{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:18:04Z","timestamp":1789640284447,"version":"4.0.0"},"reference-count":57,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01 MH104514"],"award-info":[{"award-number":["K01 MH104514"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01 MH110651"],"award-info":[{"award-number":["K01 MH110651"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["T32 MH019139"],"award-info":[{"award-number":["T32 MH019139"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["T32 MH096724"],"award-info":[{"award-number":["T32 MH096724"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To examine the prevalence of and associations between food insecurity, mental distress and suicidal ideation in three rural village clusters in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>Cross-sectional multivariate analysis of sociodemographic variables associated with mental distress and suicidal ideation in three countries. The sample included 1,142 individuals from three rural village clusters in Nigeria ( n\u2009=\u2009380), Uganda ( n\u2009=\u2009380) and Ghana ( n\u2009=\u2009382). Food insecurity was measured based on the number of months in the previous year that the respondent\u2019s family reported being \u2018unable to eat two square meals per day\u2019. Mental distress was assessed using the Kessler non-specific psychological distress scale (K6) and suicidal ideation was measured using an item from PRIME-MD. Other sociodemographic variables included gender, age, literacy and occupation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The prevalence of individuals with moderate or severe mental distress in Nigeria, Uganda and Ghana were higher than previously reported in the literature: 35.5%, 30.8% and 30.4%, respectively, and suicidal ideation rates were 29.7%, 21.3% and 10.9%. No differences were observed in mental distress between men and women in any of the sites. Being a farmer (vs student or other) was protective for mental distress in two sites (Uganda and Ghana) but no other social indicators, such as age, gender, literacy and food insecurity, were significantly associated with mental distress. Risk for suicidal ideation differed across sites: it was associated with food insecurity in Nigeria, female gender in Uganda, and older age in Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Mental distress and suicidal ideation were highly prevalent in three settings of extreme poverty across all groups, in ways that were not always consistent with the global literature. These findings suggest that more research is needed in to better understand the social etiology of mental distress in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0020764018814274","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T07:59:15Z","timestamp":1543305555000},"page":"20-27","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":58,"title":["Food insecurity, mental distress and suicidal ideation in rural Africa: Evidence from Nigeria, Uganda and Ghana"],"prefix":"10.1177","volume":"65","author":[{"given":"Annika Claire","family":"Sweetland","sequence":"first","affiliation":[{"name":"Columbia University Vagelos College of Physicians and Surgeons\/New York State Psychiatric Institute, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Norcini Pala","sequence":"additional","affiliation":[{"name":"Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Mootz","sequence":"additional","affiliation":[{"name":"Columbia University Vagelos College of Physicians and Surgeons\/New York State Psychiatric Institute, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Chien-Wen","family":"Kao","sequence":"additional","affiliation":[{"name":"Teachers College, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Carlson","sequence":"additional","affiliation":[{"name":"School of Social Work, The University of Alabama, Tuscaloosa, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Oquendo","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Teachers College, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Belkin","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Wainberg","sequence":"additional","affiliation":[{"name":"Columbia University Vagelos College of Physicians and Surgeons\/New York State Psychiatric Institute, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,27]]},"reference":[{"key":"bibr1-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1192\/bjpo.bp.116.004333"},{"key":"bibr2-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.351"},{"key":"bibr3-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1038\/532020a"},{"key":"bibr4-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-298"},{"key":"bibr5-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.11.018"},{"key":"bibr6-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.07.012"},{"key":"bibr7-0020764018814274","doi-asserted-by":"publisher","DOI":"10.3928\/00485713-20140108-08"},{"key":"bibr8-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0119464"},{"key":"bibr9-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-015-1018-1"},{"key":"bibr10-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.04.040"},{"key":"bibr11-0020764018814274","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1980.01780240027003"},{"key":"bibr12-0020764018814274","unstructured":"The Economist Intelligence Unit. 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