Risk factors for major depressive disorder among adults recruited from hospital settings in Uganda, Kenya, Ethiopia and South Africa
Abstract Major depressive disorder (MDD) significantly contributes to the mental health burden in Africa, requiring insights into prevalence and risk factors to inform culturally responsive care. This study assessed current and lifetime MDD prevalence and associated factors among 7,073 adults from hospital settings in Uganda, Kenya, Ethiopia, and South Africa within the NeuroGAP-Psychosis study. Prevalence was 0.9% for current MDD and 5.1% for lifetime MDD, substantially lower than prior estimates from the region. Lower rates may be due to the population studied or cultural variations in expression of symptoms. 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 factors to reduce the burden of MDD in diverse African contexts.
Authors
- Karoline Kuchenbaecker (ORCID: https://orcid.org/0000-0001-9726-603X)
- Lori B. Chibnik (ORCID: https://orcid.org/0000-0001-6293-806X)
- Dickens H. Akena
- Lukoye Atwoli (ORCID: https://orcid.org/0000-0001-7710-9723)
- Elizabeth G. Atkinson (ORCID: https://orcid.org/0000-0002-6308-776X)
- Rocky E. Stroud (ORCID: https://orcid.org/0000-0002-4246-7093)
- Alicia R. Martin (ORCID: https://orcid.org/0000-0003-0241-3522)
- Allan Kalungi (ORCID: https://orcid.org/0000-0002-2890-0145)
- Dan Joseph Stein (ORCID: https://orcid.org/0000-0001-7218-7810)
- Symon M. Kariuki (ORCID: https://orcid.org/0000-0002-3934-5132)
- Segun Fatumo (ORCID: https://orcid.org/0000-0003-4525-3362)
- Fred Kirumira
- Kester B. B. Tindi
- Mark Barker
- Zukiswa Zingela (ORCID: https://orcid.org/0000-0002-3425-1145)
- Jared G. Maina
- Moffat Nyirenda
- Emmanuel K. Mwesiga
- Charles R.J.C. Newton
- Solomon Teferra
- Wilber Ssembajjwe
- Eugene Kinyanda
Institutions
- Broad Institute (US)
- South African Medical Research Council (ZA)
- Harvard University (US)
- Moi University (KE)
- University of Leicester (GB)
- University of Cape Town (ZA)
- Queen Mary University of London (GB)
- Baylor College of Medicine (US)
- King's College London (GB)
- Kenya Medical Research Institute (KE)
- University of Oxford (GB)
- Massachusetts General Hospital (US)
- London School of Hygiene & Tropical Medicine (GB)
- Aga Khan University Nairobi (KE)
- African Population and Health Research Center (KE)
- University College London (GB)
- Addis Ababa University (ET)
- Makerere University (UG)
- Uganda Virus Research Institute (UG)
- Nelson Mandela University (ZA)
Publication Details
- Journal
- Nature Communications
- Published
- 2026-08-27
- DOI
- https://doi.org/10.1038/s41467-026-77189-6
- Primary Topic
- Mental Health Treatment and Access
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Wellcome Trust
- Broad Institute
- University of Cape Town
- Addis Ababa University