Information on major depressive disorder (MDD) in primary care settings in sub-Saharan Africa is limited, yet this is required to improve service development. We explored prevalence and factors associated with MDD among adolescents attending a primary care facility in urban Uganda.
At Naguru Teenage Information and Health Centre, 281 adolescents were assessed for MDD using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid). Prevalence and risk factors were determined using frequencies and regressions, respectively. The prevalence of adolescent MDD was 18.2 %. Vulnerability factors were orphanhood, childhood trauma (particularly emotional abuse and physical neglect) while social support was protective.
Considerable burden of clinically significant depression exists in primary care settings in Uganda; this may well contribute to a poor quality of life.
MaaloufFTGhandourLAHalabiF, et al.Psychiatric disorders among adolescents from Lebanon: prevalence, correlates, and treatment gap. Soc Psychiatry Psychiatr Epidemiol2016; 51: 1105–1116.
2.
LopezADMathersCDEzzatiM, et al.Measuring the global burden of disease and risk factors, 1990–2001. In: LopezADMathersCDEzzatiM, et al.(eds). Global Burden of Disease and Risk Factors, Washington, DC: World Bank, 2006, pp. 1–14.
3.
CairneyJ. Gender differences in the prevalence of depression among Canadian adolescents. Can J Public Health1998; 89: 181–182.
4.
LewinsohnPMHopsHRobertsRE, et al.Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III—R disorders in high school students. J Abnorm Psychol1993; 102: 133–144.
5.
MerikangasKRHeJPBursteinM, et al.Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry2010; 49: 980–989.
6.
CashSJBridgeJA. Epidemiology of youth suicide and suicidal behavior. Curr Opin Pediatr2009; 21: 613–619.
7.
ShafferDGouldMSFisherP, et al.Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry1996; 53: 339–348.
8.
CulpepperLClaytonALiebermanJIII, et al.Treating depression and anxiety in primary care. Prim Care Companion J Clin Psychiatry2008; 10: 145–152.
9.
MechanicD. Barriers to help-seeking, detection, and adequate treatment for anxiety and mood disorders: implications for health care policy. J Clin Psychiatry2007; 68: 20–26.
10.
SimonGEVonKorffM. Recognition, management, and outcomes of depression in primary care. Arch Fam Med1995; 4: 99–105.
11.
AfanaAhDalgardOSBjertnessE, et al.The ability of general practitioners to detect mental disorders among primary care patients in a stressful environment: Gaza Strip. J Public Health Med2002; 24: 326–331.
12.
SteinREZitnerLEJensenPS. Interventions for adolescent depression in primary care. Pediatrics2006; 118: 669–682.
13.
PapathanasiouIVDamigosDMavreasV. Higher levels of psychiatric symptomatology reported by health professionals working in medical settings in Greece. Ann Gen Psychiatry2011; 10: 28–28.
14.
AsarnowJRJaycoxLHDuanN, et al.Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial. JAMA2005; 293: 311–319.
15.
AkimanaBAbboCBalagadde-KambuguJ, et al.Prevalence and factors associated with major depressive disorder in children and adolescents at the Uganda Cancer Institute. BMC Cancer2019; 19: 466–466.
16.
KinyandaEKizzaRAbboC, et al.Prevalence and risk factors of depression in childhood and adolescence as seen in 4 districts of north-eastern Uganda. BMC Int Health Hum Rights2013; 13: 19–19.
17.
Nalugya-SserunjogiJRukundoGZOvugaE, et al.Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child Adolesc Psychiatry Mental Health2016; 10: 39–39.
18.
Naguru Teenage Information and Health Centre (NTIHC). Available at: http://www.ntihc.or.ug/ (accessed on 6 March 2019).
19.
KishL. Survey Sampling, New York: Wiley, 1965.
20.
MonroeSMSimonsAD. Diathesis-stress theories in the context of life stress research: implications for the depressive disorders. Psychol Bull1991; 110: 406–425.
21.
ZimetGDDahlemNWZimetSG, et al.The multidimensional scale of perceived social support. J Pers Assess1988; 52: 30–41.
22.
NakiguddeJMusisiSEhnvallA, et al.Adaptation of the multidimensional scale of perceived social support in a Ugandan setting. Afr Health Sci2009; 9(Suppl. 1): S35–41.
SheehanDVLecrubierYSheehanKH, et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry1998; 59(Suppl. 20): 22–33; quiz 4–57.
25.
SheehanDVSheehanKHShytleRD, et al.Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). J Clin Psychiatry2010; 71: 313–326.
26.
AbboCKinyandaEKizzaRB, et al.Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda. Child Adolesc Psychiatry Ment Health2013; 7: 21–21.
27.
JohnsonKKelch-OliverKSmithCO, et al.Depression screenings during routine visits in a reproductive healthcare setting: Identifying depressive symptoms in African American adolescent males. Psychology2012; 3: 870–870.
28.
CollinsMHKelch-OliverKJohnsonK, et al.Clinically significant depressive symptoms in African American adolescent females in an urban reproductive health clinic. J Clin Psychol Med Settings2010; 17: 175–182.
29.
AshenafiYKebedeDDestaM, et al.Prevalence of mental and behavioral disorders in children in Ethiopia. East Afr Med J2001; 78: 308–311.
30.
UdediM. The prevalence of depression among patients and its detection by primary health care workers at Matawale Health Centre (Zomba). Malawi Med J2014; 26: 34–37.
31.
JayanthiPThirunavukarasuM. Perceived Social Support - A Risk Factor for Depression Among Adolescents: An Analytical Study. ICCRJNR2016; 1: 29–34.
32.
LeeS-JDetelsRRotheram-BorusMJ, et al.The effect of social support on mental and behavioral outcomes among adolescents with parents with HIV/AIDS. Am J Public Health2007; 97: 1820–1826.
33.
PatelVFlisherAJHetrickS, et al.Mental health of young people: a global public-health challenge. Lancet2007; 369: 1302–1313.
34.
HussongAM. Perceived peer context and adolescent adjustment. J Res Adolesc2000; 10: 391–415.
35.
NewmanBMNewmanPRGriffenS, et al.The relationship of social support to depressive symptoms during the transition to high school. Adolescence2007; 42: 441–441.
36.
BrownJCohenPJohnsonJG, et al.Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality. J Am Acad Child Adolesc Psychiatry1999; 38: 1490–1496.
37.
KinyandaENakasujjaNLevinJ, et al.Major depressive disorder and suicidality in early HIV infection and its association with risk factors and negative outcomes as seen in semi-urban and rural Uganda. J Affect Disord2017; 212: 117–127.
38.
AnkwasiizeE. Adolescent trauma and psychosocial wellbeing in Entebbe-Uganda. Univers J Psychol2018; 6: 67–79.
39.
RahmanWMullickMPathanMAS, et al.Prevalence of behavioral and emotional disorders among the orphans and factors associated with these disorders. Bangabandhu Sheikh Mujib Medical University Journal2012; 5: 29–34.
