# Prevalence and social determinants of anxiety and depressive disorders and symptoms among adults in Ghana: A systematic review and meta-analysis

## TL;DR

This study finds that over a third of adults in Ghana experience anxiety or depressive symptoms, with social factors like education and urban living playing a role.

## Contribution

The study provides the first comprehensive meta-analysis of anxiety and depressive disorders in Ghana and identifies key social determinants.

## Key findings

- Pooled prevalence of anxiety symptoms was 40.3% and depressive symptoms was 33.0% among adults in Ghana.
- Educational attainment and urban environment were linked to higher anxiety symptoms.
- Ethnicity and traumatic experiences were associated with higher depressive symptoms.

## Abstract

Anxiety and depressive disorders are global health challenges, placing a significant burden on adults and healthcare systems in low- and middle-income countries (LMICs), such as Ghana. Social determinants of mental health, including poor healthcare access and poverty, may be associated with their prevalence. However, a paucity of prevalence data poses challenges for intervention planning and resource allocation. This review aimed to (1) examine the prevalence of anxiety and depressive disorders and symptoms among adults in Ghana, and (2) explore social determinants of mental health potentially associated with anxiety and depressive disorders and symptoms. We searched electronic databases and secondary sources from inception until September 30, 2024. Meta-analyses were performed to estimate the pooled prevalence. Narrative synthesis explored social determinants potentially associated with anxiety and depressive disorders and symptoms.

We included 38 studies (22,587 adults). Pooled point prevalence of anxiety and depressive disorders and symptoms was 40.3% (95% confidence interval [CI]: 31.8–49.4%) and 33.0% (95% CI: 27.7–38.8%), respectively. Most studies (37 studies) reported the prevalence of symptoms and not disorders. Social determinants of mental health, including educational attainment and urban environment, were associated with higher levels of anxiety symptoms, while ethnicity and traumatic experiences were associated with higher levels of depressive symptoms. There was a high degree of heterogeneity, and the majority of studies used self-report screening tools, which may have skewed prevalence estimates. More than a third of adults in Ghana were found to experience anxiety and depressive symptoms, and social determinants of mental health may be associated with prevalence. High-quality research and contextually appropriate interventions targeting the identified social determinants of mental health associated with anxiety and depressive symptoms are needed to reduce disparities and improve the mental well-being of adults in Ghana.