Factors associated with psychological distress among young women in Kisumu, Kenya

Abstract

BackgroundAttention to mental health issues is growing globally. In many countries, including Kenya, however, assessment of psychological distress, especially in rural areas, is limited.MethodsWe analyzed data from young women screened for a longitudinal contraceptive ring study in Kisumu, Kenya. Multivariable regression analysis was used to assess factors associated with recent moderate and high psychological distress, as measured by the Kessler (K-6) psychological distress scale.ResultsAmong the 461 women screened, most (58.4%) were categorized as having moderate psychological distress, 20.8% were categorized as having low or no psychological distress, and 20.8% were categorized as having high psychological distress. Moderate psychological distress (vs low/no) was significantly more likely among women who reported a history of forced sex and were concerned about recent food insecurity. High (vs low/no) psychological distress was significantly more likely among women who reported a history of forced sex, who were concerned about recent food insecurity, and who self-reported a sexually transmitted infection.ConclusionTo reduce psychological distress, a focus on prevention as well as care methods is needed. Girls need a path toward a healthy and productive adulthood with a focus on education, which would help them gain skills to avoid forced sex. Women would benefit from easy access to social services and supports that would help them with basic needs like food security among other things. A holistic or ecological approach to services that would address mental, educational, social, health, and economic issues may have the highest chance of having a long-term positive impact on public health.

Psychosocial distress among in-school adolescents in Mozambique: a cross-sectional study using the Global School-Based Health Survey data

“…We found that male adolescents were less likely to experience psychosocial distress than females. This observation could be because female adolescents are more prone to sexual abuse and harassment or exploitation which have negative implications for psychosocial distress [ 16 , 41 ]. Besides, the lower odds of psychological distress observed among males could be explained by the fact that male adolescents are more likely to form peer groups and are also more likely to confide in their friends, which helps them to mitigate the emotional problems which characterise adolescence [ 42 , 43 ].…”

“…Data from the US National Longitudinal Study of Adolescent Health found that single and social-parent family structure is adversely associated with emotional adjustment, depression, adolescent delinquency, cognitive skills, school engagement, school problems, and grade point average [ 13 – 15 ]. Individual and socio-cultural factors such as female sex, lower formal education and lower socio-economic status, lack of social support, and stressful life events have also shown to be important contributors [ 16 ].…”

Validating mental health assessment in Kenya using an innovative gold standard

“…First, items had to be highly endorsed by fewer than 40% of non-cases (or 40% of cases for positive valence items). Because general distress is endorsed at high levels despite absence of mental disorder in settings like Kenya (Gust et al, 2017), we used a higher level of non-case endorsement than the typical 25%. Second, items needed to have a gradient score greater than 0.25, as lower scores indicated that an item showed poor or no discrimination between cases and non-cases.…”

Implementing combined WHO mhGAP and adapted group interpersonal psychotherapy to address depression and mental health needs of pregnant adolescents in Kenyan primary health care settings (INSPIRE): a study protocol for pilot feasibility trial of the integrated intervention in LMIC settings

“…The prevalence of depression is high among pregnant women, with worldwide estimates of 11% to 18% [ 1 , 2 ] and is estimated to be between 15% to 28% in Lower- and Middle-Income Countries (LMICs) [ 3 ]. Studies in Kenya and neighboring countries have found that younger women (aged 18–24 years) experience greater psychological vulnerabilities [ 4 ] and depression in this group ranges from 8.3% to 39% [ 5 – 7 ] with high risk populations like adolescent mothers and gender-based violence impacted women [ 8 ]. Young women in Sub-Saharan Africa (SSA) lose around 10.4 disability adjusted life years due to depression during pregnancy.…”