Simone Honikman

Simone Honikman
University of Cape Town | UCT · Department of Psychiatry and Mental Health

MD; MPhil (MCH)

About

84
Publications
20,949
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2,802
Citations
Additional affiliations
January 2008 - present
University of Cape Town
Position
  • Senior Researcher

Publications

Publications (84)
Article
Full-text available
Importance Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates. Objective To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yi...
Preprint
Full-text available
Perinatal mental health refers to the psychological wellbeing of women during pregnancy and up to one year postpartum. Perinatal mental health conditions as depression significantly affect maternal, newborn health, and child development worldwide. However, the absence of standardized indicators limits effective monitoring and evaluation. This paper...
Article
Introduction. Effective empathic communication between health care providers and patients is an essential part of health care. In resource-poor contexts, evidence is needed to understand the quality and content of health care communication within real-life clinical engagements. We used the existing Enhancing Assessment of Common Therapeutic Factors...
Article
Full-text available
Background Selective reporting of results from only well-performing cut-offs leads to biased estimates of accuracy in primary studies of questionnaire-based screening tools and in meta-analyses that synthesize results. Individual participant data meta-analysis (IPDMA) of sensitivity and specificity at each cut-off via bivariate random-effects model...
Article
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Objectives This study describes the prevalence, associated factors and child mental health outcomes related to symptoms of maternal depression and anxiety within 5 years after childbirth in a rural district in Nepal. This association is not well‐understood in rural, community‐based settings in low‐ and middle‐income countries (LMIC). Methods A sam...
Article
Full-text available
Evidence for the feasibility of brief psychological interventions for pregnant women experiencing intimate partner violence (IPV) in rural, low-income country settings is scarce. In rural Ethiopia, the prevalence of antenatal depressive symptoms and lifetime IPV are 29% and 61%, respectively. We aimed to assess the feasibility and related implement...
Article
Full-text available
In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems, even though evidence suggests that screening and treating CMD...
Article
Objective: To adapt an evidence-based psychological intervention for pregnant women experiencing depressive symptoms and intimate partner violence (IPV) in rural Ethiopia. Method: We conducted a desk review of contextual factors in Sodo, Ethiopia, followed by qualitative interviews with 16 pregnant women and 12 antenatal care (ANC) providers. We...
Article
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Item 10 of the Edinburgh Postnatal Depression Scale (EPDS) is intended to assess thoughts of intentional self-harm but may also elicit concerns about accidental self-harm. It does not specifically address suicide ideation but, nonetheless, is sometimes used as an indicator of suicidality. The 9-item version of the EPDS (EPDS-9), which omits item 10...
Article
Full-text available
Common perinatal mental disorders are the most frequent complications of pregnancy, childbirth and the postpartum period, and the prevalence among women in low- and middle-income countries is the highest at nearly 20%. Women are the cornerstone of a healthy and prosperous society and until their mental health is taken as seriously as their physical...
Article
Full-text available
Background Evidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, the adaptation of such interventions for low- and middle-income countries has not been prioritised. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressiv...
Article
Full-text available
Background Perinatal mental health problems, defined as mental health problems occurring from the start of pregnancy to one year after birth, substantially affect women's and children's quality of life in low- and middle-income countries. In South Africa, despite high prevalence and documented negative impacts, most women do not receive any care....
Article
Background In South Africa, health and care service providers (SPs) face many interconnected challenges at work, including inadequate training and supervision and high levels of burnout. Nyamekela4Care (N4C) was developed as an integrated intervention for SP teams, to support their ability to provide high-quality care through providing a structure...
Article
Full-text available
Background South Africa has a high burden of perinatal common mental disorders (CMD), such as depression and anxiety, as well as high levels of poverty, food insecurity and domestic violence, which increases the risk of CMD. Yet public healthcare does not include routine detection and treatment for these disorders. This pilot study aims to evaluate...
Article
Full-text available
Background During the perinatal period, common mental disorders (CMDs) such as depression and anxiety are highly prevalent, especially in low-resource settings, and are associated with domestic violence, poverty, and food insecurity. Perinatal CMDs have been associated with several adverse maternal and child outcomes. While the Department of Health...
Preprint
Full-text available
Background: Evidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, adaptation of such interventions for low and middle-income countries has not been prioritized. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressive sy...
Preprint
Full-text available
Background South Africa has a high burden of perinatal common mental disorders (CMD), such as depression and anxiety, as well as high levels of poverty, food insecurity and domestic violence, which increases the risk of CMD. Yet public healthcare does not include routine detection and treatment for these disorders. This pilot study aims to evaluate...
Preprint
Full-text available
Background: During the perinatal period, common mental disorders (CMDs) such as depression and anxiety are highly prevalent, especially in low resource settings, and are associated with domestic violence, poverty and food insecurity. Perinatal CMDs have been associated with several adverse maternal and child outcomes. While the Department of Health...
Article
Full-text available
Abstract Background Perinatal depression is of substantial public health importance in low and middle income countries. The study aimed to evaluate the impact of a mental health intervention delivered by non-specialist health workers on symptom severity and disability in women with perinatal depression in Uganda. Methods Pregnant women in the secon...
Preprint
Full-text available
Background In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems. We investigated facilitators and barriers of servi...
Preprint
Full-text available
Background: In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems, even though evidence suggests that screening and...
Preprint
Full-text available
Background In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems, even though evidence suggests that screening and t...
Article
Full-text available
Background Symptoms of depression and anxiety are highly prevalent amongst perinatal women in low-resource settings of South Africa, but there is no access to standardised counselling support for these conditions in public health facilities. The aim of this study is to develop a task-sharing psychological counselling intervention for routine treatm...
Article
Full-text available
Background Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually ad...
Preprint
Full-text available
Background: Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are: (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually...
Preprint
Full-text available
Background: Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are: (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually...
Preprint
Full-text available
Background: Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are: (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually...
Article
Full-text available
Background: Psychological interventions for antenatal depression are an integral part of evidence-based care but need to be contextualised for respective sociocultural settings. In this study, we aimed to understand women and healthcare workers' (HCWs) perspectives of antenatal depression, their treatment preferences and potential acceptability an...
Article
Full-text available
Background: In rural Ethiopia, 72% of women are exposed to lifetime intimate partner violence (IPV); IPV is most prevalent during pregnancy. As well as adversely affecting women's physical and mental health, IPV also increases the risk of child morbidity and mortality associated with maternal depression, thus making antenatal care an important opp...
Article
Full-text available
Background: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. Aim: The study aimed to explore the barriers and facilitators to service ac...
Article
Full-text available
Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include i...
Article
Full-text available
IntroductionFood security is a prerequisite for achieving optimal health, and mothers and children living in food insecure households face barriers to physical and mental health and healthy development. Mothers in food insecure households often also experience poor mental health and domestic violence. Although associations between these domains hav...
Article
South Africa, like many low-and-middle-income countries, is integrating mental health services into routine Primary Health Care (PHC) through a task-shifting approach to reduce the gaps in treatment coverage. There is concern, however, that this approach will exacerbate nurses' abuse of patients currently common within PHC in the country. To addres...
Chapter
Common perinatal mental disorders (CPMD), including major depression and anxiety disorders, are more prevalent in low-and middle-income countries (LMIC) than in high-income settings. In South Africa, the prevalence of CPMD has been shown to be particularly high. Here, the Perinatal Mental Health Project has been developing and refining mental healt...
Article
Full-text available
Background: In South Africa, the prevalence of symptoms of common mental disorders (CMD), i.e. depression, anxiety and suicidal thoughts are high. This study aimed to use a cognitive interviewing technique to validate the content and structure of a 4-item screening tool, to adapt the tool accordingly, and to use receiver operating curve (ROC) anal...
Article
Full-text available
Purpose The burden of common perinatal mental disorders (CPMD) in low-and-middle-income countries is substantially higher than high-income countries, with low levels of detection, service provision and treatment in resource-constrained settings. We describe the development of an ultra-short screening tool to detect antenatal depression, anxiety dis...
Article
Full-text available
The study's objective was to determine the effectiveness of a task-sharing psychological treatment for perinatal depression using non-specialist community health workers. A double-blind individual randomised controlled trial was conducted in two antenatal clinics in the peri-urban settlement of Khayelitsha, Cape Town. Adult pregnant women who score...
Article
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Collaborative research partnerships are necessary to answer key questions in global mental health, to share expertise, access funding and influence policy. However, partnerships between low- and middle-income countries (LMIC) and high-income countries have often been inequitable with the provision of technical knowledge flowing unilaterally from hi...
Article
Full-text available
South Africa, like many low-and-middle-income countries, is integrating mental health services into routine Primary Health Care (PHC) through a task-shifting approach to reduce the gaps in treatment coverage. There is concern, however, that this approach will exacerbate nurses’ abuse of patients currently common within PHC in the country. To addres...
Article
Full-text available
Background: Changing global health and development trends have resulted in a need for continued professional development (CPD) within the health and development sectors. In low-resource settings, where the need for training and CPD may be highest, there are significant challenges for disseminating information and skills. There is a need to improve...
Article
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Background Perinatal depression is associated with negative effects on child behavioural, cognitive and emotional development, birth outcomes, and physical growth. In India, increased priority accorded to mental health programs mean it is now possible to reduce the population-level burden of perinatal depression. In this secondary analysis of two s...
Article
Full-text available
Background Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the cont...
Article
Full-text available
Background: Maternal mental health conditions are prevalent across the world. For women, the perinatal period is associated with increased rates of depression and anxiety. At the same time, there is widespread documentation of disrespectful care for women by maternity health staff. Improving the empathic engagement skills of maternity healthcare w...
Chapter
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In 2016, a group of collaborators from South Africa, Germany, and the United States met to plan and execute an adaptation of the “Secret History” training method from the South African to the German context. The training focuses on building empathic and self-care skills with health care workers. The project was unique in that it is an example of a...
Article
Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive...
Article
Full-text available
Background Antenatal depression and anxiety disorders are highly prevalent in low and middle-income countries. Screening of pregnant women in primary care antenatal settings provides an opportunity for entry to care, but data are needed on the performance of different screening tools. We compared five widely-used questionnaires in a sample of pregn...
Data
Sensitivity analysis of ROC output and cut-points against CPMD diagnosis. (DOCX)
Article
Full-text available
Purpose: Food insecurity has been linked with maternal depression in low-income settings. Few studies have looked at factors associated with both food insecurity and maternal depression as outcomes. This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women. Methods: We conducted...
Article
Full-text available
Background Maternal mental health conditions are prevalent across the world. For women, the perinatal period is associated with increased rates of depression and anxiety. At the same time, there is widespread documentation of disrespectful care for women by maternity health staff. Improving the empathic engagement skills of maternity healthcare wor...
Article
Full-text available
Anxiety is highly prevalent in many populations; however, the burden of anxiety disorders amongst pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal anxiety disorders amongst low-income women living with psychosocial adversity. Pregnant women were recruited from an urban, prima...
Article
Full-text available
Background Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predic...
Article
Full-text available
Background: In South Africa (SA), despite adoption of international strategies and approaches, maternal, neonatal and child (MNC) morbidity and mortality rates have not sufficiently declined. Objectives: To conduct an umbrella review (UR) that identifies interventions in low- and middle-income countries, with a high-quality evidence base, that impr...
Article
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Background Uptake of delivery and postnatal care remains low in Low and Middle-Income Countries (LMICs), where 99% of global maternal deaths take place. However, the potential impact of antenatal depression on use of institutional delivery and postnatal care has seldom been examined. This study aimed to examine whether antenatal depressive symptoms...
Article
Full-text available
Pregnant women are at increased risk for suicidal ideation and behaviours (SIB) compared to the general population. To date, studies have focused on the psychiatric correlates of SIB with lesser attention given to the associated contextual risk factors, particularly in low- and middle-income countries. We investigated the prevalence and associated...
Chapter
Maternal mental health is increasingly being seen as an important public health concern globally, and particularly within low- and middle-income countries, including South Africa. In this chapter, we describe two maternal mental health projects based in Cape Town: the Perinatal Mental Health Project (PMHP) and The Philani Plus (+) Intervention Prog...
Article
Even though maternal mental health receives low priority in healthcare, it is a vital component for the developing fetus and the raising of healthy children who are able to contribute meaningfully to society. This article explores risk factors for common mental illnesses and treatment options available in under-resourced settings.
Article
Full-text available
Even though maternal mental health receives low priority in healthcare, it is a vital component for the developing fetus and the raising of healthy children who are able to contribute meaningfully to society. This article explores risk factors for common mental illnesses and treatment options available in under-resourced settings.
Article
Full-text available
Background Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). This study aims to explore the barriers and facilitators, as well as perceptions about the feasibility and acceptability of plans to deliver perinatal mental health care in primary care settings in a low income...
Article
Background: In low and middle-income countries (LMIC), common mental disorders affecting pregnant women receive low priority, despite their disabling effect on maternal functioning and negative impact on child health and development. We investigated the prevalence of risk factors for antenatal depression among women living in adversity in a low-re...
Article
Full-text available
Background Alcohol and other drugs (AOD) use among pregnant women have been associated with adverse health outcomes for mother and child, during and after pregnancy. Factors associated with AOD use among women include age, poverty, unemployment, and interpersonal conflict. Few studies have looked at demographic, economic, and psychosocial factors a...
Article
Full-text available
The integration of maternal mental health into primary health care has been advocated to reduce the mental health treatment gap in low- and middle-income countries (LMICs). This study reports findings of a cross-country situation analysis on maternal mental health and services available in five LMICs, to inform the development of integrated materna...
Article
link for fullt ext download: http://www.hst.org.za/publications/south-african-health-review-2016
Article
Even though maternal mental health receives low priority in healthcare, it is a vital component for the developing fetus and the raising of healthy children who are able to contribute meaningfully to society. This article explores risk factors for common mental illnesses and treatment options available in under-resourced settings. © 2016, South Afr...
Article
Full-text available
There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative rese...
Article
Full-text available
Abuse of mothers in maternity settings is widespread globally. In South Africa, this human rights violation has been documented by many sources. Particular factors relating to health workers’ professional and personal contexts contribute to the problem and need to be addressed if it is to be solved. Several local and international initiatives are d...
Article
In South Africa, approximately one third of resource-poor women experience mental illness during pregnancy. Prevalence is higher in low-resource settings than in developed countries. The poverty–mental illness cycle is well documented. Through the capabilities approach, this paper locates maternal mental illness in a development framework and explo...
Article
Full-text available
Little is known about the service and system interventions required for successful integration of mental healthcare into primary care across diverse low- and middle-income countries (LMIC).AimsTo examine the commonalities, variations and evidence gaps in district-level mental healthcare plans (MHCPs) developed in Ethiopia, India, Nepal, Uganda and...
Article
Full-text available
Maternal depression carries a major public health burden for mothers and their infants, yet there is a substantial treatment gap for this condition in low-resourced regions such as sub-Saharan Africa. To address this treatment gap, the strategy of "task sharing" has been proposed, involving the delivery of interventions by non-specialist health wor...
Article
Full-text available
The prevalence of perinatal common mental disorders in South Africa is high, yet little is known about mental health service use among pregnant and postnatal women. This paper reports on pregnant women's patterns of use of a counselling service at a primary level obstetric facility in Cape Town, South Africa, between January 2010 and December 2011....
Chapter
Full-text available
This briefly reviews the literature on common perinatal mental disorders (CPMD) and describes the activities of the Perinatal Mental Health Project (PMHP) based at the University of Cape Town (UCT), South Africa. It summarizes the key lessons learnt over the 10 years regarding the integration of maternal mental health care within primary care setti...