Prevalence and Correlates of Depressive Symptoms Among High School Adolescent Girls in Southern Uganda

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 (registrationnumber: NCT03307226) on 11 October 2017.

Psychological Distress in Adolescents: Prevalence and its Relation to High Risk Behaviors Among Secondary School Students in Uganda.

“…In addition, students in boarding schools and schools with both genders tend to report more cases of psychological distress, nonetheless, this is contrary to another study where students in single-sex schools had higher odds of psychological distress (14). Contrary to existing studies; gender, social support and academic performance were not associated with psychological distress in this study (7,10,14,27,33,46,47).…”

“…Generally, previous studies have shown a high prevalence of mental health issues such as anxiety and depression among adolescents in Ugandan. A recent study conducted among high school adolescent girls in Southern Uganda revealed that the prevalence of depressive symptoms ranged from 16-29% among the study participants (27). Another study conducted among secondary school students in Central Uganda indicated that 21% had signi cant depression symptoms (14).…”

“…Meanwhile, previous studies in Uganda have focused on other mental health problems with no study conducted on psychological distress in adolescents. In addition, prior studies on adolescent mental health were centered on adolescent living with HIV/AIDS, vulnerable and marginalized population (13,14,17,(27)(28)(29). Hence, this study aimed at estimating the prevalence of psychological distress and its relationship with high risk behaviors among secondary school students in Uganda.…”

Online and offline social support deterioration: the effect of financial stress exposure on depressive symptoms

“…There is an established association between social support and mental health. Most noticeably, supportive relations help individuals in coping with several stressful situations, thus buffering the psychological consequences of life stressors (Cohen and Wills 1985;Ehsan and De Silva, 2015;Lin et al 1986;Mariani et al 2020;Nabunya et al 2020;Uphoff et al 2013;Thoits 2011;Yip et al 2007). It is argued that social support brings about better mental health outcomes through generalized perceptions of support.…”

Maternal adverse childhood experiences, child mental health, and the mediating effect of maternal depression: A cross‐sectional, population‐based study in rural, southwestern Uganda

“…Communities in recently war‐affected regions in northern Uganda report elevated levels of psychiatric morbidity. For example, one study of adolescent girls in southern Uganda found a 16% prevalence of severe depressive symptoms and a 30% prevalence of moderate symptoms (Nabunya et al, 2020). Another study of adolescents living with HIV in southwestern Uganda found 16% with major depressive disorder (Ashaba et al, 2018).…”