority (44%) were aged 18-29 years. Urban residents constituted 59.9%, while rural dwellers made up 40.1%. Overall, 67.8% of respondents reported no depression, while 32.2% had probable depression. Female respondents were 35% more likely to experience probable depression compared to men (aOR=1.35, 95% CI: 1.12-1.64, p = 0.002). Higher education levels were associated with a 48% lower likelihood of probable depression (aOR=0.52, 95% CI: 0.31-0.86, p = 0.011). Wealthier individuals were 42% more likely to experience probable depression than the poorest respondents (aOR=1.42, 95% CI: 1.05-1.93, p = 0.001). Respondents from households with two or three members were 26% and 29% less likely to report probable depression, respectively, compared to households with more members. Probable depression affects nearly one-third of Ghanaians, with women and individuals from wealthier households disproportionately impacted. Higher education and smaller household sizes are protective factors. These findings underscore the need for mental health interventions targeting socio-demographic disparities.