Table 2.
Reported prevalence of perinatal mental illness in the Middle East and North Africa.
| Country | Study | Illness | Study Setting | Sample Size | Study Instrument | Instrument Cut off Score | Antepartum | Postpartum | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1st Trimester | 2nd Trimester | 3rd Trimester | All Three | <6 Weeks | 6 Weeks to 3 Months | >3 Months up to 1 Year | |||||||
| Bahrain | (Al Dallal and Grant, 2012) [48] | Depression | Hospital | 237 | EPDS | ≥12 | - | - | - | - | - | 37.1% | - |
| Egypt | (Naglaa A. Mohamed and Maklof, 2011) [104] | Depression | Hospital | 110 | EPDS | Unclear | - | - | - | - | - | - | 51.8% |
| Egypt | (Saleh el et al., 2013) [113] | Depression | Unclear | 120 | EPDS | ≥13 | - | - | - | - | - | - | 17.9% |
| Jordan | (Mohammad et al., 2011) [65] | Depression | Hospital | 353 | EPDS | Unclear | - | - | 19.0% | - | - | 22.1% | 21.2% |
| Jordan | (Yehia et al., 2013) [69] | Depression | Hospital | 300 | EPDS | Unclear | - | - | - | - | - | - | 83.0% |
| Lebanon | (Chaaya et al., 2002) [53] | Depression | Hospital | 396 | EPDS | >12 | - | - | - | - | - | - | 21.0% |
| Morocco | (Agoub et al., 2005) [47] | Depression | Hospital | 144 | MINI | N/A | - | - | - | - | 6.9–18.7% | - | 5.6–11.8% |
| 144 | EPDS | >12 | - | - | - | - | 20.1% | - | - | ||||
| Morocco | (Alami et al., 2006) [51] | Depression | Hospital | 100 | EPDS | Unclear | - | - | - | - | 21% | - | - |
| 100 | MINI | N/A | 17.4% | 16.0% | 15.7%% | 19.2% | 16.8% | 14.0% | 6–12% | ||||
| Oman | (Al Hinai and Al Hinai, 2014) [49] | Depression | Hospital | 282 | EPDS | >13 | - | - | - | - | 13.5% | 10.6% | - |
| Pakistan | (Ahmed, 2005) [78] | Depression | Hospital | 90 | EPDS | Unclear | - | - | - | - | - | - | 27.0% |
| Pakistan | (Ali et al., 2009) [80] | Depression& Anxiety | Community | Unclear | AKUADS/ Unclear diagnostic tool | Unclear | - | - | - | - | - | - | 28.8% * |
| Pakistan | (Ali et al., 2012) [81] | Depression | Hospital | 167 | HADS | ≥8 | - | - | - | 16.8% | - | - | - |
| Pakistan | (Din et al., 2016) [86] | Depression | Hospital | 230 | DASS-42 | ≥9 | - | - | 29.1% | - | - | - | - |
| Pakistan | (Gulamani et al., 2013) [74] | Depression | Hospital | 214 | EPDS | Unclear | - | - | - | - | 15.3–35.3% | - | |
| Pakistan | (Habib, 1997) [94] | Postnatal blues & PPD | Unclear | 30 | Gordon’s (1984); Pitt’s (1968) | Unclear | - | - | - | - | 50.0% | - | 20–37% |
| Pakistan | (Fareeha Hamid, 2008) [89] | Depression | Hospital | 100 | HADS | Unclear | - | - | - | 18.0% | - | - | - |
| Pakistan | (Humayun et al., 2013) [95] | Depression | Hospital | 506 | EPDS | ≥ 10 | - | - | 75.0% | - | - | - | - |
| Pakistan | (Husain et al., 2006) [57] | Depression | Community | 149 | EPDS | ≥12 | - | - | - | - | - | 36.0% | - |
| Pakistan | (Husain et al., 2011) [58] | Depression | Hospital | 149 | EPDS | >12 | - | - | 25.8% | - | - | - | 38.3% |
| Pakistan | (Husain et al., 2014) [75] | Depression | Hospital | 1357 | EPDS | ≥12 | - | - | 13.4% | - | - | - | - |
| Pakistan | (Haider, 2010)[55] | Depression | Hospital | 213 | EPDS | >12 | - | - | 42.7% | - | - | - | - |
| Pakistan | (Kalyani et al., 2001) [59] | Depression | Community | 120 | EPDS | >10 | - | - | - | - | 63.3% | - | - |
| Pakistan | (Karmaliani et al., 2006) [98] | Perinatal mental disorders | Community | 1000 | AKUADS | Unclear | - | 11.5% | - | - | - | - | - |
| Pakistan | (Karmaliani et al., 2009) [60] | Depression | Community | 1368 | AKUADS | ≥13 | - | 18.0% | - | - | - | - | - |
| Pakistan | (Kazi et al., 2006) [76] | Depression | Hospital | 292 | CES-D | ≥16 | - | - | - | 39.4% | - | - | - |
| Pakistan | (Sharifa Mir, 2012) [115] | Depression | Hospital | 328 | AKUADS | >13 | - | - | - | 33.8% | - | - | - |
| Pakistan | (Muneer et al., 2009) [103] | Depression | Unclear | 154 | EPDS | Unclear | - | - | - | - | - | - | 33.0% |
| Pakistan | (Asad et al., 2010) [83] | Depression/ Anxiety | Hospital | 1368 | AKUADS | Unclear | - | 18.0% | - | - | - | - | - |
| Pakistan | (Syeda Rabia, 2017) [117] | Depression | Hospital | 520 | HADS | >8 | - | - | - | 23.1% | - | - | - |
| Pakistan | (Rahman et al., 2003)[67] | Perinatal mental disorders | Community | T0 = 701 T1 = 632 T2 = 541 |
SCAN | N/A | - | - | 25.0% (T1) | - | - | 28.0% (T2) | - |
| Pakistan | (Rahman et al., 2004a) [108] | Depression | Community | 265 | SCAN | N/A | - | - | - | - | - | - | 25.0% |
| Pakistan | (Rahman et al., 2004b) [109] | Depression | Hospital | 172 | SRQ-20 | Unclear | - | - | - | - | - | - | 41.0% |
| Pakistan | (Rahman and Creed, 2007) [66] | Depression | Community | T1: 701 (antepartum) T2: 632 T3: 160 T4: 129 |
SCAN | N/A | - | - | - | - | 94.0% (T2) | 76.0% (T3) |
62% (T4) |
| Pakistan | (Rasheed, 1988) [110] | Postnatal blues & PPD | Unclear | 103 | Unclear | Unclear | - | - | - | - | - | - | 54.4% |
| Pakistan | (Sadaf, 2011) [111] | Depression | Hospital | 150 | HAM-D | Unclear | - | - | - | 10.0% | - | - | - |
| Pakistan | (Saeed et al., 2016) [112] | Depression | Hospital | 82 | EPDS | ≥9 | - | - | - | 42.7% | - | - | - |
| Pakistan | (Shah et al., 2011) [68] | Depression | Community | 128 | EPDS | ≥13 | - | - | - | 46.9% | - | - | - |
| Pakistan | (Yasmeen et al., 2010) [119] | Depression | Hospital | 100 | EPDS | Unclear | - | - | - | - | - | 41.0% | |
| Pakistan | (Waqas et al., 2015) [118] | Depression | Hospital | 500 | HADS | ≥11 | - | - | - | 31.8% | - | - | - |
| Pakistan | (Zahidie et al., 2011) [70] | Depression | Mixed | 375 | CES-D | ≥16 | - | - | - | 61.1% | - | - | - |
| Qatar | (Bener et al., 2012a)[52] | Depression | Hospital | 1379 | EPDS | >12 | - | - | - | - | - | 17.6% | - |
| Saudi Arabia | (Al-Modayfer et al., 2015) [121] | Depression | Hospital | 571 | EPDS | Unclear | - | - | - | - | 14.0% | - | - |
| Saudi Arabia | (Amr and Hussein Balaha, 2010) [72] | Depression | Hospital | 367 | MINI | N/A | - | - | - | - | - | - | 6.0% |
| Saudi Arabia |
(Balaha et al., 2009) [83] | Depression | Hospital | 800 | MINI | N/A | - | - | - | - | - | - | 10.2% |
| Sudan | (Khalifa et al., 2015) [101] | Depression | Hospital | 238 | EPDS | ≥12 | - | - | - | - | - | 9.2% | - |
| 40 | MINI | N/A | - | - | - | - | - | 45%* | - | ||||
| Tunisia | (Masmoudi et al., 2008) [63] | Depression | Hospital | 213 | EPDS | >10 | - | - | - | - | 19.2% | 13.2% | - |
| UAE | (Abou-Saleh and Ghubash, 1997) [45] | Depression | Hospital | 95 | EPDS | >11 | - | - | - | - | 18.0% | - | - |
| 95 | SRQ | Unclear | - | - | - | - | 24.0% | - | - | ||||
| UAE | (Green et al., 2006) [54] | Depression | Hospital | T0 = 125 T1 = 86 T2 = 56 |
EPDS | ≥13 | - | - | - | - | - | 22.0% (T1) | 12.5% (T2) |
| UAE | (Hamdan and Tamim, 2011) [56] | Depression | Hospital | 137 | MINI | N/A | - | - | - | - | - | 10.0% | - |
| EPDS | >10 | - | - | - | - | - | 85.6% | - | |||||
N/A, not applicable as this is a diagnostic tool; * two stage sample and not true prevalence; T, time frame; EPDS, Edinburgh Postnatal Depression Scale; CES-D, Centre for Epidemiologic Studies Depression Scale; MINI, Mini International Neuropsychiatric Interview; SCAN, WHO Schedules for Clinical Assessment in Neuropsychiatry; AKUADS, Aga Khan University Anxiety and Depression Scale; HAM-D, Hamilton Depression Rating Scale; HADS, Hospital Anxiety and Depression scale; SRQ-20, Self-Reporting Questionnaire; and DASS, Depression, Anxiety, Stress Scale. In studies where prevalence was measured at multiple points of the perinatal period: T1= antepartum prevalence; T2 = 1st recording postpartum; T3 = 2nd recording post-partum and T4 = 3rd recording postpartum.