CoChat
Sign Up
Cited by 82Mental Health Treatment and AccessGender Roles and Identity StudiesMental Health and Psychiatry

Explanatory models of depression in sub-Saharan Africa: Synthesis of qualitative evidence.

Open access
Mayston, Rosie, Frissa, Souci, Tekola, Bethlehem, Hanlon, Charlotte, Prince, Martin, Fekadu, Abebaw·2020·Social Science & Medicine
DOI 10.1016/j.socscimed.2019.112760PMC PMC7014569
Open this paper in CoChat — free accountOpen PDF

Abstract

Debate about the cross-cultural relevance of depression has been central to cross-cultural psychiatry and global mental health. Although there is now a wealth of evidence pertaining to symptoms across different cultural settings, the role of the health system in addressing these problems remains contentious. Depression is undetected among people attending health facilities. We carried out a thematic synthesis of qualitative evidence published in the scientific literature from sub-Saharan Africa to understand how depression is debated, deployed and described. No date limits were set for inclusion of articles. Our results included 23 studies carried out in communities, among people living with HIV, attendees of primary healthcare and with healthcare workers and traditional healers. Included studies were carried out between 1995 and 2018. In most cases, depression was differentiated from 'madness' and seen to have its roots in social adversity, predominantly economic and relationship problems, sometimes entangled with HIV. Participants described the alienation that resulted from depression and a range of self-help and community resources utilised to combat this isolation. Both spiritual and biomedical causes, and treatment, were considered when symptoms were very severe and/or other possibilities had been considered and discarded. Context shaped narratives: people already engaged with the health system for another illness such as HIV were more likely to describe their depression in biomedical terms. Resolution of depression focussed upon remaking the life world, bringing the individual back to familiar rhythms, whether this was through the mechanism of encouraging socialisation, prayer, spiritual healing or biomedical treatment. Our findings suggest that it is essential that practitioners and researchers are fluent in local conceptualisations and aware of local resources to address depression. Design of interventions offered within the health system that are attuned to this are likely to be welcomed as an option among other resources available to people living with depression.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.socscimed.2019.112760

Cites

64 of 64 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent systematic narrative synthesis of 25 qualitative studies concluded that depression was rooted in social adversities, especially relationship and financial problems.

    “A recent systematic narrative synthesis of 25 qualitative studies explored the explanatory models of depression in people living in diverse sub-Saharan African countries [25]. The review concluded that depression was rooted in social adversities, especially relationship and financial problems [25].”

    From Experience and perceptions of mental ill-health in people with epilepsy in rural Ethiopia: A qualitative study (2024) · cites this paper as [25]

    The Abstract reports a thematic synthesis of qualitative evidence from sub-Saharan Africa and says depression was seen as rooted in social adversity, predominantly economic and relationship problems. It reports 23 included studies, not the 25 stated in the citing sentence. Page numbers are unavailable in our copy. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • The review noted that manifestations of depression in people with physical health conditions (e.g., HIV, pregnancy) were uniquely described as "thinking too much".

    “The review also noted that manifestations of depression in people with physical health conditions (e.g., HIV, pregnancy) were uniquely described as “thinking too much” [25].”

    From Experience and perceptions of mental ill-health in people with epilepsy in rural Ethiopia: A qualitative study (2024) · cites this paper as [25]

    The Results section (‘Naming and describing the problem’; page unavailable) identifies ‘thinking too much’ as a key feature of depression in every included study of people living with HIV. It also describes the phrase across other settings, so it does not support ‘uniquely,’ and the cited passages do not establish the claim for pregnancy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The experiences and conceptualizations of depression and anxiety have been investigated in some countries of sub-Saharan Africa, including Ethiopia, but not in the context of people with epilepsy.

    “The experiences and conceptualizations of depression and anxiety have similarly been investigated in some countries of sub-Saharan Africa, including Ethiopia, but not in the context of people with epilepsy [25, 26].”

    From Experience and perceptions of mental ill-health in people with epilepsy in rural Ethiopia: A qualitative study (2024) · cites this paper as [25]

    The Results (Description of studies; page unavailable) list qualitative studies across sub-Saharan Africa, including an Ethiopian study that explored perceptions of depression and anxiety. The Abstract describes the reviewed populations without identifying people with epilepsy. This supports the examples of prior research, but does not establish the broader claim that these experiences have not been investigated among people with epilepsy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Kirmayer L. Adeponle A. Dzokoto V.A.A. Varieties of Global Psychology: Cultural Diversity and Constructions of the Self. Global Psychologies. S. Fernando 2018 Palgrave Macmillan Moodley, R. UK
  2. Mkhize N. Hook D. Psychology: an African Perspective. Critical Psychology 2004 University of Cape Town Press Cape Town, South Africa 24 52

Cited by

Sorted by citations

Related

Authors
Mayston, R., Frissa, S., Tekola, B., Hanlon, C., Prince, M., & Fekadu, A.
Affiliations
  • King's College London (GB)
  • Brighton and Sussex Medical School (GB)
Corresponding author
Mayston, Rosie
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2020-02
Volume
246
Pages
112760
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2019.112760
PMC
PMC7014569
OpenAlex
W2997726935
Cited by
82
References
64
Citations by year
2026: 11 · 2025: 11 · 2024: 18 · 2023: 14 · 2022: 9 · 2021: 13 · 2020: 6
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Science & Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • Greater South Information System
Funders
Medical Research Council
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Gender Studies › Gender Roles and Identity Studies
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
depression, sub-Saharan Africa, cross-cultural psychiatry, madness, social adversity, HIV, primary care, traditional healers, healthcare workers, spiritual healing, self-help, community resources, global mental health, health system engagement
MeSH terms
Mental Disorders, Depression, Health Personnel, Humans, Mental Health, Africa South of the Sahara

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review