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Ahun MN, Appiah R, Aurino E, Wolf S. Caregiver mental health and school-aged children's academic and socioemotional outcomes: Examining associations and mediators in Northern Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003724. [PMID: 39269978 PMCID: PMC11398656 DOI: 10.1371/journal.pgph.0003724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024]
Abstract
While there is a strong link between caregiver mental health, caregiver engagement, and child development, limited research has examined the underlying mechanisms of these associations in Africa. We examined the mediating role of dimensions of caregiver engagement in the association of caregiver psychological distress with children's academic and socioemotional outcomes in Ghana. Data came from 4,714 children (aged 5-17 years) and their caregivers in five regions of northern Ghana. Caregiver psychological distress and engagement (i.e., engagement in education, emotional supportiveness, and parenting self-efficacy) were self-reported by children's primary caregiver. Children's academic (literacy and numeracy) and socioemotional (prosocial skills and socioemotional difficulties) outcomes were directly assessed using validated measures. Structural equation modelling was used to estimate mediation models. We tested moderation by caregiver exposure to formal education, child's age, and child's sex. Fourteen percent of caregivers experienced elevated psychological distress. Higher levels of psychological distress were associated with children's poorer literacy and numeracy skills, and higher socioemotional difficulties, but not prosocial skills. The mediating role of caregiver engagement varied by caregiver exposure to formal education but not child's age or sex. Caregiver engagement in education explained the association between psychological distress and children's literacy skills (but not numeracy or socioemotional) in families where the caregiver had no formal education (indirect effect: β = 0.007 [95% CI: 0.000, 0.016]), explaining 23% of the association. No mediator explained the association of psychological distress with child outcomes among families where the caregiver had some formal education. The mechanisms through which caregiver psychological distress is associated with child outcomes in rural Ghana differ as a function of caregivers' exposure to formal education. These results highlight the importance of developing multi-component and culturally-sensitive programs to improve child outcomes. Further research in similar contexts is needed to advance scientific understanding on how to effectively promote child and family wellbeing.
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Affiliation(s)
- Marilyn N Ahun
- Department of Medicine, McGill University, Montréal, Canada
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Richard Appiah
- Department of Psychology, Northumbria University, Newcastle-upon-Tyne, United Kingdom
- College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Sharon Wolf
- Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Waltereit J, Schulte-Rüther M, Roessner V, Waltereit R. Retrospective assessment of ICD-10/DSM-5 criteria of childhood ADHD from descriptions of academic and social behaviors in German primary school reports. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02509-4. [PMID: 39046525 DOI: 10.1007/s00787-024-02509-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/17/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND The diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adolescence and adulthood is particularly challenging because retrospective confirmation of previous childhood ADHD is mandatory. Therefore, collecting valid diagnostic information about behavior at school is important. Primary school reports often contain descriptions of academic performance and social behaviors associated with ADHD criteria. Yet, there is no systematic approach available how to assess such reports quantitatively, and therefore, there is also no study on how valid such an approach could predict an ADHD diagnosis. METHODS We examined primary school reports from Germany (ADHD: n = 1197, typically developing controls: n = 656) for semantic references to ICD-10/DSM-5 main and sub-criteria of ADHD. Descriptions were assessed on a quantitative scale (blinded clinical expert rating) for disorder-associated behaviors (symptoms scale) as well as for desired, adaptive behaviors (competencies scale) according to these criteria. The scores of these developed scales have been summarized to summary scores. Scores were analyzed using linear mixed models, and sensitivity and specificity were estimated using receiver operating characteristics (ROC). RESULTS Ratings showed highly significant differences between school reports of children with and without ADHD. For the summary scores, both symptoms and competencies scales showed high diagnostic accuracy (ROC area under the curve at least 0.96) with best discrimination when combining both into an integrated index (sensitivity and specificity > 0.97). CONCLUSIONS Our findings suggest that systematic quantitative analysis of primary school reports should be further explored to construct a valid instrument for retrospective assessment of childhood ADHD criteria to aid the diagnostic process in adolescents and adults.
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Affiliation(s)
- Johanna Waltereit
- Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, LWL-Klinikum Marsberg, Marsberg, Germany
| | - Martin Schulte-Rüther
- Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine - University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Waltereit
- Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany.
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
- Department of Child and Adolescent Psychiatry, LWL-Klinikum Marsberg, Marsberg, Germany.
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Mthiyane N, Rapulana AM, Harling G, Copas A, Shahmanesh M. Effect of multi-level interventions on mental health outcomes among adolescents in sub-Saharan Africa: a systematic review. BMJ Open 2023; 13:e066586. [PMID: 37788931 PMCID: PMC10551963 DOI: 10.1136/bmjopen-2022-066586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/09/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE In sub-Saharan Africa (SSA), multiple factors contribute to the considerable burden of mental health disorders among adolescents, highlighting the need for interventions that address underlying risks at multiple levels. We reviewed evidence of the effectiveness of community or family-level interventions, with and without individual level interventions, on mental health disorders among adolescents in SSA. DESIGN Systematic review using the Grades of Recommendation, Assessment, Development and Evaluation approach. DATA SOURCES A systematic search was conducted on Cochrane Library, MEDLINE, EMBASE, PSYCINFO and Web of Science up to 31 March 2021. ELIGIBILITY CRITERIA Studies were eligible for inclusion in the review if they were randomised controlled trials (RCTs) or controlled quasi-experimental studies conducted in sub-Saharan African countries and measured the effect of an intervention on common mental disorders in adolescents aged 10-24 years. DATA EXTRACTION AND SYNTHESIS We included studies that assessed the effect of interventions on depression, anxiety, post-traumatic stress disorder and substance abuse. Substance abuse was only considered if it was measured alongside mental health disorders. The findings were summarised using synthesis without meta-analysis, where studies were grouped according to the type of intervention (multi-level, community-level) and participants. RESULTS Of 1197 studies that were identified, 30 studies (17 RCTs and 3 quasi-experimental studies) were included in the review of which 10 delivered multi-level interventions and 20 delivered community-level interventions. Synthesised findings suggest that multi-level interventions comprise economic empowerment, peer-support, cognitive behavioural therapy were effective in improving mental health among vulnerable adolescents. Majority of studies that delivered interventions to community groups reported significant positive changes in mental health outcomes. CONCLUSIONS The evidence from this review suggests that multi-level interventions can reduce mental health disorders in adolescents. Further research is needed to understand the reliability and sustainability of these promising interventions in different African contexts. PROSPERO REGISTRATION NUMBER CRD42021258826.
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Affiliation(s)
- Nondumiso Mthiyane
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
| | - Antony M Rapulana
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
| | - Guy Harling
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology & Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Maryam Shahmanesh
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
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Yu W, Abbey C, Qian Y, Wang H, Rozelle S, Singh MK. Behavioral Strengths and Difficulties and Their Associations with Academic Performance in Math among Rural Youth in China. Healthcare (Basel) 2022; 10:healthcare10091642. [PMID: 36141254 PMCID: PMC9498325 DOI: 10.3390/healthcare10091642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Behavioral strengths and difficulties among children and adolescents may be significantly associated with their academic performance; however, the evidence on this issue for rural youth in developing contexts is limited. This study explored the prevalence and correlates of mental health from three specific dimensions—internalizing problems, externalizing problems, and prosocial behavior—measured by the Strengths and Difficulties Questionnaire (SDQ), and the association of these dimensions with academic performance in math among a sample of 1500 students in rural China. Our findings indicated that students in rural China had worse behavioral difficulties and poorer prosocial skills when compared to most past studies conducted inside and outside of China. In addition, total difficulties and prosocial scores on the SDQ were significantly associated with student math test scores, as students whose externalizing, internalizing, and prosocial scores were in the abnormal range scored lower in math by 0.35 SD, 0.23 SD, and 0.33 SD, respectively. The results add to the growing body of empirical evidence related to the links between social environment, mental health, and academic performance in developing countries, highlighting the importance of students’ mental health for their academic performance, and of understanding risk factors in the social environment among rural youth in developing countries.
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Affiliation(s)
- Wenjing Yu
- China Academy for Rural Development, Zhejiang University, Hangzhou 310058, China
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Cody Abbey
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Yiwei Qian
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu 610074, China
- Correspondence:
| | - Huan Wang
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Manpreet K. Singh
- Stanford School of Medicine, Stanford University, Stanford, CA 94305-5101, USA
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Street Children in Ghana's Golden Triangle Cities: Mental Health Needs and Associated Risks. Child Psychiatry Hum Dev 2022; 53:840-851. [PMID: 34350504 DOI: 10.1007/s10578-021-01223-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
More than 61,000 persons below the age of 18 are living on the streets in the Greater Accra region in Ghana. Street children is a hidden vulnerable population and a global public health issue in the world, but little is known about their mental health and health needs, and mechanisms that contribute to their poor health. With a lack of mental health research to guide intervention or psychoeducation programme and policy planning, this study aimed to address these research gaps by examining prevalence of mental health problems and a set of associated risk factors (i.e. Perceived quality of life, and social connection). In addition, we examined whether the associations between risk factors and mental health problems were moderated by demographic and contextual factors (i.e., gender, age, work status, reason for living on street, number of years in street). Two hundred and seven children between age 12 and 18 who lived on the street in three cities (Accra, Sekondi Takoradi, and Kumasi) were recruited. Data were gathered through adolescent survey/interviews. Multiple regression was utilized to examine risk factors and moderation effects. Results support high mental health needs among street children. Approximately 73% street children experienced moderate to severe mental health problems, and 90% experienced poor quality of life. Perceived quality/happiness of life was the strongest predictor for street children's mental health. Social connection was associated with children's mental health only in certain subgroups and contexts. This study adds new epidemiological evidence for street children, an extremely vulnerable population, in Ghana and global child and adolescent mental health.
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Psychometric properties of the ASEBA Child Behaviour Checklist and Youth Self-Report in sub-Saharan Africa - A systematic review. Acta Neuropsychiatr 2022; 34:167-190. [PMID: 35466902 DOI: 10.1017/neu.2022.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Behavioural screening tools may be used to identify at-risk children in resource-limited settings in sub-Saharan Africa. The ASEBA forms (Child Behaviour Checklist and Youth Self-Report) are frequently translated and adapted for use in sub-Saharan African populations, but little is known about their measurement properties in these contexts. METHODS We conducted a systematic review of all published journal articles that used the ASEBA forms with sub-Saharan African samples. We evaluated the reported psychometric properties, as well as the methodological quality of the psychometric evaluations, using COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidelines. RESULTS Fifty-eight studies reported measurement properties of the ASEBA forms. Most studies came from Southern (n = 29, 50%) or East African (n = 25, 43%) countries. Forty-nine studies (84%) used translated versions of the tool, but details regarding the translation process, if available, were often sparse. Most studies (n = 47, 81%) only reported internal consistency (using coefficient alpha) for one or more subscale. The methodological quality of the psychometric evaluations ranged from 'very good' to 'inadequate' across all measurement properties, except for internal consistency. CONCLUSIONS There is limited good quality psychometric evidence available for the ASEBA forms in sub-Saharan Africa. We recommend (i) implementing a standardised procedure for conducting and reporting translation processes and (ii) conducting more comprehensive psychometric evaluations of the translated versions of the tools.
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Sheriff B, Sakyi K, Malm EK, Zabel C, Owusu PG, Sowah LA, Anum A. Knowledge of developmental disabilities and referral sources among health workers in two Ghanaian hospitals. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:458-468. [PMID: 38699501 PMCID: PMC11062274 DOI: 10.1080/20473869.2022.2097413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/28/2022] [Indexed: 05/05/2024]
Abstract
Proper treatment of developmental disabilities requires health workers to have adequate knowledge of etiology and referral procedures. There is a dearth of research on knowledge of developmental disabilities among health workers in Ghana. The purpose of this study was to document knowledge about developmental disorders, causes, and referral procedures among health workers. Researchers used a successive free-listing method to interview 37 health workers. Developmental disabilities which present with physical symptoms were the most salient disorders identified among health workers, while learning disabilities and attention deficit disorder were largely overlooked. The most commonly listed developmental disabilities were cerebral palsy, Down syndrome, and autism spectrum disorder. Respondents had limited knowledge about the causes of and referral resources for developmental disabilities. Results show the need for continuing medical education, public awareness, and enhanced resources to support the identification and care of children with developmental disabilities in Ghana.
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Affiliation(s)
- Blessed Sheriff
- Center for Learning and Childhood Development, Accra, Ghana
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kwame Sakyi
- Department of Public and Environmental Wellness, Oakland University, Rochester Hills, OK, USA
| | - Esther K. Malm
- Center for Learning and Childhood Development, Accra, Ghana
- Department of Psychology, Murray State University, Murray, KY, USA
| | | | | | | | - Adote Anum
- Center for Learning and Childhood Development, Accra, Ghana
- Department of Psychology, University of Ghana, Ghana
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Xie X, Liu Q, Zhu K, Jiang Q, Feng Y, Xiao P, Wu X, Song R. Psychological Symptom Progression in School-Aged Children After COVID-19 Home Confinement: A Longitudinal Study. Front Psychiatry 2022; 13:809107. [PMID: 35492713 PMCID: PMC9043353 DOI: 10.3389/fpsyt.2022.809107] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The long-term mental health effects of coronavirus disease 2019 (COVID-19) in children are rarely reported. We aimed to investigate the progression of depressive and anxiety symptoms among a cohort of children in the initial epicenter of COVID-19 in China. METHODS Two waves of surveys were conducted in the same two primary schools in Wuhan and Huangshi, Hubei province: Wave 1 from 28 February to 5 March, 2020 (children had been confined to home for 30-40 days) and Wave 2 from 27 November to 9 December, 2020 (schools had reopened for nearly 3 months). Depressive and anxiety symptoms were estimated using the Children's Depression Inventory - Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. ΔCDI-S and ΔSCARED scores between Wave 2 and Wave 1 were calculated and further categorized into tertiles. Multivariable linear regression and multinomial logistic regression models were then applied. RESULTS A total of 1,224 children completed both surveys. The prevalence of mental health outcomes at Wave 2 increased significantly compared to Wave 1, specifically depressive symptoms (age-standardized prevalence rates: 37.5 vs. 21.8%) and anxiety symptoms (age-standardized prevalence rates: 24.0 vs. 19.6%). Higher ΔSCARED scores were observed in females and children in Wuhan, and children with experience of neglect had higher ΔCDI-S (β = 1.12; 95% CI = 0.67-1.58) and ΔSCARED (β = 6.46; 95% CI = 4.73-8.19) scores compared with those without experience of neglect. When the Δ scores were further categorized into tertiles, similar results were found. CONCLUSIONS The prevalence of depressive and anxiety symptoms after schools resumed was increased compared with that during the home quarantine period, even though the COVID-19 pandemic was under control. Females and children in Wuhan, and also children with experience of neglect were at increased risk of mental health disorders.
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Affiliation(s)
- Xinyan Xie
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Liu
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Jiang
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Feng
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pei Xiao
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqian Wu
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ranran Song
- Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Dziwornu E, Dey NEY, Owusu Ansah K, Arthur-Holmes F, Duah HO, Amoah PA, Agbadi P. Association between remembering difficulty and anxiety and depression among children in Ghana. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Norman QA, Dey NEY, Owusu Ansah K, Arthur-Holmes F, Duah HO, Agbadi P. Relationship between mothers'/caregivers' reported learning difficulty and internalizing symptoms (anxiety and depression) of children aged 5-17 years in Ghana. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104108. [PMID: 34653831 DOI: 10.1016/j.ridd.2021.104108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/07/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children with learning difficulties are vulnerable to internalizing symptoms, particularly anxiety and depression. However, only few studies have examined this relationship in low-and-middle-income countries using a nationally representative data. AIMS This study aimed to examine the relationship between learning difficulty and internalizing symptoms of children aged 5-17 years in Ghana while controlling for covariates. METHODS AND PROCEDURES We analyzed children's data using mothers'/caregivers' reports from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). Data of 8,958 children aged 5-17 years were used for the analysis. OUTCOMES AND RESULTS About 20% of the children had some learning difficulties whereas 5% could not learn at all. Learning difficulty was associated with symptoms of anxiety and depression of children. Specifically, children who had some learning difficulties had higher odds of feeling anxious [APOR = 1.28, 95% CI:1.11, 1.49, p = 0.001] while those with some difficulties [APOR=1.24, 95% CI:1.07, 1.44, p = 0.004] and a lot of difficulties or could not learn at all [APOR=1.74, 95% CI:1.28, 2.37, p < 0.01] had higher odds of feeling depressed. CONCLUSION AND IMPLICATIONS The findings call on stakeholders in education and health to prioritize the mental health of all school-going children, particularly those with learning difficulties in Ghana.
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Affiliation(s)
| | | | | | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, 8 Castle Peak Road, Hong Kong Special Administrative Region
| | | | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, 8 Castle Peak Road, Hong Kong Special Administrative Region
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Amu H, Osei E, Kofie P, Owusu R, Bosoka SA, Konlan KD, Kim E, Orish VN, Maalman RSE, Manu E, Parbey PA, Saah FI, Mumuni H, Appiah PK, Komesuor J, Ayanore MA, Amenuvegbe GK, Kim S, Jung H, Adjuik M, Tarkang EE, Alhassan RK, Donkor ES, Zottor FB, Kweku M, Amuna P, Kim SY, Gyapong JO. Prevalence and predictors of depression, anxiety, and stress among adults in Ghana: A community-based cross-sectional study. PLoS One 2021; 16:e0258105. [PMID: 34624044 PMCID: PMC8500438 DOI: 10.1371/journal.pone.0258105] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 09/19/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Over the past two decades, there have been several global interventions including the Sustainable Development Goals (SDGs), aimed at improving health outcomes. Despite efforts by countries to achieve the SDG targets, mental health challenges remain major public health concerns globally. We examined the prevalence and predictors of depression, anxiety, and stress as well as the comorbidities of these mental health issues among adults. Materials and methods This was a community-based cross-sectional study conducted among 2456 adults in four districts of the Volta Region of Ghana using data from the UHAS-Yonsei University Partnership Project. We analysed the data using frequency, percentage, mean, standard deviation, correlation, and binary logistic regression. Results Overall, 51.8% of the participants had at least one of the mental health issues examined. The prevalence of a mental health issue was 25.2%, 53.3%, and 9.7% for depression, anxiety, and stress respectively. Participants constituting 8.3% experienced all three mental health issues as comorbidities. Participants’ level of formal education and income significantly predicted depression, anxiety, and stress respectively at the multivariable level. Adults with a tertiary level of education were, for instance, 68% (AOR = 0.32, 95%CI = 0.15–0.66), 65% (AOR = 0.35, 95%CI = 0.17–0.73), and 50% (AOR = 0.50, 95%CI = 0.33–0.76) less likely to experience depression, anxiety, and stress, respectively compared with those who had no formal education. Conclusion The majority of our study participants either experienced depression, anxiety, or stress. There were quite high comorbidities of the mental health issues among the adult population. To accelerate progress towards the achievement of SDG 3.4 target of promoting mental health and wellbeing for all by the year 2030, there is a need for effective implementation of the country’s 2012 Mental Health Act which makes provisions for the establishment of a Mental Health Fund. This could improve the financial circumstances of indigenes as income has been realised in the present study as an important factor influencing depression, anxiety, and stress among the adult population.
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Affiliation(s)
- Hubert Amu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- * E-mail:
| | - Eric Osei
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Philip Kofie
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Owusu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Samuel Adolf Bosoka
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Kennedy Diema Konlan
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Eunji Kim
- Korean Foundation for International Healthcare, Seoul, Korea
| | | | | | - Emmanuel Manu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Phyllis Atta Parbey
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Hadiru Mumuni
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Prince Kubi Appiah
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Korea
| | - Joyce Komesuor
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | | | - Siwoo Kim
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Korea
| | - Hajun Jung
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Korea
| | - Martin Adjuik
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Robert Kaba Alhassan
- Directorate of International Affairs, University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Margaret Kweku
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Paul Amuna
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - So Yoo Kim
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Korea
| | - John Owusu Gyapong
- Office of the Vice-Chancellor, University of Health and Allied Sciences, Ho, Ghana
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