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 (registration number: NCT03307226) on 11 October 2017.

Assessing longitudinal patterns of depressive symptoms and the influence of symptom trajectories on HIV pre‐exposure prophylaxis adherence among adolescent girls in the HPTN 082 randomized controlled trial

“…Ours is one of the first studies to focus on depressive symptom prevalence and patterns in a population of African AGYW seeking PrEP. Other studies with African AGYW engaged in HIV treatment, other types of prevention services, or those in nationally representative cohorts report depressive symptom prevalence estimates around 40% to 50% [17,53,54]. Consistent with our findings, analyses of depressive symptom patterns among populations living with or at‐risk of HIV in the United States and South Africa also found distinct trajectories characterized by severe or persistent symptoms, declining symptoms and low or no symptoms [28‐31].…”

“…depressive symptom prevalence estimates around 40% to 50% [17,53,54]. Consistent with our findings, analyses of depressive symptom patterns among populations living with or at-risk of HIV in the United States and South Africa also found distinct trajectories characterized by severe or persistent symptoms, declining symptoms and low or no symptoms [28][29][30][31].…”

Predictors of Depressive Symptoms among Thai Undergraduate Students

“…Previous research reported that the level of social support perceived by students was associated with depression 14,16,17 . Additionally, students who perceived more support tended to report lower levels of depression.…”

“…Additionally, students who perceived more support tended to report lower levels of depression. A study conducted among Ugandan students demonstrated that support from family, caregivers, and peers was associated with lower levels of depressive symptoms 16 . In addition, a study reported that social support from family and friends was a significant predictor of depressive symptoms.…”

Exploring multilevel social determinants of depressive symptoms for Tanzanian adolescents: evidence from a cross-sectional study

“…7 While identifying the social determinants of poor mental health is crucial to inform interventions which target these mechanisms, research gaps on the influence of environmental events, macroeconomic determinants, and household economics remain. 8 Recent studies have explored determinants of poor mental health among African youth, 9 although the evidence has largely been focused on specific subgroups, such as youth living with HIV, 10 school-going children, [11][12][13] pregnant women, 14 and orphans or adults. [15][16][17] With the majority of the population younger than 18 years, 18 understanding the determinants of adolescent mental health in Tanzania is crucial.…”