Abstract
BackgroundIn 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.MethodsBaseline 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.ResultsOf 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.ConclusionFindings 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 registrationThis trial was prospectively registered with ClinicalTrials.gov (registration number: NCT03307226) on 11 October 2017.
Highlights
In sub-Saharan Africa (SSA), adolescent girls and young women are three times more likely than boys to have depressive disorders
This study aims to address the following research questions: 1) What are the prevalence rates of depressive symptoms among adolescent girls in southern Uganda, a geographical region heavily impacted by HIV/AIDS? 2) Do levels of depressive symptoms vary based on age groups i.e., younger versus older adolescent girls? 3) What are the key individual and family -level predictors of depressive symptoms among adolescent girls? This is an important area of inquiry, as findings may inform the development of and incorporation of gender-specific mental health components in programs and policies targeting adolescent girls –given the high levels of vulnerability, especially in low-resource communities in SSA
Study findings contribute to the limited literature estimating the prevalence and correlates of depressive symptoms among adolescent girls in low resource settings in Uganda
Summary
In sub-Saharan Africa (SSA), adolescent girls and young women are three times more likely than boys to have depressive disorders. Mental health disorders account for 16% of the global burden of disease and injury among children and adolescents between 10 and 19 years of age [1]. There is poor understanding of mental health illness, that disorders such as depression are unrecognized and as such, remain untreated [5, 6]. Given that most mental health disorders start early in childhood and continue to rise through adolescence [10,11,12,13], if unaddressed, these conditions extend to adulthood resulting in poor health outcomes, limiting opportunities for a productive adult life [13, 14]
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