Depression, anxiety and stress are major contributors to the global burden of diseases. The ageing population faces an escalating burden of these conditions, and half of the cases are largely undiagnosed. Yet a paucity of epidemiological data limits understanding the full scope of the disease burden among older adults. This protocol outlines a systematic review to estimate the prevalence and incidence of anxiety, depression and stress among older people (60 years and above) and to identify contributing factors across South-East Asian countries.

A study protocol for a systematic review and meta-analysis has been registered in PROSPERO. The research team will systematically search, appraise and synthesise observational studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive searches will be conducted from inception to May 2025 across PubMed (NCBI), MEDLINE (Ovid), Web of Science, Cochrane Library, Scopus (Elsevier) and PsycINFO (APA), supplemented by grey literature from government reports, the WHO Library and Google Scholar. Two investigators will independently screen titles and abstracts, review full-text articles published in the English language and extract data, with discrepancies resolved by a third reviewer. Methodological quality and risk of bias of the included studies will be assessed using standardised tools. Primary outcomes are the prevalence and incidence of depression, anxiety and stress. Secondary outcomes include variations in the prevalence and incidence of these conditions based on sociodemographic factors, as well as associated risk factors that differ across regional contexts. Data will be pooled via meta-analysis where feasible or narratively synthesised if heterogeneity precludes quantitative synthesis. The systematic review will provide a comprehensive understanding of the burden of anxiety, depression and stress among older people in South-East Asia. This novel evidence will guide policymakers and healthcare practitioners in developing targeted interventions and generating essential evidence for supporting policy development in the region.

Ethical approval will not be required as this study will not involve collection of original data. The findings will be disseminated through publications in a peer-reviewed journal and presentations at scientific conferences.

CRD42024609033.

This study aimed to estimate the frequency of depression in mothers during the antepartum and postpartum periods and identify predictors of perinatal depression in the tertiary care hospital of Karachi, Pakistan.

Analytical cross-sectional study.

Public Tertiary Care Hospital, Civil Hospital, Karachi, Sindh, Pakistan.

The study involved 262 mothers for the assessment of frequency and predictors of perinatal depression in Pakistan.

The Edinburgh Postpartum Depression Scale (EPDS) was used as the tool to screen for depression. The data were collected through a structured questionnaire encompassing the sociodemographic factors, pregnancy and birth-related information, newborn characteristics sections, family relationship and marital status and psychosocial and psychological history. Mean and SD were computed for continuous data, whereas frequencies and percentages were determined for categorical data. Pearson ² test was applied to determine the association between categorical variables. Predictors of perinatal depression were identified through multivariate logistic regression.

Out of 262 enrolled mothers, 198 screened positive for depressive symptoms using EPDS with a cut-off value ≥10. The mean age of participating mothers was 27.4±5.95 years. Approximately 39.7% of the mothers were illiterate, 75% were housewives and about 42% had a family income of less than US$126. Women with access to a healthcare facility had higher odds of antepartum depression symptoms, possibly due to poor healthcare experiences during antenatal visits. Emotional support by husband reduces the odds by 45.8% while experiencing abuse increases odds by three times. Significant predictors of postpartum depression symptoms included decision-making power, which reduced the odds of postpartum depression symptoms by 72.5% and emotional support by 80%.

The study concluded that maternal decision-making power is a significant protective factor against postpartum depression. Strikingly, access to health facilities by the mother was associated with higher odds of antepartum depression. Other factors, including household income, husband’s employment status, domestic violence, emotional support and family abuse, did not show significant associations with either antepartum or postpartum depression. These findings emphasise the importance of routine screening to identify women at risk during the perinatal period.