Screening for Depression in Adolescents in Gokarneshwor Municipality-4, Kathmandu

Niraj Shrestha,S Pandey

doi:10.3126/nmcj.v21i1.24857

Abstract

Depression which is characterized by hopelessness and loss of interest in social activities is common during adolescence. However it is often unrecognized and the burden is even more in low income countries. It also increases the risk of suicide in future. Hence in a developing country like Nepal it is important that such cases are detected at the early stage preventing further worsening of the condition. A simple set of questionnaires like Patient Health Questionnaire (PHQ) 9 can be used to screen for depression. Using this questionnaire screening for depression was carried out in adolescents of Gokarneshwor municipality, ward 4. Four hundred and twenty participants were selected by the process of systematic random sampling. Based on answers to nine questions score was given and adolescents categorized as having no, mild, moderate or severe depression. The PHQ 9 score suggested that 13.1% were suffering from depression, out of which 23.6% from moderate to severe depression which required psychiatric consultation. Out of those shown to have some form of depression 40.0% said they had thought of self harm in last 2 weeks. Late adolescence was significantly associated with depression. Thoughts related to self harm were also six times more in late adolescent age group than the early adolescent age group.

Highlights

Thirty years ago, depression was predominantly seen as adult disorder
This study has shown that on screening 13.1 % were shown to be having some form of depression (11.9% of total male subjects and 14.9% of total female subjects)
Studies done in different communities of United States of America have shown prevalence of depression in children and adolescents ranging from 2.2% to 3.4%

Summary

Introduction

Depression was predominantly seen as adult disorder. Adolescent low mood was seen as a part of normal teenage mood swings. Various developmental studies in youth have shown that adolescent depressive disorders is associated with range of adverse outcomes including social and educational impairments as well as physical and mental problems later in life.[1] Adolescence has been defined by WHO as period between age 10 to 19 years This is transition period from childhood to adulthood where rapid change in psychological functioning takes place.[2] As changes take place in this period adolescents are highly susceptible to mental disorders than at other times of life.[3] Depression, a common mental disorder in adolescence, is highly unrecognized and the burden is even higher in low and middle income countries.[4] The Patient Health Questionnaire- 9(PHQ-9) consisting of 9 items was developed as screening instrument for depression.[5] PHQ-9 can be used as depression screener for adolescents more than 11 years.[6] Adolescent depression increases the risk of depression in adulthood.[7] Studies have shown association between depression and suicidal thoughts.[8,9] it is very important that depression is identified at early stage and treatment is advised so that future harm is minimized including reduction in suicide attempts

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Results

Conclusion