Review

. 2015 Aug 30:252:27-35.

doi: 10.1016/j.jneumeth.2015.03.016. Epub 2015 Mar 19.

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

D J Stein¹, N Koen², K A Donald³, C M Adnams⁴, S Koopowitz⁴, C Lund⁴, A Marais⁴, B Myers⁵, A Roos⁶, K Sorsdahl⁴, M Stern⁴, M Tomlinson⁷, C van der Westhuizen⁴, B Vythilingum⁴, L Myer⁸, W Barnett³, K Brittain³, H J Zar³

Affiliations

¹ Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa. Electronic address: dan.stein@uct.ac.za.
² Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa.
³ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
⁴ Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
⁵ Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa.
⁶ Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa; Department of Psychiatry, Stellenbosch University, South Africa.
⁷ Department of Psychology, Stellenbosch University, South Africa.
⁸ School of Public Health and Family Medicine, University of Cape Town, South Africa.

PMID: 25797842
PMCID: PMC4556362
DOI: 10.1016/j.jneumeth.2015.03.016

Review

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

D J Stein et al. J Neurosci Methods. 2015.

. 2015 Aug 30:252:27-35.

doi: 10.1016/j.jneumeth.2015.03.016. Epub 2015 Mar 19.

Authors

Affiliations

¹ Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa. Electronic address: dan.stein@uct.ac.za.
² Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa.
³ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
⁴ Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
⁵ Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa.
⁶ Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa; Department of Psychiatry, Stellenbosch University, South Africa.
⁷ Department of Psychology, Stellenbosch University, South Africa.
⁸ School of Public Health and Family Medicine, University of Cape Town, South Africa.

PMID: 25797842
PMCID: PMC4556362
DOI: 10.1016/j.jneumeth.2015.03.016

Abstract

Background: Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).

Methods: We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.

Results: Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.

Discussion: These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.

Keywords: Birth cohort; Child health; Depression; Intimate partner violence; South Africa; Substance use.

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Figures

**Figure 1**
Table of antenatal and perinatal psychosocial measures

**Fig. 2**
(a) Prevalence of maternal psychological distress and depression across recruitment site. (b) Prevalence of recent intimate partner violence (IPV) and suspected PTSD across recruitment site. (c) Prevalence of self-reported lifetime substance use across

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Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

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Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

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