Examining the prevalence, inequalities, and determinants of depression and anxiety in Kenya: A concentration index approach

Acta Psychol (Amst). 2025 Sep 13;260:105563. doi: 10.1016/j.actpsy.2025.105563. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, mental disorders such as depression and anxiety are on the rise. While effective prevention and treatment interventions exist, access to these is influenced by, among other things, household socioeconomic status. However, there is a shortage of evidence that highlights the prevalence and inequalities of depressive and anxiety disorders, especially in low- and middle-income countries. Consequently, this study aimed to generate new knowledge by examining the prevalence, inequalities, and determinants of depression and anxiety in Kenya.

METHODS: This study utilized the 2022 Kenya Demographic and Health Survey data. Employing multilevel modeling techniques, this study examined the influence of communal settings, independent of household-specific factors, on the prevalence of depression, anxiety, or both. We used household wealth quintiles as a socioeconomic ranking variable, while the prevalence rates of depression and anxiety served as the primary health variables of interest. We used concentration indices and curves to examine the inequalities in the distribution of depression and anxiety in Kenya.

RESULTS: There was a 3.6 % prevalence of anxiety and/or depression, sexual violence was positively correlated with anxiety and/or depression (OR = 2.70 [1.93-3.79], P < 0.001, p < 0.001). Chronic diseases tripled the odds of anxiety and/or depression disorders (OR = 3.47 [2.96-4.08], P < 0.001). Poorer self-health perception ratings escalated the risk of anxiety and/or depression (OR = 6.72 [2.61-17.29], P < 0.001). Marriage reduced odds of mental illness (OR = 0.77 [0.65-0.91], P = 0.002). Regional clustering was explained by the Intraclass correlation coefficient of 10.8-12.7 % variance. Depression or anxiety scored a concentration index that indicated prevalence was more pronounced among the better-off wealth categories (CI = 0.053 [0.002-0.104], P < 0.041).

CONCLUSION: Marriage reduces risks, but sexual violence, chronic illness, and geographical inequities have a significant impact on mental health. Strengthen social support networks, chronic care, regional mental health services, and violence prevention.

PMID:40946695 | DOI:10.1016/j.actpsy.2025.105563