Prevalence of Depression Symptoms amongst Orphaned Adolescents at Secondary Schools in Townships of South Africa

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Abstract

Introduction:

Depression among orphans is a matter of concern due to its impairing effect on functioning and emotions. This study determined the prevalence of depression symptoms and the extent of emotional and functional problems among orphaned adolescents in secondary schools.

Methods:

A cross-sectional descriptive observational design using a Children’s Depression Inventory 2 (CDI 2) test was conducted. The CDI 2 was used to measure the prevalence of depression symptoms among 301 orphaned adolescents. The CDI 2 T-scores of more than 65 indicated the presence of depression symptoms. Among 301 participants aged between 13 and 17 years old, 176 (58.4%) were females, 61% (n = 184) were double orphans, and 39% (n = 117) were maternal orphans.

Results:

The prevalence of depression symptoms was 21%, with 63 (20.9%) having elevated emotional problems, 77 (25.5%), elevated functional problems, 9.9% (n=30) very low self-esteem and 90% (n = 271) no self-esteem problems. Elevated negative mood was 20.6% (n = 26), 14.6% (n = 44) had an elevated level of ineffectiveness and 32.5% (n = 98) had elevated interpersonal problems.

Conclusion:

The results of this study preclude any conclusions about the comparison of common characteristics between orphaned and non-orphaned adolescents. The standardised tool used narrowed the number of participants of interest due to the cut-off age.

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Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. We also discuss barriers to, and approaches for, the implementation of such strategies in low-resource settings. Action is imperative to reduce the burden of mental health problems in future generations and to allow for the full development of vulnerable children and adolescents worldwide. Copyright © 2011 Elsevier Ltd. All rights reserved.

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Unipolar depressive disorder in adolescence is common worldwide but often unrecognised. The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%. The burden is highest in low-income and middle-income countries. Depression is associated with substantial present and future morbidity, and heightens suicide risk. The strongest risk factors for depression in adolescents are a family history of depression and exposure to psychosocial stress. Inherited risks, developmental factors, sex hormones, and psychosocial adversity interact to increase risk through hormonal factors and associated perturbed neural pathways. Although many similarities between depression in adolescence and depression in adulthood exist, in adolescents the use of antidepressants is of concern and opinions about clinical management are divided. Effective treatments are available, but choices are dependent on depression severity and available resources. Prevention strategies targeted at high-risk groups are promising. Copyright Â© 2012 Elsevier Ltd. All rights reserved.

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