Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda

Abstract

BackgroundDepression in adolescents constitutes a global public health concern. However, data on its prevalence and associated factors are limited in low income countries like Uganda.MethodsUsing a cross-sectional descriptive study design, 519 adolescent students in 4 secondary schools in Mukono district, Uganda, were randomly selected after meeting study criteria. The 4 school types were: boarding mixed (boys and girls) school; day mixed school; girls’ only boarding school; and, boys’ only boarding school. The 519 participants filled out standardized questionnaires regarding their socio-demographic characteristics and health history. They were then screened for depression using the Children Depression Inventory (CDI) and those with a cut-off of 19 were administered the Mini International Neuro-Psychiatric Interview for Children and Adolescents 2.0 (MINI-KID), to ascertain the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) diagnostic types of depression and any co morbidity. Logistic regression analyses were used to assess factors associated with significant depression symptoms (a score of 19 or more on the CDI).ResultsThere were 301 (58 %) boys and 218 (42 %) girls with age range 14–16 years and a mean age of 16 years (SD 2.18). Of 519 participants screened with the CDI, 109 (21 %) had significant depression symptoms. Of the 109 participants with significant depression symptoms, only 74 were evaluated with the MINI-KID and of these, 8 (11 %) met criteria for major depression and 6 (8 %) met criteria for dysthymia. Therefore, among participants that were assessed with both the CDI and the MINI-KID (n = 484), the prevalence of depressive disorders was 2.9 %. In this sample, 15 (3.1 %) reported current suicidal ideation. In the logistic regression analyses, significant depression symptoms were associated with single-sex schools, loss of parents and alcohol consumption.LimitationsThis is a cross-sectional study therefore, causal relationships are difficult to establish. Limited resources and the lack of collateral information precluded the assessment of a number of potential factors that could be associated with adolescent depression. The MINI-KID was administered to only 74 out of 109 students who scored ≥19 on the CDI since 35 students could not be traced again due to limited resources at the time.ConclusionsSignificant depression symptoms are prevalent among school-going adolescents and may progress to full-blown depressive disorders. Culturally sensitive psychological interventions to prevent and treat depression among school-going adolescents are urgently needed.

Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub‐Saharan African adolescents aged 10‐19 years: cross‐sectional study

“…Women disproportionately attempt suicide relative to men, and it is estimated that suicide accounts for about 50% of all violent deaths in men and 71% in women . In sub‐Saharan Africa, available evidence shows a high prevalence of depression amongst adolescents . Since mental health problems often begin in adolescence, there is the need for more research to generate empirical evidence to inform pragmatic interventions to improve mental health outcomes for depression and suicide behaviours during adolescence.…”

“…Evidence from a systematic review of prevalence studies on adolescent mental health affirms considerable levels of mental health problems amongst children and adolescents in the sub‐Saharan African region . Yet, mental health problems in the region appear to be neglected in the global health agenda . Despite the debilitating effect of adolescent mental disorders, limited research evidence exists in sub‐Saharan Africa to provide the basis for understanding the scale of the problem.…”

“…Despite the debilitating effect of adolescent mental disorders, limited research evidence exists in sub‐Saharan Africa to provide the basis for understanding the scale of the problem. Literature on the subject reports few studies showing variations in country‐specific prevalence estimates . Much less is known about regional prevalence estimates.…”

Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study

“…The burden of CAMH disorders in Uganda has not been accurately estimated but various studies indicate a high prevalence of depression (21%) among school going adolescents [4] and disadvantaged children in four districts (8.6%) [5]. Okello et al (2007) estimated that approximately 44% of war-affected adolescents in another district suffered from one or more CAMH disorder [6, 7] and a high prevalence of anxiety disorders (26.6%) and adolescent suicidality [8, 9] are documented.…”

Relationship between depressive symptoms and cumulative 24-hour urinary norepinephrine excretion level among undergraduate medical students in Uganda

“…The prevalence and risk factors for depression in Ugandan university students has not been well studied in Uganda. The few available studies have examined depression amongst adolescents in secondary schools [9], traumatized individuals [10] and among persons living with human immune deficiency virus (HIV) infection [11]. Although psychosocial problems had been reported among the undergraduate students in Uganda [12], no study has examined the link between socio-demographic factors and biological effects of the disease in this population.…”