Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study

Abstract

BackgroundThe COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda.MethodsA cross-sectional study was conducted among undergraduates [N = 540; 363 males; mean age = 23.3 (± 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation.ResultsThe prevalence of moderate to severe depression was 20% (n = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% (n = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13–2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10–3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32–0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03–0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10–21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08–3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23–0.70, p = 0.001).ConclusionApproximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.

Knowledge, attitudes, and experiences in suicide assessment and management: a qualitative study among primary health care workers in southwestern Uganda

“…The primary health care workers reported different challenging experiences, including knowledge and skills deficits, mental illness and suicide stigma, low staffing levels, and the lack of supportive community resources. The staff also noted predominantly having male patients admitted due to suicide behaviors, a finding similar to other studies done in Uganda [14,20,40].…”

“…Previous suicide research in Uganda and other sub-Saharan countries has not focused on health professionals' , knowledge, skills and practices but have easily focused on suicide prevalence and associated factors [14,15,[17][18][19][20]. In this paper, therefore, we explored the knowledge, attitudes, and experiences of PCHWs in assessing and managing suicidality in structured PHC services in southwestern Uganda.…”

Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment

“…The participants were enrolled using a snowball convenience sampling technique where students who were approached could forward the survey link to other students in the university. To avoid physical contact and to include as many eligible students as possible, snowball convenience sampling was employed to enable efficient recruitment of university students during the COVID-19 pandemic as has been employed in previous studies conducted inside or outside Uganda [31][32][33][34].…”

Prevalence of depression in Uganda: A systematic review and meta-analysis

“…Despite the lower increase in the burden of depression in sub-Saharan Africa, most individuals with depression go undiagnosed and untreated in the region [4]. This has led to some individuals having extreme complications of depression, such as suicide [5][6][7][8][9][10][11]. The effect is even worse in low-income countries such as Uganda, with a high prevalence of depression (i.e., approximately one-fifth of the population between 2010 and 2017, and 27% of outpatients being depressed based on previous systematic review and meta-analyses [12,13]).…”