Incidence of depressive symptoms among sexually abused children in Kenya

Prevalence and correlates of depressive disorders in commercially sexual exploited children: A cross-sectional study in Mombasa, Kenya

BACKGROUND

Commercial sexual exploitation of children (CSEC) is a global concern and is among the common forms of sexual violence against children. In Kenya, about 32 % of girls and 16 % of boys experience sexual violence before the age of 18 years. While much has been written about the impact of child sexual exploitation, there's little on the prevalence of depressive disorders among CSE children.

OBJECTIVES

This study was conducted to assess the prevalence and correlates of depressive disorders among CSE children in Mombasa, Kenya.

PARTICIPANTS AND SETTING

The study was conducted among CSE children (10-17 years) in Mombasa County.

METHODS

A cross-sectional study conducted between May 2021 and June 2022. A total of 409 CSE children were enrolled, using a case management approach. Data was collected using the child identification tool and the Patient Health Questionnaire (PHQ-9), at the first counselling session to determine the prevalence of depression levels.

RESULTS

Of the 409 children, 367 (90 %) were girls while 42 (10 %) were boys. The mean age was 15 years (10-17) (SD = 1.4, t = 0.765). In 286 (70 %) 'Depression unlikely' was recorded, while 123 (30 %) 'Depression likelihood.' Prevalence of mild to severe depression was significantly higher in girls than boys (p = 0.002). Other determinants of depression were having a primary level of education (p = 0.03) and being an orphan. (p = 0.03).

CONCLUSION

It is important to prioritize mental health interventions such as screening and early diagnosis of mental health among CSE children in order to prevent and manage both short and long term effects.

Sexual Trauma Informed Understanding of Longitudinal Depression among Repeat Juvenile Offenders

Childhood sexual assault (CSA) victimization and depression are global public health concerns that disproportionately affect youths involved in the juvenile justice system. Little research has examined the influence of CSA on the stability of depressive symptoms among repeat juvenile offenders. The present study tested a gendered model of the association between lifetime CSA victimization and depression for three time points: baseline juvenile assessment entry; second reentry; and third reentry. Further, covariate analyses were conducted to explore the impact of socio-demographics on CSA victimization and depression. Results indicate that CSA victimization was associated directly with baseline depression and indirectly with depression at second reentry for both male and female justice-involved youths. For white, male youth, there were significantly higher rates of depression over time, than other males. However, age, African American or Hispanic race/ethnicity, living situation, and urbanity were not significantly associated with CSA victimization at baseline or depression over time. These findings underscore the need for juvenile justice services that address exposure to childhood trauma and mental illness more effectively.

Rape Survivors' Sorrow: Major Depressive Symptoms and Sexually Transmitted Infection Among Adolescent Girls, Southwest Ethiopia

Purpose

Rape is one of the sexual violence acts against women globally. Adolescent girls are vulnerable to this event and experience more severe and long-standing adverse effects. Thus, this study aimed to examine major depressive symptoms and associated factors and the level of sexually transmitted infection among female adolescents evaluated for rape cases at Jimma Medical Center.

Patients and Methods

Institutional-based cross-sectional study was conducted among adolescent girls assessed for rape cases in Jimma Medical Center. Data were collected using structured questionnaire and entered into Epi Data version 3.1 then exported to SPSS version 21.0 for analysis. Descriptive statistics and regression analyses were carried out.

Results

A total of 174 raped adolescent females took part in the study. Of the total participants, 155 (89.1%) of these individuals had major depressive symptoms (95 CI %, 84.5–93.7%), while 85 (48.9%) of them had an STI (95% CI, 41.1–56.9%). From logistic regression, place of residence (AOR 14.65, 95%, (p=0.002)), attending school currently (AOR 9.01, 95%, p=0.004), raped by hitting (AOR 17.67, 95%, p<0.001) and unwanted pregnancy (AOR 14.68, 95%, p=0.001) were the variables associated with major depression.

Conclusion

This study indicates that adolescents were suffering from several encumbrances like major depressive symptoms, sexually transmitted diseases and unwanted pregnancy. It also indicated that place of residence, school attending, and unwanted pregnancy had an association with major depressive symptoms. Therefore, the need for a comprehensive approach while treating this vulnerable group is highly recommended.

Self-Harm Among School-Going Adolescent Survivors of Sexual Violence Victimisation: A Cross-Sectional Study

Background: A growing body of evidence from high-income contexts suggests a strong association between sexual violence victimisation and self-harm and eventual suicide. However, both sexual violence and self-harm among adolescents are still less researched in sub-Saharan African countries, including Ghana. Objectives: To estimate the 12-month prevalence of self-harm, and to describe the associated factors and reported reasons for self-harm among school-going adolescent survivors of sexual violence victimisation during the previous 12 months in urban Ghana. Methods: Analytic data came from a regional-based representative cross-sectional survey including in-school youth (N = 1,723) conducted in 2017 within the Greater Accra Region of Ghana. Of these, 297 (17.2%) self-reported sexual violence victimisation in the previous 12 months; this proportion of the participants (n = 297) was the focus of the current study. Items measuring sexual violence victimisation, self-harm, and correlates were adopted from the 2012 Ghana WHO-Global School-based Student Health Survey and the Child and Adolescent Self-harm in Europe Study. Data analysis involved multivariable logistic regression models. Results: The estimate of self-harm ideation during the previous 12 months was 45.8% (95% CI: 40-52), whereas the estimate of self-harm behaviour was 38.7% (95% CI: 33-44). About two in five of the participants who reported self-harm wanted to die by their last episode of the behaviour. While bullying victimisation was associated with increased odds of self-harm ideation (aOR = 1.97, 95% CI 1.17, 3.31, p = 0.010) and behaviour (aOR = 2.76, 95% CI 1.59, 4.80, p < 0.001), weekly alcohol use (aOR = 2.56, 95% CI 1.32, 4.93, p = 0.005), conflict with parents (aOR = 2.30, 95% CI 1.28, 4.12, p = 0.005), and physical abuse victimisation (aOR = 1.80, 95% CI 1.03, 3.15, p = 0.037) showed strong associations with increased odds of self-harm behaviour in the past 12 months. Conclusions: The evidence underscores the need for both universal and targeted multi-level intervention and prevention programmes to mitigate the offence of sexual violence and reduce the chances of self-harm among adolescent survivors of sexual violence in urban Ghana.

A systematic review of short and medium-term mental health outcomes in young people following sexual assault

Objective: Sexual assault peaks in adolescence, yet sequelae at this age are not well understood. This systematic review aimed to describe mental health outcomes following sexual assault in young people. Method: Two reviewers independently searched databases, screening publications from 1990 to 2018. Inclusion criteria included: longitudinal studies, systematic reviews, and meta-analyses with ≥50% participants aged ten to 24 years; baseline mental health assessment prior to/or <8 weeks post-assault with follow-up ≥ 3 months after the initial assessment.Results: 5 124 titles and abstracts were screened, with 583 papers examined in full. Ten studies met inclusion criteria (sample size 31 to 191). Five studies examined rates of post-traumatic stress disorder (PTSD), reporting rates of up to 95% within one month and up to 60% at 12 months post-assault. Studies evaluating post-traumatic (n = 5) and anxiety (n = 3) symptom scores showed symptoms were highest in the immediate aftermath of the trauma, generally reducing over four to 12 months post-assault. Depressive symptomology appeared to vary between studies (n = 5). However, the majority showed symptoms decreasing over the same time period.Conclusions: Psychopathology is common following sexual assault in young people. Most studies observed reduced rates over time, but there is a paucity of longitudinal research. Psychopathology during the first year after sexual assault is an important treatment target to consider.