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Batte C, Apio PO, Semulimi AW, Nuwasiima S, Kasoma RM, Mwesigwa MM, Twinamasiko N, Siddharthan T, Mukisa J, Mukunya D, Abaatyo J, Nalugya JS. Prevalence and factors contributing to mental health challenges among school-going adolescents: a case of a climate-vulnerable Manafwa Watershed in Uganda. BMC Public Health 2024; 24:2752. [PMID: 39385115 PMCID: PMC11462693 DOI: 10.1186/s12889-024-20288-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 10/04/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND Globally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area. METHODS This was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges. RESULTS A total of 762 adolescents participated, with a median age of 17 years (interquartile range =16-17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% - 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08-1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15-1.24, p value <0.001] were significantly associated with mental health challenges. CONCLUSION The prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.
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Affiliation(s)
- Charles Batte
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda
- Climate and Health Unit, Tree Adoption, Kampala, Uganda
| | - Pamela Okwir Apio
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda.
| | - Andrew Weil Semulimi
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda
| | - Shivan Nuwasiima
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda
| | - Ronald Mutebi Kasoma
- Climate and Health Unit, Tree Adoption, Kampala, Uganda
- Department of Medicine, Nakaseke General Hospital, Nakaseke, Uganda
| | - Martin Menya Mwesigwa
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda
| | - Nelson Twinamasiko
- College of Health Sciences, Makerere University Lung Institute, Makerere University, Kampala, Uganda
| | - Trishul Siddharthan
- Miller School of Medicine, University of Miami, Florida, United States of America
| | - John Mukisa
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Mukunya
- Faculty of Health Sciences, Busitema University, Busitema, Uganda
| | - Joan Abaatyo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joyce Sserunjogi Nalugya
- Department of Psychiatry, Directorate of Medicine, Mulago National Referral Hospital, Kampala, Uganda
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Ainamani HE, Rukundo G, Gumisiriza N, Tumwine C, Hall J. Traumatised youth harbour feelings of revenge: investigating the association between PTSD symptomatology, vengeance, and willingness to forgive among the Congolese adolescent refugees in Uganda. Eur J Psychotraumatol 2024; 15:2406169. [PMID: 39356003 PMCID: PMC11448343 DOI: 10.1080/20008066.2024.2406169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/12/2024] [Accepted: 08/20/2024] [Indexed: 10/03/2024] Open
Abstract
Background: Prolonged conflicts in the Democratic Republic of Congo (DRC) have caused widespread psychological trauma among civilians leading to maladaptive coping strategies across generations. Despite this occurrence, empirical studies on the prevalence of trauma and its impact on attitudes towards revenge and forgiveness, particularly among the youth, are scarce. This study aims to clarify the relationship between Post Traumatic Stress Disorder (PTSD) symptom severity and the desires for forgiveness and revenge among Congolese adolescents residing in Uganda.Methods: We analysed data from 269 adolescent refugees from the DRC living in the Nakivale refugee settlement in Southwestern Uganda. The assessment included exposure to war-related traumatic events and the MINI-KID for DSM-V PTSD symptom severity. The Heartland Forgiveness and Vengeance Scales measured willingness to forgive and feelings of vengeance.Results: Exposure to war-related traumatic events was notably high in our sample, with severe deprivation of food (260 [97%]), exposure to armed combat (249 [93%]), witnessing bombing, burning, or destruction of houses (245 [91%]), disappearance of family members (239 [89%]), and seeing dead bodies (236 [88%]). PTSD symptom severity was negatively associated with willingness to forgive (b = -0.48; 95% CI -0.71--0.25; p < .001) and positively associated with vengeance (b = 0.18; 95% CI 0.04-0.32; p = .011).Conclusion: PTSD symptom severity reduces the willingness to forgive and increases the desire for vengeance among adolescent refugees. Mental health clinicians and policymakers should consider addressing maladaptive coping behaviours related to feelings of revenge and unwillingness to forgive in their support strategies for refugees.
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Affiliation(s)
- Herbert E. Ainamani
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Godfrey Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Nolbert Gumisiriza
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Christopher Tumwine
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Jonathan Hall
- Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden
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Pouravari M, Finet C, Panaghi L, Hosseinian S, Bosmans G. A qualitative exploration of depressed female Iranian adolescents' attachment narratives. Arch Psychiatr Nurs 2024; 50:40-48. [PMID: 38789232 DOI: 10.1016/j.apnu.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/09/2023] [Accepted: 03/07/2024] [Indexed: 05/26/2024]
Abstract
It is assumed that depressed and suicidal adolescents struggle with issues reflecting insecure attachment. However, less is known about which insecure attachment-related themes characterize depression and suicidality in adolescents. To explore this further, semi-structured in-depth interview were conducted with 18 Iranian female adolescents (Mage = 16.6 ± 0.70), with depression and/or suicidal ideation or suicide attempts, who self-reported being insecurely attached. Qualitative data were analysed using thematic analysis. Three main themes were identified from the data: (1) quality of parenting, (2) attachment representation, and (3) attachment behavior. The theme parenting quality included the subthemes "emotionally absent", "emotionally supportive", "psychologically controlling", "overprotective", "punitive", "aggressive", and "passive". The theme attachment representation comprised: "not accepting", "not feeling loved", "not feeling understood", "lack of intimacy", "unreliable", "reliable", "mixed emotions", "hatred", and "dismiss and devaluation". The theme attachment behavior included "aggression", "relational avoidance", and "emotional role reversal". Findings point to the possible usefulness of attachment-based interventions to treat suicidal adolescents and their families in Iran. However, the results also showed culture-specific themes, pointing at the father-daughter relationship's unique importance, which deserves special attention in attachment-based interventions.
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Affiliation(s)
- Minoo Pouravari
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
| | - Chloë Finet
- Department of School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
| | - Leili Panaghi
- Family Research Institute, Shahid Beheshti University, Tehran, Iran.
| | - Simin Hosseinian
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
| | - Guy Bosmans
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
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Nalugya JS, Engebretsen IMS, Nakasujja N, Ndeezi G, Babirye JN, Bakken V, Skar AMS, Tumwine JK, Skokauskas N. Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda. Addict Sci Clin Pract 2024; 19:38. [PMID: 38745244 PMCID: PMC11095024 DOI: 10.1186/s13722-024-00465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Children at risk of substance use disorders (SUD) should be detected using brief structured tools for early intervention. This study sought to translate and adapt the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool to determine its diagnostic accuracy, and the optimum cut-point to identify substance use disorders (SUD) risk in Ugandan children aged 6 to 13 years. METHODS This was a sequential mixed-methods study conducted in two phases. In the first qualitative phase, in Kampala and Mbale, the clinician-administered CRAFFT tool version 2.1 was translated into the local Lumasaaba dialect and culturally adapted through focus group discussions (FGDs) and in-depth interviews, in collaboration with the tool's authors. Expert reviews and translations by bilingual experts provided insights on linguistic comprehensibility and cultural appropriateness, while pilot testing with the target population evaluated the tool's preliminary effectiveness. In the second phase, the CRAFFT tool, adapted to Lumasaaba, was quantitatively validated against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) for diagnosing SUD in Mbale district, through a survey. Participants, chosen randomly from schools stratified according to ownership, location, and school size, were assessed for the tool's reliability and validity, including comparisons to the MINI KID as the Gold Standard for diagnosing SUD. Data were analyzed using STATA-15. Receiver-operating-characteristic analysis was performed to determine the sensitivity, specificity, and criterion validity of the CRAFFT with the MINI-KID. RESULTS Of the 470 children enrolled, 2.1% (n = 10) had missing data on key variables, leaving 460 for analysis. The median age and interquartile range (IQR) was 11 (9-12) years and 56.6% were girls. A total of 116 (25.2%) children had consumed alcohol in the last twelve-month period and 7 (1.5%) had used other substances. The mean CRAFFT score for all the children (n = 460) was 0.32 (SD 0.95). The prevalence of any alcohol use disorder (2 or more positive answers on the MINI KID) in the last 12 months was 7.2% (n = 32). The Lumasaaba version of the CRAFFT tool demonstrated good internal consistency (Cronbach's α = 0.86) and inter-item correlation (Spearman correlation coefficient of 0.84 (p < 0.001). At a cut-off score of 1.00, the CRAFFT had optimal sensitivity (91%) and specificity (92%) (Area Under the Curve (AUC) 0.91; 95% CI 0.86-0.97) to screen for SUD. A total of 62 (13.5%) had CRAFFT scores of > 1. CONCLUSION The Lumasaaba version of the CRAFFT tool has sufficient sensitivity and specificity to identify school-age children at risk of SUD.
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Affiliation(s)
- Joyce Sserunjogi Nalugya
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
- Department of Psychiatry, Mulago National Referral and Teaching Hospital, Ministry of Health, Kampala, Uganda.
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Ingunn Marie Stadskleiv Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace Ndeezi
- Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Juliet N Babirye
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Bakken
- Centre for Child and Adolescent Mental Health and Child Protection, Institute of Psychiatry, Faculty of Medicine, NTNU, Trondheim, Norway
| | - Ane-Marthe Solheim Skar
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - James K Tumwine
- Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pediatrics and Child Health, School of Medicine, Kabale University, Kabale, Uganda
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Institute of Psychiatry, Faculty of Medicine, NTNU, Trondheim, Norway
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Giri R, Khadka S, Chalise A, Swar K, Paudel S. Depressive symptoms and its associated factors among secondary school adolescents of Birtamod Municipality, Jhapa, Nepal. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002826. [PMID: 38241240 PMCID: PMC10798441 DOI: 10.1371/journal.pgph.0002826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
Depression is a rising public health concern affecting adolescents' mental health throughout the world. This cross-sectional study aimed to assess the prevalence of depressive symptoms and its associated factors among adolescents from urban Nepal. The depressive symptoms among 271 randomly selected secondary school adolescents of Britamod Municipality were assessed using Center for Epidemiologic Studies Depression Scale (CES-D). The chi-square test and multivariable logistic regression were executed to assess the statistical relationship between potential risk factors and depressive symptoms at 5% level of significance. The prevalence of depressive symptoms was 42.8% (95% CI: 37.3-49.1%). Multiple logistic regression revealed that female adolescents (aOR: 2.309, 95% CI: 1.233-4.325), adolescents enrolled in higher grades i.e. 10th grade (aOR: 4.576, 95% CI: 1.482-9.128), studying at private school (aOR: 2.302, 95% CI: 1.184-4.476), not sharing their problems with their friends (aOR: 3.022, 95% CI: 1.477-6.186), presence of perceived academic stress (aOR: 2.388, 95% CI: 1.263-4.518), dissatisfaction with current academic performance (aOR: 2.278, 95% CI: 1.141-4.518), lower perceived family support (aOR: 3.440, 95% CI: 1.276-9.275), and lower self-esteem (aOR: 2.139, 95% CI: 1.061-8.708) had higher odds of experiencing depressive symptoms. There is a high prevalence of depression among Nepalese adolescents. The findings highlight the need for health promotion interventions focusing on mental health awareness, enhancing social support systems, and implementing stress reduction strategies within schools to mitigate the burden of depression among Nepalese adolescents.
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Affiliation(s)
- Rachana Giri
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Santosh Khadka
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Anisha Chalise
- Center for Research on Environment, Health and Population Activities (CREHPA), Lalitpur, Nepal
| | | | - Shishir Paudel
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
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Cheah YK, Zainuddin NH, Kee CC, Lim KH, Omar MA, Cheong YL. Lifestyles and Sexual Behaviour Among School-Going Adolescents: A Mediational Role of Mental Health. Clin Child Psychol Psychiatry 2023; 28:1341-1357. [PMID: 36428238 DOI: 10.1177/13591045221142497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sexual behaviour and mental health among adolescents are major public health issues. This study examines how lifestyles affect sexual behaviour among school-going adolescents in Malaysia, and the potential mediational role of mental health. It is the first to our knowledge to explore the mediating effect of mental health on sexual behaviour with a focus on a fast-growing developing country. Data were obtained from the National Health and Morbidity Survey 2017 (n = 27,497). Structural equation modelling was utilized to examine depression and anxiety as mediators of the relationships between sexual behaviour and smoking, alcohol drinking and illicit drug use, controlling for sociodemographic factors. Results showed that adolescents who smoked, consumed alcohol, used illicit drugs, and had depression and anxiety were more likely to engage in sexual behaviour than others. Depression and anxiety partially mediated the relationships between sexual behaviour and smoking, and illicit drug use. The association between alcohol drinking and sexual behaviour was fully mediated by depression and anxiety. In conclusion, lifestyles may affect sexual behaviour through mediation of mental health. Therefore, policymakers should take mental health factors into consideration when designing adolescent sexual behaviour preventative interventions.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Kedah, Malaysia
| | - Nabilah Hanis Zainuddin
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Yoon Ling Cheong
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
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Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
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Chekol AT, Wale MA, Abate AW, Beo EA, Said EA, Negash BT. Predictors of depression among school adolescents in Northwest, Ethiopia, 2022: institutional based cross-sectional. BMC Psychiatry 2023; 23:429. [PMID: 37316773 PMCID: PMC10265885 DOI: 10.1186/s12888-023-04899-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Adolescent depression is a serious mental disorder that makes family problems, learning challenges, drug addiction, and increases absenteeism from school. It also has a major impact on a person's ability to manage his or her daily tasks. In the end, the condition may result in self-destruction. Research is scarce among high schools in the study setting. Therefore, this study aimed to assess the prevalence and its associated factors of depression among high school adolescent students in Bahirdar City, Northwest Ethiopia in 2022. METHODS An institutional-based cross-sectional study was done from June 18 to July 16, 2022, among public and private high school adolescent students in Bahir Dar City, Amhara region, Ethiopia. A two-stage sampling technique was utilized. First, stratification by school type was made and schools were selected 30-40% by using a simple random sampling technique. Finally, an updated sampling frame was taken from each school director to select a sample of 584 study participants after proportional allocation by simple random sampling from six high schools. Patient Health Questionnaires were used to assess depression in high school students. The independent variables, like substance-related factors, were assessed by yes-or-no questions, and the academic stressor by academic stress in secondary education, was assessed by structured questionnaires. Binary and multivariate logistic regressions were used to identify factors associated with depression. Statistical significance was declared at a 95% confidence interval when the value of p was less than or equal to 0.05. RESULTS The response rate of the participants was 96.9%. The overall magnitude of adolescent depression was found to be 22.1% (95%CI 18.7, 25.7%). Being female (AOR: 3.43; 95%CI 2.11, 5.56), small family size (AOR: 3.01; 95%CI 1.47, 6.15); ever alcohol use (AOR: 2.40; 95%CI 1.51, 3.81); attending a public school (AOR: 3.01; 95%CI 1.68, 5.40), and having a history of abuse (AOR: 1.92; 95%CI 2.2, 3.08) were associated with depression. CONCLUSION In this study, the magnitude of depression among high school students in Bahir Dar City was higher than the national threshold. There was a significant association between sex, family size of parents, ever alcohol use, public schools, and having a history of abuse with depression among adolescents. Hence, it is better for schools to screen and provide intervention for depression in public high school students and offer therapies, especially in females and those with a history of abuse, small family size, or alcohol use.
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Affiliation(s)
- Aklile Tsega Chekol
- Department of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Mastewal Aschale Wale
- Department of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Agmas Wassie Abate
- Department of Psychiatry, Dr. Ambachew Memorial Hospital, Amhara Regional Health Bureau, South Gondar, Ethiopia
| | - Eyerusalem Abebe Beo
- Department of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Eman Ali Said
- Department of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Berhan Tsegaye Negash
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Ramos-Vera C, Quispe Callo G, Basauri Delgado M, Vallejos Saldarriaga J, Saintila J. Factorial and network structure of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents. PLoS One 2023; 18:e0286081. [PMID: 37228053 DOI: 10.1371/journal.pone.0286081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
Depression in young people is considered a public health problem, given that it affects their personal, social, and academic lives; therefore, early detection of depressive symptoms is of importance for a favorable prognosis. This study aimed to estimate the psychometric properties of the second edition of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents. The sample was composed of 917 Peruvian adolescents, aged 13 to 18 years (M = 15,241, SD = 1,020), who were selected from two public educational institutions in Metropolitan Lima. Confirmatory factor analysis supported the 25-item model with the four-dimensional structure and its overall and interdimensional reliability. This structure was found to be gender invariant. Finally, network analysis was performed to assess the relationships and centralities of the depressive symptoms of the validated version of the RADS-2. The results show that the RADS-2 measure is a consistent and reliable test that yields valid results in the Peruvian adolescent context.
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Affiliation(s)
- Cristian Ramos-Vera
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Peru
| | - Gleni Quispe Callo
- School of Psychology, Universidad Nacional de San Agustín, Arequipa, Perú
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Ssewamala FM, Brathwaite R, Sensoy Bahar O, Namatovu P, Neilands TB, Kiyingi J, Huang KY, McKay MM. The Post-intervention Impact of Amaka Amasanyufu on Behavioral and Mental Health Functioning of Children and Adolescents in Low-Resource Communities in Uganda: Analysis of a Cluster-Randomized Trial From the SMART Africa-Uganda Study (2016-2022). J Adolesc Health 2023; 72:S3-S10. [PMID: 37062581 PMCID: PMC10442860 DOI: 10.1016/j.jadohealth.2022.09.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 04/18/2023]
Abstract
PURPOSE Disruptive behavioral disorders (DBDs) are common among children/adolescents in sub-Saharan Africa. A 16-week manualized multiple family group (MFG) intervention called Amaka Amasanyufu designed to reduce DBDs among school-going children/adolescents in low-resource communities in Uganda was efficacious in reducing symptoms of poor mental health relative to usual care in the short-term (4 months post-intervention-initiation). We examined whether intervention effects are sustained 6 months postintervention. METHODS We used longitudinal data from 636 children positive for DBDs: (1) Control condition, 10 schools, n = 243; (2) MFG delivered via parent peers (MFG-PP), eight schools, n = 194 and; (3) MFG delivered via community healthcare workers (MFG-CHW), eight schools, n = 199 from the SMART Africa-Uganda study (2016-2022). All participants were blinded. We estimated three-level linear mixed-effects models and pairwise comparisons at 6 months postintervention and time-within-group effects to evaluate the impact on Oppositional Defiant Disorder (ODD), impaired functioning, depressive symptoms, and self-concept. RESULTS At 6 months postintervention, children in MFG-PP and MFG-CHW groups had significantly lower means for ODD (mean difference [MD] = -1.08 and -1.35) impaired functioning (MD = -1.19 and -1.16), and depressive symptoms (MD = -1.06 and -0.83), than controls and higher means for self-concept (MD = 3.81 and 5.14). Most outcomes improved at 6 months compared to baseline. There were no differences between the two intervention groups. DISCUSSION The Amaka Amasanyufu intervention had sustained effects in reducing ODD, impaired functioning, and depressive symptoms and improving self-concept relative to usual care at 6 months postintervention. Our findings strengthen the evidence that the intervention effectively reduces DBDs and impaired functioning among young people in resource-limited settings and was sustained over time.
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Affiliation(s)
- Fred M Ssewamala
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri; Brown School, Washington University in St. Louis, St. Louis, Missouri.
| | - Rachel Brathwaite
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri; Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri; Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Phionah Namatovu
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri; International Center for Child Health and Development - Uganda Field Office, Masaka, Uganda
| | - Torsten B Neilands
- Division of Prevention Science, University of California, San Francisco, California
| | - Joshua Kiyingi
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Keng-Yen Huang
- Department of Child and Adolescent Psychiatry, and Department of Population Health, New York University School of Medicine, New York, New York
| | - Mary M McKay
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, Missouri; Brown School, Washington University in St. Louis, St. Louis, Missouri
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Muwanguzi M, Kaggwa MM, Najjuka SM, Mamun MA, Arinaitwe I, Kajjimu J, Nduhuura E, Ashaba S. Exploring adverse childhood experiences (ACEs) among Ugandan university students: its associations with academic performance, depression, and suicidal ideations. BMC Psychol 2023; 11:11. [PMID: 36639808 PMCID: PMC9838032 DOI: 10.1186/s40359-023-01044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) among university students have been linked to a variety of factors and have been shown to have a dose-response relationship with adult health and behavior. OBJECTIVE To investigate the effect of exposure to ACEs on academic performance, depression, and suicidal ideations among university students. METHODS A cross-sectional survey among university students at a public university in southwestern Uganda was conducted in 2021, integrating the Adverse Childhood Experiences International Questionnaire for assessing ACEs, the Patient Health Questionnaire for assessing depression symptoms and suicidal ideations, and questions assessing the family structure and academic performance as adopted from similar studies. Regression analysis was performed, and 3 models were generated to answer the study hypotheses. RESULTS A total of 653 undergraduate university students with a mean age of 22.80 (± 3.16) years were recruited. Almost all students (99.8%) experienced one or more ACEs, with physical abuse being the common ACE reported. The average depression symptom severity was statistically higher among individuals who experienced any form of ACEs. No relationship was observed between the ACEs experienced and self-rated academic performance. Similarly, on regression analysis, the cumulative number of ACEs was not associated with self-rated academic performance (β = - 0.007; 95% CI - 0.031 to 0.016; p = 0.558). However, the cumulative number of ACEs was positively associated with depression symptom severity (β = 0.684; 95% CI 0.531-0.837; p < 0.001), as well as increased the likelihood of suicidal ideations (aOR = 1.264; 95% CI 01.090-1.465; p < 0.001). CONCLUSIONS The burden of ACEs is exceedingly high among Ugandan university students, highlighting the urgency in strengthening effective child protection strategies to protect Uganda's rapidly growing population from mental ill-health and avoid future psychological disability, a burden to the healthcare system. The study's findings will also be useful to practitioners/policymakers working to prevent/limit child maltreatment globally.
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Affiliation(s)
- Moses Muwanguzi
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Sarah Maria Najjuka
- grid.11194.3c0000 0004 0620 0548Makerere University, College of Health Sciences, Kampala, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka Bangladesh
| | - Innocent Arinaitwe
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Kajjimu
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elicana Nduhuura
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Scholastic Ashaba
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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12
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Anyanwu MU. Psychological distress in adolescents: prevalence and its relation to high-risk behaviors among secondary school students in Mbarara Municipality, Uganda. BMC Psychol 2023; 11:5. [PMID: 36624544 PMCID: PMC9830719 DOI: 10.1186/s40359-023-01039-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Psychological distress among adolescents negatively affects their academic performance, relationships with family and friends, and ability to participate fully in the community. Stressful life events in low-income countries and risk-taking behavior of adolescents have raised concerns regarding the impact of psychological distress among adolescents. Therefore, the present study estimated the prevalence of psychological distress and examined the high-risk behaviors associated with psychological distress among Ugandan adolescents. METHODS A community based cross-sectional study was conducted among secondary school students in Mbarara Municipality, Uganda. Multistage cluster sampling was used to recruit 921 adolescents from 12 schools. Psychological distress was assessed using the 10-item Kessler Psychological Distress Scale (K10). Logistic regression was used with p-value estimating regression coefficient and 95% confidence interval for odds ratio and adjusted odds ratio (AOR). RESULTS The prevalence of psychological distress using the K10 was 57%. Logistic regression analyses showed that risky sexual behavior [AOR = 1.52; 95% confidence interval (CI) 1.02-2.28], substance use (AOR = 2.06; 95% CI 1.49-2.84) were associated with psychological distress. Students in mixed schools (comprising both sexes) (AOR = 1.94; 95% CI 1.19-3.15) and adolescents with chronic illness (AOR = 1.68; 95% CI 1.18-2.38) were more likely to report psychological distress. CONCLUSION The prevalence of psychological distress among school-going adolescents is high. Risky sexual behavior, substance use as well as chronic illness were associated with psychological distress. In addition, the type of school was significantly associated with psychological distress. The findings suggest the need for policy makers and stakeholders in health and education sectors to institute measures that will address mental health issues among adolescents.
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Affiliation(s)
- Michael U Anyanwu
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
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13
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Chukwuere PC. Connecting and Attuning Mental Health Care for Adolescent Patients: The Role of Presence Practice. SAGE Open Nurs 2023; 9:23779608231193758. [PMID: 37584035 PMCID: PMC10424542 DOI: 10.1177/23779608231193758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/03/2023] [Accepted: 07/22/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction The healthcare system over the years has witnessed evolvement and transformation in the care pattern, including in the mental healthcare system. This has seen a considerable and commendable improvement in patient care. This article aims to demonstrate the need for "presence practice" and practical implications thereof, in the care of adolescents with mental health illnesses and to further demonstrate the need for connecting and attuning mental health care for good care and positive nurse and patient outcomes. The developmental stage of adolescents is characterized by various psychosocial changes. At the same time, the emergence of numerous mental health conditions is prevalent at the adolescent stage, contributing to the disease burden among this age group. Understandably, the prevalence of mental health illnesses in adolescents could be associated with their vulnerability and the result of the interaction of numerous biopsychosocial factors in the lives of the individuals, asserting influences on their development and mental health such as family challenges, the stress associated with schooling, relationship issues, and abuse. Method This article follows a quality improvement method where the author took time to nonsystematically explain existing literature on presence practice and its practical implication and further practically demonstrated the need for and how to facilitate connecting and attuning mental health care for good care and positive nurse and patient outcomes. Result Presence practice should be adopted by mental health nurses to foster the establishment of relational care with mental health care users, such as adolescents with mental illness, and to help mitigate relapse. Being open-minded and preparing their minds to be receptive and present during care should be part of nurses effective presence practice. Conclusion The article concludes that mental health nurses, as frontline caregivers, should always endeavor to connect and attune care to the needs of the adolescents receiving mental health care to foster positive outcomes.
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2022; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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Ssewamala FM, McKay MM, Sensoy Bahar O, Nabunya P, Neilands T, Kiyingi J, Namatovu P, Guo S, Nakasujja N, Mwebembezi A. Suubi4StrongerFamilies: A study protocol for a clustered randomized clinical trial addressing child behavioral health by strengthening financial stability and parenting among families in Uganda. Front Psychiatry 2022; 13:949156. [PMID: 36506418 PMCID: PMC9726732 DOI: 10.3389/fpsyt.2022.949156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Children in Sub-Saharan Africa are burdened by significant unmet mental health needs. Across the region, high rates of poverty, HIV/AIDS, food insecurity, stigma, and an inadequate health safety net system exacerbate serious child behavioral health needs and impede an effective response. Disruptive behavioral disorders are particularly concerning as they persist through adolescence and adulthood. Hence, addressing the context-specific social influences on child behavioral health is critical given that children in the region comprise more than half of the total regional population. Against this backdrop, this study protocol describes a randomized clinical trial that will examine the mechanisms by which economic empowerment and family strengthening interventions targeting social, familial, and context-specific drivers affect the mental health of children in Uganda. Methods The study uses an experimental, longitudinal design across 30 cluster-randomized primary schools to compare single and combination intervention options; influences of economic empowerment and family strengthening on economic, perceptual, and functioning mediators; and context-specific moderators. The study will be conducted with 900 Ugandan children in mid-upper primary school (10-14 years). The three study conditions (n = 300 each) are: (1) economic empowerment only (EE only), (2) multiple family group-based family strengthening only (MFG-based FS only), and (3) combined EE + MFG-based FS. The interventions will be provided for 12 months; and assessments will occur at baseline, 12, 24, and 36 months. Conclusion Children in Sub-Saharan Africa are burdened by significant unmet mental health needs, including disruptive behavior disorders that persist through adolescence and adulthood if left untreated. The proposed study will examine the mechanisms by which economic empowerment and family strengthening interventions targeting social, familial and context-specific drivers affect the mental health of children in mid-upper primary schools in Uganda. Findings from this study can inform group, community, and population approaches that are needed for scalable solutions to address the social drivers negatively impacting child behavioral health in low-resource settings, including in Sub-Saharan Africa. Clinical trial registration [https://clinicaltrials.gov/], identifier [NCT053 68714].
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Affiliation(s)
- Fred M. Ssewamala
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Mary M. McKay
- Vice Provost Office, Washington University in St. Louis, St. Louis, MO, United States
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Torsten Neilands
- School of Medicine, University of California, San Francisco, San Francisco, LA, United States
| | - Joshua Kiyingi
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Phionah Namatovu
- International Center for Child Health and Development Field Office, Masaka, Uganda
| | - Shenyang Guo
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
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Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One 2022; 17:e0276552. [PMID: 36264962 PMCID: PMC9584512 DOI: 10.1371/journal.pone.0276552] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Depression is one of the most studied mental health disorders, with varying prevalence rates reported across study populations in Uganda. A systematic review and meta-analysis was carried out to determine the pooled prevalence of depression and the prevalence of depression across different study populations in the country. METHODS Papers for the review were retrieved from PubMed, Scopus, PsycINFO, African Journal OnLine, and Google Scholar databases. All included papers were observational studies regarding depression prevalence in Uganda, published before September 2021. The Joanna Briggs Institute Checklist for Prevalence Studies was used to evaluate the risk of bias and quality of the included papers, and depression pooled prevalence was determined using a random-effects meta-analysis. RESULTS A total of 127 studies comprising 123,859 individuals were identified. Most studies were conducted among individuals living with HIV (n = 43; 33.9%), and the most frequently used instrument for assessing depression was the Depression sub-section of the Hopkins Symptom Checklist (n = 34). The pooled prevalence of depression was 30.2% (95% confidence interval [CI]: 26.7-34.1, I2 = 99.80, p<0.001). The prevalence of depression was higher during the COVID-19 pandemic than during the pre-pandemic period (48.1% vs. 29.3%, p = 0.021). Refugees had the highest prevalence of depression (67.6%; eight studies), followed by war victims (36.0%; 12 studies), individuals living with HIV (28.2%; 43 studies), postpartum or pregnant mothers (26.9%; seven studies), university students (26.9%; four studies), children and adolescents (23.6%; 10 studies), and caregivers of patients (18.5%; six studies). LIMITATION Significantly high levels of heterogeneity among the studies included. CONCLUSION Almost one in three individuals in Uganda has depression, with the refugee population being disproportionately affected. Targeted models for depression screening and management across various populations across the country are recommended. TRIAL REGISTRATION Protocol registered with PROSPERO (CRD42022310122).
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, Forensic Psychiatry Program, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Maria Najjuka
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2022; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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Qasrawi R, Vicuna Polo SP, Abu Al-Halawa D, Hallaq S, Abdeen Z. Assessment and Prediction of Depression and Anxiety Risk Factors in Schoolchildren: Machine Learning Techniques Performance Analysis. JMIR Form Res 2022; 6:e32736. [PMID: 35665695 PMCID: PMC9475423 DOI: 10.2196/32736] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 02/03/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression and anxiety symptoms in early childhood have a major effect on children's mental health growth and cognitive development. The effect of mental health problems on cognitive development has been studied by researchers for the last 2 decades. OBJECTIVE In this paper, we sought to use machine learning techniques to predict the risk factors associated with schoolchildren's depression and anxiety. METHODS The study sample consisted of 3984 students in fifth to ninth grades, aged 10-15 years, studying at public and refugee schools in the West Bank. The data were collected using the health behaviors schoolchildren questionnaire in the 2013-2014 academic year and analyzed using machine learning to predict the risk factors associated with student mental health symptoms. We used 5 machine learning techniques (random forest [RF], neural network, decision tree, support vector machine [SVM], and naive Bayes) for prediction. RESULTS The results indicated that the SVM and RF models had the highest accuracy levels for depression (SVM: 92.5%; RF: 76.4%) and anxiety (SVM: 92.4%; RF: 78.6%). Thus, the SVM and RF models had the best performance in classifying and predicting the students' depression and anxiety. The results showed that school violence and bullying, home violence, academic performance, and family income were the most important factors affecting the depression and anxiety scales. CONCLUSIONS Overall, machine learning proved to be an efficient tool for identifying and predicting the associated factors that influence student depression and anxiety. The machine learning techniques seem to be a good model for predicting abnormal depression and anxiety symptoms among schoolchildren, so the deployment of machine learning within the school information systems might facilitate the development of health prevention and intervention programs that will enhance students' mental health and cognitive development.
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Affiliation(s)
- Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Ramallah, Occupied Palestinian Territory
- Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Stephanny Paola Vicuna Polo
- Center for Business Innovation and Technology, Al-Quds University, Jerusalem, Occupied Palestinian Territory
| | - Diala Abu Al-Halawa
- Faculty of Medicine, Al-Quds University, Jerusalem, Occupied Palestinian Territory
| | - Sameh Hallaq
- Al-Quds Bard College for Arts and Sciences, Al-Quds University, Jerusalem, Occupied Palestinian Territory
| | - Ziad Abdeen
- Faculty of Medicine, Al-Quds University, Jerusalem, Occupied Palestinian Territory
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Al-Sabah R, Al-Taiar A, Shaban L, Albatineh AN, Sharaf Alddin R, Durgampudi PK. Vitamin D level in relation to depression symptoms during adolescence. Child Adolesc Psychiatry Ment Health 2022; 16:53. [PMID: 35761369 PMCID: PMC9238117 DOI: 10.1186/s13034-022-00489-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/15/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency. METHODS A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children's Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry. RESULTS Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression symptom (a score of 19 or more on the CDI). There was no significant difference in the median CDI score between different vitamin D status (p = 0.366). There was also no significant correlation between serum 25(OH)D concentration and CDI score (Spearman's rank correlation = 0.01; p = 0.825).There was no significant association between 25(OH)D and depression symptoms whether 25(OH)D was fitted as a continuous variable (crude odds ratio (OR) 0 .99 [95%CI: 0.98, 1.01], p = 0.458 and adjusted OR 1.01 [95%CI: 0.99, 1.02], p = 0.233), categorical variable as per acceptable cut-of points (crude analysis p = 0.376 and adjusted analysis p = 0.736), or categorical variable as quartiles (crude analysis p = 0.760 and adjusted analysis p = 0.549). CONCLUSION Vitamin D status does not seem to be associated with depression symptoms among adolescents in our setting. Nevertheless, it is important to have sufficient vitamin D levels during adolescence for several other health benefits.
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Affiliation(s)
- Reem Al-Sabah
- grid.411196.a0000 0001 1240 3921Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
| | - Abdullah Al-Taiar
- School of Community & Environmental Health, College of Health Sciences, Old Dominion University, 4608 Hampton Blvd, 3136 Health Sciences Building, Norfolk, VA, 23508, USA.
| | - Lemia Shaban
- grid.411196.a0000 0001 1240 3921Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Kuwait, Kuwait
| | - Ahmed N. Albatineh
- grid.411196.a0000 0001 1240 3921Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
| | - Reem Sharaf Alddin
- grid.255414.30000 0001 2182 3733CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, United States
| | - Praveen K. Durgampudi
- grid.261368.80000 0001 2164 3177School of Community & Environmental Health, College of Health Sciences, Old Dominion University, 4608 Hampton Blvd, 3136 Health Sciences Building, Norfolk, VA 23508 USA
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20
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Abstract
The current study examines the prevalence of depression, anxiety, suicide risk, and PTSD in Ugandan youth (13-25 years) attending vocational training programs. Youth from five urban (n=224 females, 81 males) and four rural (n=153 females only) vocational training centers operated by a non-governmental organization completed demographic and mental health questionnaires. Nearly half of the youth reported moderate or severe depression and/or anxiety. More than half reported anxiety and depression-related impairment. Nearly a quarter of youth had considered or attempted suicide. More than half screened positive on the PC-PTSD screen. Rural female youth reported the most food insecurity (56.9%), trafficking (37.9%), severe depression (35.9%), depression-related impairment (56.9%), severe anxiety (26.1%), and anxiety-related impairment (55.6%). Results from this study suggest that Ugandan youth have exceedingly high rates of depression, anxiety, suicide risk, and probable PTSD. Rural female youth may be especially at risk. Relevant treatment interventions are needed that can be adapted to youth in vocational training centers.
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Chukwuere PC, Sehularo LA, Manyedi ME. Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa. Curationis 2022; 45:e1-e9. [PMID: 35261252 PMCID: PMC8905408 DOI: 10.4102/curationis.v45i1.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/29/2021] [Accepted: 11/20/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms. OBJECTIVE This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa. METHOD A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch's open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations. RESULTS The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression. CONCLUSION The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents' recovery and strengthen the adolescents' and parents' coping mechanisms for a healthier family.
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Affiliation(s)
- Precious C Chukwuere
- Department of Nursing Science, Faculty of Health Science, North-West University, Mahikeng.
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22
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Asiimwe R, Tseng C, Murray SM, Ojuka JC, Arima EG, Familiar‐Lopez I. Association of pregnancy‐related stigma and intimate partner violence with anxiety and depression among adolescents. J Adolesc 2022; 94:270-275. [DOI: 10.1002/jad.12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Ronald Asiimwe
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Chi‐Fang Tseng
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Sarah M. Murray
- Department of Mental Health Johns Hopkins School of Public Health Baltimore Maryland USA
| | | | - Ethan G. Arima
- Makerere University Johns Hopkins University Research Collaboration Kampala Uganda
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23
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Nantaayi B, Ndawula RK, Musoke P, Ssewante N, Nakyagaba L, Wamala JN, Makai EA, Wannyana B, Wamala NK, Kanyike AM, Akech GM, Ojilong D, Agira D, Nakimuli AB, Asiimwe A, Bongomin F. Psychological Distress and Access to Mental Health Services Among Undergraduate Students During the COVID-19 Lockdown in Uganda. Front Psychiatry 2022; 13:792217. [PMID: 35722591 PMCID: PMC9201074 DOI: 10.3389/fpsyt.2022.792217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lockdown is an important public health approach aimed at curbing the raging effect of the coronavirus disease-2019 (COVID-19). This study aimed at determining the impact of prolonged lockdown on mental health and access to mental health services among undergraduate students in Uganda. METHODS An online cross-sectional study was conducted anonymously among undergraduates across 10 universities in Uganda. The Distress Questionnaire-5 (DQ-5) and the Patient Health Questionnaire-2 (PHQ-2) were used. Logistic regression analysis was conducted to determine factors associated with psychological distress. RESULTS We enrolled 366 participants with a mean age of 24.5 ± 4.6 years. The prevalence of psychological distress was 40.2% (n = 147) (cut off 14/25 based on DQ-5) while depression stood at 25.7% (n = 94; cut off 3/6 based on PHQ-2) with mean scores of 12.1 ± 4.6 and 1.7 ± 1.6 respectively. Female gender (aOR: 1.6, 95%CI: 1.0-2.6, p = 0.032), pursuing a non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) were factors associated with psychological distress while non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) was associated with increased depression. Access to mental health services was associated with both reduced distress (aOR: 0.5, 95%CI: 0.3-0.8, p = 0.005) and depression (aOR: 0.6, 95%CI: 0.3-0.9, p = 0.034). A majority (65.3%) of the participants reported knowing how to access mental health care and 188 (51.4%) reported having needed emotional support but, only 67 (18.3%) ever sought care from a mental health professional. Of those who had access, only 10 (7%), and 13 (9%) accessed a counselor or a mental health unit, respectively. The barriers to accessibility of mental health care included financial limitations (49.5%), lack of awareness (32.5%), lack of mental health professionals (28.4%), and stigma (13.9%). CONCLUSION Among university students in Uganda during the COVID- 19 lockdown, the burden of psychological distress and depression was substantial. However, access to mental health services was limited by several factors.
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Affiliation(s)
- Brandy Nantaayi
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rodney Kato Ndawula
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Phillip Musoke
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Ssewante
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lourita Nakyagaba
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Emmanuel Arthur Makai
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Babrah Wannyana
- School of Clinical Medicine and Dentistry, Kampala International University Western, Bushenyi, Uganda
| | - Nicholas Kisaakye Wamala
- School of Clinical Medicine and Dentistry, Kampala International University Western, Bushenyi, Uganda
| | | | | | - Daniel Ojilong
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Drake Agira
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | - Asaph Asiimwe
- School of Medicine, Soroti University, Soroti, Uganda
| | - Felix Bongomin
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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24
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Mugisha J, Van Damme T, Vancampfort D. Associations between mild depression and anxiety and physical inactivity among school-going Ugandan adolescents aged 14 to 17 years. J Child Adolesc Ment Health 2022; 34:115-125. [PMID: 38632955 DOI: 10.2989/17280583.2023.2288969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Objective: The aim of this cross-sectional study was to investigate associations between physical activity levels and emotional and behavioural problems in school-going adolescents aged 14 to 17 years in Uganda.Methods: Two-hundred and five adolescents [median (interquartile range) age = 16.0 (1.0) years; female = 61.9%] completed the interviewer-administered Strengths and Difficulties Questionnaire (SDQ), Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 questionnaire (GAD-7), and the Physical Activity Vital Sign (PAVS) measure. Spearman's rho correlations and Mann-Whitney U-tests were applied.Results: Among 205 adolescents, 97.1% were physically inactive (PAVS < 420min/week), while 64.4% reported either mild depressive (PHQ-9 ≥ 5) or anxiety (GAD-7 ≥ 5) symptoms. Higher PAVS scores correlated significantly with lower SDQ emotional problems (ρ = -0.23, p < 0.001), lower PHQ-9 (ρ = -0.26, p < 0.001), and lower GAD-7 (ρ = -0.22, p < 0.001) scores. Those with emotional problems (SDQ ≥ 5) (n = 86) were significantly less physically active than those without (n = 119) [30.0 (62.5) versus 60.0 (105.0) min/week, p < 0.001]. Those with depressive symptoms (PHQ-9 ≥ 5) were significantly less physically active than those without [35.0 (70.0) versus 60.0 (120.0) min/week, p < 0.001].Conclusion: Physical inactivity and mental health problems are related important public health concerns in school-going adolescents in low-income countries such as Uganda. The efficacy and effectiveness of school-based mental health literacy programs, including physical activity promotion, should be explored in these low-resource settings.
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Affiliation(s)
- James Mugisha
- Department of Sociology and Social Administration, Kyambogo University, Kampala, Uganda
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Leuven, Belgium
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Leuven, Belgium
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25
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Ainamani HE, Weierstall-Pust R, Bahati R, Otwine A, Tumwesigire S, Rukundo GZ. Post-traumatic stress disorder, depression and the associated factors among children and adolescents with a history of maltreatment in Uganda. Eur J Psychotraumatol 2022; 13:2007730. [PMID: 35028113 PMCID: PMC8751492 DOI: 10.1080/20008198.2021.2007730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
UNLABELLED Worldwide, children who grow up under adverse conditions risk the development of mental health problems. However, reliable data on the estimated magnitude of mental disorders of PTSD, depression and their associated factors among maltreated children and adolescents in low- and middle-income-countries (LMICs) is still lacking. This study estimated the magnitude of PTSD, depression and the associated factors among the children and adolescents with ahistory of maltreatment in Southwestern Uganda. METHODS In this cross-sectional study, we assessed 232 children and adolescents on the prevalence of PTSD using Child PTSD Symptoms Scale for DSM-5 - Self-Report (CPSS-VSR) and Depression using the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Predictor variables were taken from the Maltreatment and Abuse Chronology of Exposure- Paediatric Version (Pedi MACE). Logistic regressions analyses were selected for statistical modelling while odds-ratios were calculated to assess the strength of associations between the predictor and outcome variables. RESULTS In total, 140 (60%) participants fulfiled diagnostic criteria for PTSD and 91 (39%) for depression respectively. Predictor variables of PTSD were witnessing intimate partner violence (OR = 1.48, 95% CI: 1.19-1.83, p = <0.001), having lived in more than two homes (OR = 2.69, 95%CI: 1.34-5.41, p = .005), and being cared for by non-relatives (OR = 2.25; 95%CI: 2.26-223.9, p = .008). Variables predicting depression were witnessing intimate partner violence (OR = 1.30; 95%CI: 108-1.57, p = .006); being cared for by non-relatives (OR = 5.62, 95%CI: 1.36-23.1, p = .001) and being female (OR = .054, 95% CI: 0.30-1.00, p = .005). CONCLUSION Children living under adverse conditions are at a higher risk of developing PTSD and depression. We recommend interventions that aim at reducing adverse psychosocial stressors so as to improve or restore the children's mental health.Abbreviations: PTSD: Post traumatic stress disorder; LMICs: Low- and middle-income countries; IPV: Intimate partner violence; OVC: Orphans and vulnerable children.
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Affiliation(s)
- Herbert E Ainamani
- Department of Mental Health, Kabale University-School of Medicine, Kabale, Uganda
| | - Roland Weierstall-Pust
- Medical School of Hamburg Department of Clinical Psychology and Psychotherapy, Germany and Oberberg Group, Berlin, Germany
| | - Ronald Bahati
- Department of Public Health and Bio Medical Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Anne Otwine
- Department of Public Health and Bio Medical Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Sam Tumwesigire
- Department of Pediatrics, Kabale University School of Medicine, Kabale, Uganda
| | - Godfrey Z Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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26
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Nsereko JR, Garman EC, Roomaney R. Depressive symptoms and socio-demographic correlates among adolescents in Kampala: a cross-sectional study. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211049886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the prevalence of depressive symptoms in secondary school students in Kampala, Uganda, and assess associations with demographic characteristics and living arrangements. In this cross-sectional study, 14- to 17-year-olds were recruited from six randomly selected schools in Kampala. Participants completed a questionnaire, covering demographic questions and the affective problems subscale of the Youth Self-Report (YSR) – a depression screening tool for minors. Scores range from 0 to 26; a minimum score of 9 and 8 for female and male participants, respectively, suggests depressive symptoms in the clinical range, according to standard (non-local) norms. Unadjusted logistic regressions were used to assess demographic (e.g., age, gender, religion, parental education) and family-related characteristics (e.g., living arrangements, household size) associated with symptoms of depression in the clinical range. In total, 503 participants were recruited, of which 26.6% had depressive symptoms in the clinical range (female: 32.5%, male: 18.1%; risk ratio [RR] = 1.79, 95% confidence interval [CI] [1.28, 2.51]). Those who reported living with only one parent (RR = 1.62, 95% CI [1.14, 2.30]) or another family member/friend (RR = 1.98, 95% CI [1.14, 2.30]) were at increased risk of depressive symptoms above clinical threshold compared with participants living with both parents. A quarter of urban low-risk school-going adolescents had depressive symptoms in the clinical range in Kampala; girls and adolescents not living with their parents were particularly vulnerable. It recommended that school staff be equipped with skills to identify students who may be at risk for depression and make appropriate referrals.
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Affiliation(s)
| | - Emily Claire Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
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Shorey S, Ng ED, Wong CHJ. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:287-305. [PMID: 34569066 DOI: 10.1111/bjc.12333] [Citation(s) in RCA: 288] [Impact Index Per Article: 96.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 08/02/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Adolescence is a formative and turbulent phase where physiological, psychosocial, and cognitive changes leave adolescents vulnerable to psychological disorders. Given the lack of reviews that consolidate and compare worldwide prevalence of depression among adolescents, this review aims to examine the global prevalence of major depressive disorders, dysthymia, and elevated depressive symptoms among adolescents. METHODS A systematic review and meta-analysis was conducted. Six databases were searched for studies published from 2001 to December 2020. Seventy-two studies were included. Subgroup analysis were performed for year of publication, geographical region, gender, and assessment tools used. RESULTS The global point prevalence rate of elevated self-reported depressive symptoms from 2001 to 2020 was 34% (95% CI: 0.30-0.38). Point prevalence for major depressive disorder (MDD) and dysthymia was 8% (95% CI: 0.02-0.13) and 4% (95% CI: 0.01-0.07), respectively. The pooled one-year prevalence and lifetime prevalence for MDD were 8% (95% CI: 0.05-0.12) and 19% (95% CI: 0.12-0.26). Point prevalence of elevated depressive symptoms among adolescents increased from 24% (95% CI: 0.19-0.28) between 2001 and 2010 to 37% (95% CI: 0.32-0.42) between 2011 and 2020. The Middle East, Africa, and Asia have the highest prevalence of elevated depressive symptoms, and female adolescents were reported to have a higher prevalence of elevated depressive symptoms than male adolescents. CONCLUSION Besides targeting those with existing clinical depression, research and policies should also focus on educational and supportive mitigation efforts to curb depressive symptoms among adolescents before escalation. The findings encourage future research to develop more gender-specific and culturally relevant intervention programmes. PRACTITIONER POINTS 34% of adolescents globally, aged 10-19 years, are at risk of developing clinical depression, which exceeds the reported estimates of individuals aged 18 to 25 years. Practitioners are highly encouraged to prioritize depression screening and intervention implementation for individuals in this age group. Female adolescents and adolescents from Middle East, Africa, and Asia have the highest risk of developing depression. This urges practitioners and researchers to develop more gender-specific and culturally relevant intervention programmes.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Celine H J Wong
- Department of Psychological Medicine, National University Hospital, Singapore
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2021; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among 'healthy' children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None of the factors examined were associated with the disorders. Conclusions: The unexpectedly high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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Brathwaite R, Ssewamala FM, Neilands TB, Nabunya P, Byansi W, Damulira C. Development and external validation of a risk calculator to predict internalising symptoms among Ugandan youths affected by HIV. Psychiatry Res 2021; 302:114028. [PMID: 34129997 PMCID: PMC8277696 DOI: 10.1016/j.psychres.2021.114028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
The aim of the study was to develop and externally validate a model to predict individualized risk of internalizing symptoms among AIDS-affected youths in low-resource settings in sub-Saharan Africa. Longitudinal data from 558 Ugandan adolescents orphaned by AIDS was used to develop our predictive model. Least Absolute Shrinkage and Selection Operator logistic regression was used to select the best subset of predictors using 10-fold cross-validation. External validation of the final model was conducted in a sample of 372 adolescents living with HIV in Uganda. Best predictors for internalizing symptoms were gender, family cohesion, social support, asset ownership, recent sexually transmitted infection (STI) diagnosis, physical health self-rating, and previous poor mental health; area under the curve (AUC) = 72.2; 95% CI = 67.9-76.5. For adolescents without history of internalizing symptoms, the AUC = 69.0, 95% CI = 63.4-74.6, and was best predicted by gender, drug use, social support, asset ownership, recent STI diagnosis, and physical health self-rating. Both models were well calibrated. External validation in adolescents living with HIV sample was similar, AUC = 69.7; 95% CI = 64.1-75.2. The model predicted internalizing symptoms among African AIDS-affected youth reasonably well and showed good generalizability. The model offers opportunities for the design of public health interventions addressing poor mental health among youth affected by HIV/AIDS.
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Affiliation(s)
- Rachel Brathwaite
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, 63130, U.S.A..
| | - Fred M. Ssewamala
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, 63130, U.S.A
| | - Torsten B. Neilands
- Division of Prevention Science, University of California, San Francisco, California, 94143, U.S.A
| | - Proscovia Nabunya
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, 63130, U.S.A
| | - William Byansi
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, MO, 63130, U.S.A
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Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Common mental health problems among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. J Child Adolesc Ment Health 2021; 33:90-110. [PMID: 38041439 DOI: 10.2989/17280583.2023.2266451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Background and aim: This review examined the prevalence of mental health problems among adolescents in sub-Saharan Africa.Methods: The review included studies indexed in the MEDLINE, EMBASE, and PsycINFO databases, supplemented by a search on Google Scholar and tracking of references from articles identified. A total of 725 articles were found, of which 28 met the inclusion criteria. Finally, 22 eligible studies were reviewed.Findings: The pooled current prevalence of mental health problems was 23% (95% CI: 18; 28, I2 = 99.41%). Any depression, 19% (95% CI: 9; 30, I2 = 99.64%), and anxiety, 20% (95% CI: 01; 31, I2 = 99.64%), were the most common mental health problems reported. Attention deficit hyperactivity disorder, 5% (95% CI: 3; 7, I2 = 97.60%), and conduct disorders, 15% (95% CI: 8; 22, I2 = 99.58%), were also significant mental health problems among adolescents in the region.Conclusion: About one in five adolescents in sub-Saharan Africa suffer from one or more mental health problems. The findings have important implications for policy and practice as they indicate that mental health problems are a major public health issue among adolescents in sub-Saharan Africa and that there is a need for effective and context-specific interventions that address mental health.
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Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Yadeta Dessie
- School of Public Health College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Biftu Geda
- Department of Preventive Medicine, School of Public Health College of Health Sciences, Addis Ababa University, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Negussie Deyessa
- Department of Nursing, College of Health Sciences, Shashamene Compass, Madda Walabu University, Ethiopia
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31
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Tsehay M, Girma S, Mamaru A, Abera M. Depression and association with diet diversity score among adolescent (14-19) students of Jimma town high school, Jimma, southwest Ethiopia. JOURNAL OF PUBLIC MENTAL HEALTH 2021. [DOI: 10.1108/jpmh-11-2020-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Dietary patterns are important for the physical and psychological development of adolescents. The purpose of this study is to determine magnitude and severity of depression and its relation with diet diversity score (DDS) among adolescent high school students.
Design/methodology/approach
A cross-sectional study was conducted among 546 adolescents selected from schools using multistage sampling technique. Dietary intakes were assessed using a 24-h dietary recall, and depression severity and prevalence were assessed by PHQ-9A. A structured questionnaire was used to collect data. Linear regression analysis was used, and unstandardized beta (ß) coefficients with 95% confidence intervals (CI) were computed to determine the association of depression and its severity with dietary diversity score.
Findings
In all, 546 questionnaires were filled completely and consistently making a response rate of 97.3%. The dietary diversity score in 97 (17.8%) of the adolescents were between 1 and 3 (low dietary diversity score) but 259 (47.4%) scored greater than 6 (high dietary diversity score). Chi-square test revealed that with a decrease in DDS from highest to lowest level, the percentage of moderate to severe and severe depression slightly increased (3.4%). In addition, the percentage of moderate to severe and severe depression who consumed meat, fish and milk and dairy products slightly increased (3% and 3.2%). Multivariate adjusted regression analysis demonstrated that dietary diversity score was found to be inversely associated with depression severity and prevalence.
Originality/value
It was found that linear association between diet diversity and depression severity, and prevalence after adjustment for relevant con-founders. The study provided epidemiological evidence of a robust association of dietary pattern with depression symptoms' severity and prevalence in adolescents.
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Cavazos-Rehg P, Byansi W, Doroshenko C, Neilands TB, Anako N, Sensoy Bahar O, Kasson E, Nabunya P, Mellins CA, Ssewamala FM. Evaluating potential mediators for the impact of a family-based economic intervention (Suubi+Adherence) on the mental health of adolescents living with HIV in Uganda. Soc Sci Med 2021; 280:113946. [PMID: 34020312 DOI: 10.1016/j.socscimed.2021.113946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/26/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Many adolescents living with HIV in sub-Saharan Africa (SSA) experience poverty and have access to limited resources, which can impact HIV and mental health outcomes. Few studies have analyzed the impact of economic empowerment interventions on the psychosocial wellbeing of adolescents living with HIV in low resource communities, and this study aims to examine the mediating mechanism(s) that may explain the relationship between a family economic empowerment intervention (Suubi + Adherence) and mental health outcomes for adolescents (ages 10-16 at enrollment) living with HIV in Uganda. METHOD We utilized data from Suubi + Adherence, a large-scale six-year (2012-2018) longitudinal randomized controlled trial (N = 702). Generalized structural equation models (GSEMs) were conducted to examine 6 potential mediators (HIV viral suppression, food security, family assets, and employment, HIV stigma, HIV status disclosure comfort level, and family cohesion) to determine those that may have driven the effects of the Suubi + Adherence intervention on adolescents' mental health. RESULTS Family assets and employment were the only statistically significant mediators during follow-up (β from -0.03 to -0.06), indicating that the intervention improved family assets and employment which, in turn, was associated with improved mental health. The proportion of the total effect mediated by family assets and employment was from 42.26% to 71.94%. CONCLUSIONS Given that mental health services provision is inadequate in SSA, effective interventions incorporating components related to family assets, employment, and financial stability are crucial to supporting the mental health needs of adolescents living with HIV in under-resourced countries like Uganda. Future research should work to develop the sustainability of such interventions to improve long-term mental health outcomes among this at-risk group.
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Affiliation(s)
- Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA.
| | - William Byansi
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Christine Doroshenko
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Torsten B Neilands
- University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Nnenna Anako
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA; Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Claude A Mellins
- Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
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Girma S, Tsehay M, Mamaru A, Abera M. Depression and its determinants among adolescents in Jimma town, Southwest Ethiopia. PLoS One 2021; 16:e0250927. [PMID: 33939748 PMCID: PMC8092653 DOI: 10.1371/journal.pone.0250927] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 04/16/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine the prevalence and socio-demographic and parental-related factors of depression among school adolescents in Jimma town, southwest Ethiopia. METHODS Using a cross-sectional survey, 546 school adolescents were screened for depression using the patient health questionnaire (PHQ-9) from five randomly selected public and private schools. Oslo social support scale, adverse childhood experience tool, and socio-demographic questionnaire were used to gather data on risk factors. Linear regression analysis was used, and unstandardized beta (β) coefficients with 95% confidence intervals (CI) were reported to declare statistical significance. RESULTS A total of 546 adolescents participated in the study, with a response rate of 97.3%. The mean (±SD) age of participants was 16.8 ± 1.3 years. The majority (81%) of the adolescents were attending day classes at public schools. The prevalence of depression was found to be 28% using the patient health questionnaire. Based on the PHQ-9 depression severity scale, 18.5% and 8.2% of the adolescent had moderate and moderate to severe depression while 1.3% had severe depression. In the final multivariate linear regression analysis, it was found that sex, rural residence, low social support, being in higher grade level, and adverse childhood experience were found to be independently associated with a higher score of depression. CONCLUSION One in three adolescents was found to have a depressive syndrome. We recommend schools to integrate school mental health service that contains routine screening and intervention services. Moreover, efforts are needed to sensitize and educate the communities on child protection, social support, and safeguarding to effectively tackle the magnitude of adolescent depression.
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Affiliation(s)
- Shimelis Girma
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mekonnen Tsehay
- Department of Psychiatry, Wollo University, Dessie, Wollo, Ethiopia
| | - Almaz Mamaru
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
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Paul B, Usha VK. Prevalence and Predictors of Depression Among Adolescents. Indian J Pediatr 2021; 88:441-444. [PMID: 33011899 DOI: 10.1007/s12098-020-03491-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To determine the prevalence of depression among school going adolescents and to identify the predictors of adolescent depression. METHODS A total of 1057 adolescents (619 males and 438 females) studying in six selected schools of Ernakulam District, Kerala participated in the study. All the students from 8th to 12th standards of the schools present during the time of data collection who met the inclusion criteria were enrolled into the study. Data were collected using Socio personal data sheet and CESD-R (Centre for Epidemiological Studies Depression scale- Revised). RESULTS Of 1057 samples, 150 (14.19%) had depression and 907 (85.87%) had no depression. Among them 14.53% (90) of males and 13.69% (60) of females had depression. Family history of medication use (OR: 1.43, CI: 0.5-0.585), history of medication use among adolescents (OR: 6.07, CI: 0.496-0.515), history of family dispute (OR: 3.32, CI: 0.536-0.605), presence of learning disability (OR: 2.20, CI: 0.51-0.571), chronic physical illness (OR: 2.22, 0.508-0.567) and mother's occupation (OR: 1.40, CI: 0.499-0.581) were significantly associated with depression among adolescents. Family dispute (OR: 2.65, CI: 0.232-0.608) was the only predictor of depression among adolescents. CONCLUSIONS With limitations of the study, authors observed that family dispute is a significant predictor of depression in adolescents.
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Affiliation(s)
- Besi Paul
- Department of Mental Health Nursing, MOSC College of Nursing, Kolenchery, Kerala, India.
| | - V K Usha
- Govt. Nursing College, Kottayam, Kerala, India
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Satinsky EN, Kakuhikire B, Baguma C, Rasmussen JD, Ashaba S, Cooper-Vince CE, Perkins JM, Kiconco A, Namara EB, Bangsberg DR, Tsai AC. Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study. PLoS Med 2021; 18:e1003642. [PMID: 33979329 PMCID: PMC8153443 DOI: 10.1371/journal.pmed.1003642] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 05/26/2021] [Accepted: 04/29/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda. METHODS AND FINDINGS Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a modified version of the Adverse Childhood Experiences-International Questionnaire, and depression symptom severity and suicidal ideation were assessed using the Hopkins Symptom Checklist for Depression (HSCL-D). We applied a validated algorithm to determine major depressive disorder diagnoses. Overall, 1,458 participants (90%) had experienced at least one ACE, 159 participants (10%) met criteria for major depressive disorder, and 28 participants (1.7%) reported suicidal ideation. We fitted regression models to estimate the associations between cumulative number of ACEs and depression symptom severity (linear regression model) and major depressive disorder and suicidal ideation (Poisson regression models). In multivariable regression models adjusted for age, sex, primary school completion, marital status, self-reported HIV status, and household asset wealth, the cumulative number of ACEs was associated with greater depression symptom severity (b = 0.050; 95% confidence interval [CI], 0.039-0.061, p < 0.001) and increased risk for major depressive disorder (adjusted relative risk [ARR] = 1.190; 95% CI, 1.109-1.276; p < 0.001) and suicidal ideation (ARR = 1.146; 95% CI, 1.001-1.311; p = 0.048). We assessed the robustness of our findings by probing for nonlinearities and conducting analyses stratified by age. The limitations of the study include the reliance on retrospective self-report as well as the focus on ACEs that occurred within the household. CONCLUSIONS In this whole-population, cross-sectional study of adults in rural Uganda, the cumulative number of ACEs had statistically significant associations with depression symptom severity, major depressive disorder, and suicidal ideation. These findings highlight the importance of developing and implementing policies and programs that safeguard children, promote mental health, and prevent trajectories toward psychosocial disability.
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Affiliation(s)
- Emily N. Satinsky
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | - Jessica M. Perkins
- Peabody College, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Allen Kiconco
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - David R. Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- Oregon Health and Science University—Portland State University School of Public Health, Portland, Oregon, United States of America
| | - Alexander C. Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
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Pathways to Depression and Poor Quality of Life Among Adolescents in Western Kenya: Role of Anticipated HIV Stigma, HIV Risk Perception, and Sexual Behaviors. AIDS Behav 2021; 25:1423-1437. [PMID: 32737818 DOI: 10.1007/s10461-020-02980-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Depression is a major cause of disease burden and is linked to poor quality of life (QOL) among adolescents. We examined the roles of sexual behaviors, HIV risk perception, and anticipated HIV stigma on depressive symptomatology and QOL among 4096 adolescents in a rural region of western Kenya with a high burden of HIV. Participants were aged 15-19 years, had not been tested for HIV in the previous 6 months, and had never been diagnosed with HIV. Anticipated stigma and risk perception were directly associated with depressive symptomatology and QOL. There was evidence of small indirect effects-through stigma-of risk perception on depressive symptomatology and QOL. Gender moderated relationships between sexual behavior and risk perception, depressive symptomatology, and QOL. Results suggest that developing effective gender-based interventions to address stigma, sexual behavior, and risk perception may be important for improving adolescent well-being in high HIV prevalence contexts.
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Fuseekul N, Orchard F, Reynolds S. Psychometric properties of the Thai Mood and Feelings Questionnaire (MFQ) for adolescent depression. Child Adolesc Psychiatry Ment Health 2021; 15:17. [PMID: 33836780 PMCID: PMC8035723 DOI: 10.1186/s13034-021-00372-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Mood and Feelings Questionnaire (MFQ) is a widely used screening tool for child and adolescence depression but has not been validated with young people in Thailand. This study aimed to assess the reliability and validity and to determine the optimal clinical cut-off of the Thai MFQ. METHODS The Thai MFQ was evaluated in two parts. In part 1, The MFQ was translated and back translated into the Thai language and piloted on a small number of Thai adolescents. Then 1275 young people aged 12-18 years from three secondary schools in Thailand completed the MFQ and related measures of depression. In part 2, 138 students were invited to take part in a structured diagnostic interview (the Thai translation of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children -Present and Lifetime Version (the K-SADS-PL). Of those, 103 students were interviewed and completed the Thai MFQ a second time to assess test-retest reliability. Receiver Operating Characteristics (ROC) analyses were conducted to evaluate diagnosis accuracy and examine the optimal cut-off score of the Thai MFQ. RESULTS The Thai MFQ had excellent internal consistency (α = 0.92) and good to moderate test-retest reliability in 2-week and 4-week intervals. The Thai MFQ also had good convergent validity with related measures of depression. The ROC analyses demonstrated that the Thai MFQ also had excellent accuracy distinguishing between depressed and non-depressed adolescents [AUC = 0.95, 95% CI [0.92, 0.99]. A total score of 28 on the Thai MFQ was the optimal cut-off score (sensitivity was 0.97 and specificity was 0.83). DISCUSSION The Thai MFQ demonstrated excellent psychometric properties and accurately distinguished between depressed and non-depressed adolescents. It is appropriate to use as a screening measure to identify adolescents with depression in community settings in Thailand.
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Affiliation(s)
- Nanthaka Fuseekul
- School of Psychology and Clinical Language School Sciences, University of Reading, Reading, RG6 6AL, UK.
| | - Faith Orchard
- grid.12082.390000 0004 1936 7590School of Psychology, University of Sussex, Sussex, UK
| | - Shirley Reynolds
- grid.9435.b0000 0004 0457 9566School of Psychology and Clinical Language School Sciences, University of Reading, Reading, RG6 6AL UK
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Ashaba S, Cooper-Vince C, Maling S, Satinsky EN, Baguma C, Akena D, Nansera D, Bajunirwe F, Tsai AC. Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100094. [PMID: 34841384 PMCID: PMC8623847 DOI: 10.1016/j.jadr.2021.100094] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors. METHODS We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support. RESULTS Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted. LIMITATIONS Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse. CONCLUSIONS Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.
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Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | | | - Samuel Maling
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Emily N. Satinsky
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Charles Baguma
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere College of Health Sciences, Makerere, Uganda
| | - Denis Nansera
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Francis Bajunirwe
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Alexander C. Tsai
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Wang Z, Zhang Q, Huang H, Liu Z. The efficacy and acceptability of curcumin for the treatment of depression or depressive symptoms: A systematic review and meta-analysis. J Affect Disord 2021; 282:242-251. [PMID: 33418373 DOI: 10.1016/j.jad.2020.12.158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/11/2020] [Accepted: 12/23/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Curcumin, a potential natural substance is a promising complementary and alternative therapeutic intervention for depression or depressive symptoms. We undertook a systematic review and meta-analysis to evaluate the efficacy and acceptability. METHODS PubMed, EMBASE, PsycInfo, Web of Science, Cochrane Library and ClinicalTrials.gov were searched from the inception up until March 4, 2020. The Outcomes were depressive symptoms, response rates, drop-out rates, and adverse effects. RESULTS A total of 594 patients from ten trials were subjected to meta-analysis. Three trials were judged to be at high risk of bias, four at unclear risk of bias and three at low risk of bias. Most of the domains for risk of bias were at low risk or unclear risks and three domains at high risks. The pooling results suggested a significant difference in depression or depressive symptoms(SMD= -0.32, 95% CI: -0.50 to -0.13, I2=15%, n=594) and response rates (OR=3.20, 95% CI: 1.28-7.99, I2=35%, n=271). However, there was no difference between drop-out rates (OR=1.06, 95% CI: 0.58-1.93, I2=0%, n=594), digestive symptoms (OR=1.27, 95% CI: 0.69-2.32, I2=0%, n=284) and neurological symptoms (OR=1.08, 95% CI: 0.49-2.36, I2=0%, n=284). Subgroup analysis showed depression was associated with a reduction(SMD= -0.35, 95% CI: -0.56 to -0.15, I2=7%, n=432) but depressive symptoms were not (SMD= -0.17, 95% CI: -0.61 to 0.26, I2=40%, n=162). CONCLUSIONS The evidence quality is low, indicating that there is great uncertainty about the efficacy and acceptability of curcumin for the treatment of depression or depressive symptoms.
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Affiliation(s)
- Zhe Wang
- The first hospital of China Medical University, 155 Nanjingbei Street, Shenyang, Liaoning, 110001, China.
| | - Qun Zhang
- The first hospital of China Medical University, 155 Nanjingbei Street, Shenyang, Liaoning, 110001, China.
| | - Hongfei Huang
- The first hospital of China Medical University, 155 Nanjingbei Street, Shenyang, Liaoning, 110001, China.
| | - Ziping Liu
- The first hospital of China Medical University, 155 Nanjingbei Street, Shenyang, Liaoning, 110001, China.
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Nabwera HM, Shah V, Neville R, Sosseh F, Saidykhan M, Faal F, Sonko B, Keita O, Schmidt WP, Torondel B. Menstrual hygiene management practices and associated health outcomes among school-going adolescents in rural Gambia. PLoS One 2021; 16:e0247554. [PMID: 33630924 PMCID: PMC7906402 DOI: 10.1371/journal.pone.0247554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 02/10/2021] [Indexed: 01/18/2023] Open
Abstract
Inadequate menstrual hygiene management (MHM) practices have been associated with adverse health outcomes. This study aimed to describe MHM practices among schoolgirls from rural Gambia and assess risk factors associated with urogenital infections and depressive symptoms. A cross-sectional study was conducted among adolescent schoolgirls in thirteen schools in rural Gambia. A questionnaire was used to collect information on socio-demographics, MHM practices and clinical symptoms of reproductive and urinary tract infections (UTIs). A modified Beck Depression Inventory-II was used to screen for depressive symptoms. Mid-stream urine samples were collected to assess for UTIs. Modified Poisson regression analysis was used to determine risk factors for symptoms of urogenital infections and depression among adolescent girls. Three hundred and fifty-eight girls were recruited. Although, 63% of the girls attended schools providing free disposable pads, reusable cloths/towels were the commonest absorbent materials used. Heavy menstrual bleeding was associated with depressive symptoms (adjusted prevalence ratio, aPR 1.4 [95% CI 1.0, 1.9]), while extreme menstrual pain (aPR 1.3 [95% CI 1.2, 1,4]), accessing sanitary pads in school (aPR 1.4 [95% CI 1.2, 1.5]) and less access to functional water source at school (aPR 1.4 [95% CI 1.3, 1.6]) were associated with UTI symptoms. Conversely, privacy in school toilets (aPR 0.6 [95% CI 0.5, 0.7]) was protective for UTI symptoms. Heavy menstrual bleeding (aPR 1.4 [95% CI 1.1, 2.0]) and taking <30 minutes to collect water at home were associated with RTI symptoms (aPR 1.2 [95% CI 1.0, 1.5]) while availability of soap in school toilets (aPR 0.6 [95% CI 0.5, 0.8] was protective for RTI symptoms. Interventions to ensure that schoolgirls have access to private sanitation facilities with water and soap both at school and at home could reduce UTI and RTI symptoms. More attention is also needed to support girls with heavy menstrual bleeding and pain symptoms.
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Affiliation(s)
- Helen M. Nabwera
- Environmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Vishna Shah
- Environmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Rowena Neville
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Fatou Sosseh
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Mariama Saidykhan
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Fatou Faal
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Bakary Sonko
- Nutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Omar Keita
- Regional Education Directorate Four, Ministry of Basic and Secondary Education, Mansakonko Lower River Region, The Gambia
| | - Wolf-Peter Schmidt
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Belen Torondel
- Environmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
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Folayan MO, Tantawi ME, Oginni O, Oziegbe E, Mapayi B, Arowolo O, Adeniyi AA, Sam-Agudu NA. Oral health practices and oral hygiene status as indicators of suicidal ideation among adolescents in Southwest Nigeria. PLoS One 2021; 16:e0247073. [PMID: 33630858 PMCID: PMC7906320 DOI: 10.1371/journal.pone.0247073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background Oral health is a less-recognized correlate of overall and mental wellbeing. This study aimed to assess the relationship between suicidal behavior (ideation and attempt) and oral health practices and status, and to determine the effect of sex on these associations among Nigerian adolescents. Methods Household survey data were collected from 10 to 19-year-old adolescents in southwestern Nigeria. Dependent variables were daily tooth brushing, daily consumption of refined carbohydrates between meals, and oral hygiene status (measured by plaque index). The independent variable was lifetime suicidal ideation/attempt, dichotomized into ‘yes’ and ‘never’. ‘Daily tooth brushing’ and ‘daily consumption of refined carbohydrates between meals’ were included in two separate logistic regression models, and ‘oral hygiene status’ was included in a linear regression model. The models were adjusted for sex, age, and socioeconomic status. The linear regression model was also adjusted for frequency of daily tooth-brushing and of consumption of refined carbohydrates between meals. Interactions between sex and suicidal ideation/suicide attempt in association with dependent variables were assessed. Significance was set at 5%. Results We recruited 1,472 participants with mean age (standard deviation) of 14.6 (2.6) years. The mean plaque index was 0.84 (0.56), and 66 (4.5%) adolescents reported ever having suicidal ideation/attempt. Suicidal ideation/attempt was associated with significantly lower likelihood of tooth brushing (OR = 0.48, 95% CI: 0.26, 0.91), higher likelihood of consuming refined carbohydrates between meals (OR = 2.30, 95% CI: 1.29, 4.10), and having poor oral hygiene (B = 0.18, 95% CI: 0.05, 0.32). Among males, suicidal ideation/attempt was associated with less likelihood of eating refined carbohydrates between meals (OR = 0.96, 95% CI: 0.35, 2.61). Conversely, it was associated with a significantly higher likelihood of this outcome (OR = 4.85, 95% CI: 2.23, 10.55) among females. Conclusion The study findings suggest that poor tooth brushing habits and poor oral hygiene are indicators for risk of suicidal behavior for adolescents in Nigeria, while high sugar consumption may be an additional risk factor for adolescent females. These findings support the role of dental practitioners as members of healthcare teams responsible for screening, identifying and referring patients at risk for suicidal ideation/attempt.
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Affiliation(s)
| | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Alexandria Governorate, Egypt
| | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Elizabeth Oziegbe
- Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olaniyi Arowolo
- Obafemi Awolowo University Teaching Hospitals’ Complex, Ile-Ife, Osun State, Nigeria
| | | | - Nadia A. Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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42
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Nabunya P, Damulira C, Byansi W, Muwanga J, Bahar OS, Namuwonge F, Ighofose E, Brathwaite R, Tumwesige W, Ssewamala FM. Prevalence and correlates of depressive symptoms among high school adolescent girls in southern Uganda. BMC Public Health 2020; 20:1792. [PMID: 33238965 PMCID: PMC7689972 DOI: 10.1186/s12889-020-09937-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022] Open
Abstract
Background In sub-Saharan Africa (SSA), adolescent girls and young women are three times more likely than boys to have depressive disorders. Understanding adolescents’ unique and common vulnerabilities and protective factors is essential for the development of appropriate interventions and programming focused on child and adolescent mental health. This paper examines the prevalence and predictors of depressive symptoms among high school adolescent girls in southern Uganda. Methods Baseline data from a longitudinal cluster randomized study involving 1260 adolescent girls (14–17 years), recruited from 47 secondary schools were utilized. Depressive symptoms were estimated using the 21-item Beck’s Depression Inventory. Hierarchical linear regression modelling was utilized to estimate key predictors of depressive symptoms among adolescent girls. Results Of the total sample, 16.35% (n = 206) reported severe depressive symptoms and almost one in every three adolescent girls interviewed (29.68%, n = 374) reported moderate symptoms. These symptoms were more prevalent among older adolescents (16 years and above). In addition, family relationships, social support, as well as measures of psychological wellbeing (self-concept and self-esteem) were all associated with lower levels of depressive symptoms. Hopelessness was associated with higher levels of depressive symptoms among adolescent girls. Conclusion Findings from this study indicate a high prevalence of depressive symptoms, especially among older adolescent girls. In addition, family support factors and adolescents’ psychological wellbeing were associated with low levels of depressive symptoms –pointing to the need to strengthen family functioning and adolescent’s psychological wellbeing to mitigate risks. Taken together, findings support increasing calls for early screening and detection of depressive symptoms to facilitate timely referral to care and treatment. Findings may also inform the development and incorporation of gender-specific mental health components in programming targeting adolescent girls, in low-resource communities in SSA. Trial registration This trial was prospectively registered with ClinicalTrials.gov (registration number: NCT03307226) on 11 October 2017.
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Affiliation(s)
- Proscovia Nabunya
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Christopher Damulira
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - William Byansi
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Joelynn Muwanga
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Flavia Namuwonge
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Eloho Ighofose
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Rachel Brathwaite
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Wilberforce Tumwesige
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Fred M Ssewamala
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
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43
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Engebretsen IMS, Nalugya JS, Skylstad V, Ndeezi G, Akol A, Babirye JN, Nankabirwa V, Tumwine JK. "I feel good when I drink"-detecting childhood-onset alcohol abuse and dependence in a Ugandan community trial cohort. Child Adolesc Psychiatry Ment Health 2020; 14:42. [PMID: 33110445 PMCID: PMC7585688 DOI: 10.1186/s13034-020-00349-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 10/15/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Alcohol, substance use, and mental health disorders constitute major public health issues worldwide, including in low income and lower middle-income countries, and early initiation of use is an important predictor for developing substance use disorders in later life. This study reports on the existence of childhood alcohol abuse and dependence in a sub-study of a trial cohort in Eastern Uganda. METHODS The project SeeTheChild-Mental Child Health in Uganda (STC) included a sub-study of the Ugandan site of the study PROMISE SB: Saving Brains in Uganda and Burkina Faso. PROMISE SB was a follow-up study of a trial birth cohort (PROMISE EBF) that estimated the effect that peer counselling for exclusive breast-feeding had on the children's cognitive functioning and mental health once they reached 5-8 years of age. The STC sub-study (N = 148) used the diagnostic tool MINI-KID to assess mental health conditions in children who scored medium and high (≥ 14) on the Strengths and Difficulties Questionnaire (SDQ) in the PROMISE SB cohort N = (119/148; 80.4%). Another 29/148 (19.6%) were recruited from the PROMISE SB cohort as a comparator with low SDQ scores (< 14). Additionally, the open-ended questions in the diagnostic history were analysed. The MINI-KID comprised diagnostic questions on alcohol abuse and dependence, and descriptive data from the sub-study are presented in this paper. RESULTS A total of 11/148 (7.4%) children scored positive for alcohol abuse and dependence in this study, 10 of whom had high SDQ scores (≥ 14). The 10 children with SDQ-scores ≥ 14 had a variety of mental health comorbidities of which suicidality 3/10 (30.0%) and separation anxiety disorder 5/10 (50.0%) were the most common. The one child with an SDQ score below 14 did not have any comorbidities. Access to homemade brew, carer's knowledge of the drinking, and difficult household circumstances were issues expressed in the children's diagnostic histories. CONCLUSIONS The discovery of alcohol abuse and dependence among 5-8 year olds in clinical interviews from a community based trial cohort was unexpected, and we recommend continued research and increased awareness of these conditions in this age group.Trial registration Trial registration for PROMISE SB: Saving Brains in Uganda and Burkina Faso: Clinicaltrials.gov (NCT01882335), 20 June 2013. Regrettably, there was a 1 month delay in the registration compared to the commenced re-inclusion in the follow-up study: https://clinicaltrials.gov/ct2/show/NCT01882335?term=saving+brains&draw=2&rank=1.
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Affiliation(s)
- Ingunn Marie Stadskleiv Engebretsen
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Joyce S. Nalugya
- grid.11194.3c0000 0004 0620 0548Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vilde Skylstad
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- grid.11194.3c0000 0004 0620 0548Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Angela Akol
- grid.7914.b0000 0004 1936 7443Global Mental Health Research Group, Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Juliet N. Babirye
- grid.11194.3c0000 0004 0620 0548School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- grid.11194.3c0000 0004 0620 0548School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda ,grid.7914.b0000 0004 1936 7443Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - James K. Tumwine
- grid.11194.3c0000 0004 0620 0548Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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44
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Saupe LB, Gößmann K, Catani C, Neuner F. Understanding the link between child maltreatment and adolescent future expectations in Northern Uganda: A serial mediation analysis. CHILD ABUSE & NEGLECT 2020; 106:104511. [PMID: 32408023 DOI: 10.1016/j.chiabu.2020.104511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 03/20/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Recent research has identified high levels of child maltreatment and harsh parenting in post-war societies which have had detrimental effects on children's development. Future expectations are an important aspect of adolescents' development particularly in the challenging contexts of post-war societies where social instabilities and violence are prevalent. To date, however, the link between child maltreatment and adolescent future expectations remains understudied. OBJECTIVE By applying a socio-ecological perspective, this study aimed to investigate risk (internalizing symptoms) and protective factors (community integration) linking experiences of harsh parenting with adolescents' future expectations. PARTICIPANTS AND SETTING Data was collected from N = 199 northern Ugandan adolescents (40.2 % females, Mage = 14.56 years) with structured interviews. METHODS Serial mediation analyses were calculated with child maltreatment as the predictor, future expectations as the outcome, and internalizing symptoms as well as community integration as mediating variables. RESULTS Results of the mediation model (R2 = .22, F(5193) = 10.54, p < .001, total effect (b = -0.28, p < .005) revealed a direct effect of child maltreatment on future expectations (effect size: -.20, 95 % bootstrap CI = -0.40, -.01) as well as an indirect effect of child maltreatment via internalizing symptoms and community integration on future expectations (effect size of -.07 (95 % bootstrap CI = -0.14, -0.01). CONCLUSION Child maltreatment was found to be linked to negative future expectations among Northern Ugandan adolescents, and both internalizing symptoms as well as community integration played mediating roles in the associations. Interventions should take psychopathology and community factors into account.
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Affiliation(s)
- Laura B Saupe
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany.
| | - Katharina Gößmann
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Claudia Catani
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
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Mugisha J, Kinyanda E, Osafo J, Nalukenge W, Knizek BL. Health care professionals' perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with HIV/AIDS and mental distress in a rural district in central, Uganda. Child Adolesc Psychiatry Ment Health 2020; 14:26. [PMID: 32518588 PMCID: PMC7271468 DOI: 10.1186/s13034-020-00332-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 05/26/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little/no research has been conducted in Uganda in particular and sub-Saharan Africa in general on the health professional's perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with a double burden of HIV/AIDS and mental distress. AIM To explore health professionals' perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with HIV/AIDS and mental distress in Masaka, Uganda. METHOD Qualitative research design using key informant interviews with health service managers and staff in agencies working with children and adolescents with HIV/AIDS in Masaka district, Uganda. RESULTS Barriers to treatment seeking reported by health care professionals were quite enormous and are summarized under: family, individual, community and health systems level barriers. The crosscutting finding here is that the societal informal and formal systems of care had been affected by the HIV/AIDs epidemic, and, mental distress aggravates this challenge for the individuals afflicted and families affected by mental distress. CONCLUSION Children and adolescents with both HIV/AIDS and mental distress are vulnerable due to constraints at family, community and health systems levels. Effective public health interventions to address the double burden of HIV/AIDS and mental distress will be vital in the study communities addressing the constraints at family, community and institutional level. Public health interventions should aim at increased access and effective utilization of services for both HIV/AIDS and mental health services. Stigma reduction strategies at individual, family and community levels are also recommended.
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Affiliation(s)
- James Mugisha
- Kyambogo University, Kampala, Uganda
- Butabika National Referral and Teaching Mental Hospital, Kampala, P.O. Box 2958, Kampala, Uganda
| | - Eugene Kinyanda
- MRC/UVRI & LSHTM Uganda Research Unit On AIDS & Senior Wellcome Trust Fellowship, 50-59 Nakiwogo Street, Entebbe, Uganda
- Department of Psychiatry, Makerere University, Mulago Hill, Kampala, Uganda
| | - Joseph Osafo
- College of Humanities, School of Social Sciences, Department of Psychology, University of Ghana, Legon, Accra, Ghana
| | - Winfred Nalukenge
- MRC/UVRI & LSHTM Uganda Research Unit On AIDS & Senior Wellcome Trust Fellowship, 50-59 Nakiwogo Street, Entebbe, Uganda
| | - Birthe Loa Knizek
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Chibuike Chukwuere P, Jacobus Pienaar A, Sehularo LA. Psychosocial management of depression in adolescent learners: Results and implications of a Nigerian study. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1744282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Abel Jacobus Pienaar
- Faculty of Nursing, University of Venda, South Africa
- Faculty of Nursing and Midwifery at Shifa Tameer-et-Millat University, Pakistan
| | - Leepile Alfred Sehularo
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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47
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When adolescents face both Internet addiction and mood symptoms: A cross-sectional study of comorbidity and its predictors. Psychiatry Res 2020; 284:112795. [PMID: 31986358 DOI: 10.1016/j.psychres.2020.112795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 01/06/2023]
Abstract
This study aimed to determine the prevalence of comorbid Internet addiction (IA) and mood symptoms and to identify common and unique risk profiles for individual and comorbid mental health problems among adolescents. A total of 2272 high school students in Changchun, China, were included in a cross-sectional study. Participants were asked to complete paper-based questionnaires on sociodemographic characteristics, lifestyle factors, Internet use, parent-child relationships, IA, and mood symptoms. Multivariate logistic regressions were used to compare the risk profiles for IA, mood symptoms, and their comorbidity. The Bonferroni correction was used for multiple tests. Students who were girls, were current smokers, had more than 1.5 h sleep deprivation per day on weekdays, used the Internet for more than 30 and 240 min per day on weekdays and weekends, respectively, used social networking sites more than 6 times per day, were Internet gamers, and/or reported poor parent-child relationships reported higher rates of comorbid IA and mood symptoms. Adolescents exposed to more of these correlates would have a higher risk of IA, mood symptoms, and their comorbidity. Public strategies for the prevention of mental illnesses should expand their capacity to identify and limit the co-occurrence of IA and mood symptoms.
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48
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Nyundo A, Manu A, Regan M, Ismail A, Chukwu A, Dessie Y, Njau T, Kaaya SF, Smith Fawzi MC. Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub-Saharan African adolescents aged 10-19 years: cross-sectional study. Trop Med Int Health 2019; 25:54-69. [PMID: 31698526 DOI: 10.1111/tmi.13336] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors. METHODS Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed. RESULTS The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001). CONCLUSIONS Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention.
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Affiliation(s)
- Azan Nyundo
- Department of Psychiatry and Mental Health, School of Medicine, University of Dodoma, Dodoma, Tanzania
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mathilda Regan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Abbas Ismail
- Department of Statistics, University of Dodoma, Dodoma, Tanzania
| | - Angela Chukwu
- Department of Statistics, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tasiana Njau
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sylvia F Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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49
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Kyohangirwe L, Okello E, Namuli JD, Ndeezi G, Kinyanda E. Prevalence and factors associated with major depressive disorder among adolescents attending a primary care facility in Kampala, Uganda. Trop Doct 2019; 50:30-36. [PMID: 31594531 DOI: 10.1177/0049475519879586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Information on major depressive disorder (MDD) in primary care settings in sub-Saharan Africa is limited, yet this is required to improve service development. We explored prevalence and factors associated with MDD among adolescents attending a primary care facility in urban Uganda. At Naguru Teenage Information and Health Centre, 281 adolescents were assessed for MDD using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid). Prevalence and risk factors were determined using frequencies and regressions, respectively. The prevalence of adolescent MDD was 18.2 %. Vulnerability factors were orphanhood, childhood trauma (particularly emotional abuse and physical neglect) while social support was protective. Considerable burden of clinically significant depression exists in primary care settings in Uganda; this may well contribute to a poor quality of life.
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Affiliation(s)
- Leticia Kyohangirwe
- Psychiatrist, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda.,Scientist and study coordinator, Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Kampala, Uganda
| | - Elialilia Okello
- Associate Professor, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Justine D Namuli
- Lecturer, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Grace Ndeezi
- Professor, Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eugene Kinyanda
- Professor, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda.,Head of the Mental Health Section, Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Kampala, Uganda
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50
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Effect of Group Cognitive Behavioural Therapy on Depressive Symptoms in a Sample of College Adolescents in Nigeria. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2019. [DOI: 10.1007/s10942-019-00327-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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