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Depression and Its Association with Parental Neglect among Adolescents at Governmental High Schools of Aksum Town, Tigray, Ethiopia, 2019: A Cross Sectional Study
Background. Depression is one of the most serious and prevalent mental illnesses that can result in serious disability and ending life by committing suicide and homicide. The risks of having depression are substantially higher in persons who have parental neglect when compared to the general population. Objective. To detect prevalence of depression and its association with parental neglect among adolescents in governmental high schools at Aksum town, Tigray, Ethiopia, 2019. Method. A facility-based cross-sectional study was conducted at Aksum town high schools. A simple random sampling technique was applied. Data was collected with face-to-face interview. Data was analyzed using IBM Statistical Package for Social Science version 22. Bivariate and multivariate logistic regressions were done. Adjusted odds ratio at a value < 0.05 with 95% confidence interval was taken to declare statistical significance of variables. Result. A total of 624 students were asked to participate with a response rate of 99.05%. Prevalence of depression was found to be 36.2%. Depression among adolescents was found to have significant and strong association with parental neglect (, 95% CI 1.83, 3.72). Conclusion and Recommendation. In the current study, the prevalence of depression is found to be high when compared to other populations. Significant and strong association is also determined between parental neglect and depression. It is good if teachers give emphasis for those students who seem psychologically unwell. It is good if Aksum University comprehensive hospital starts a campaign which will teach about the effect of parental neglect on the adolescents’ mental health.
Epigenetic Mechanisms in the Neurodevelopmental Theory of Depression
The genome (genes), epigenome, and environment work together from the earliest stages of human life to produce a phenotype of human health or disease. Epigenetic modifications, including among other things: DNA methylation, modifications of histones and chromatin structure, as well as functions of noncoding RNA, are coresponsible for specific patterns of gene expression. This refers also to mental disorders, including depressive disorders. Early childhood experiences accompanied by severe stressors (considered a risk factor for depression in adult life) are linked with changes in gene expression. They include genes involved in a response to stress (hypothalamic-pituitary-adrenal axis, HPA), associated with autonomic nervous system hyperactivity and with cortical, and subcortical processes of neuroplasticity and neurodegeneration. These are, among others: gene encoding glucocorticoid receptor, FK506 binding protein 5 gene (FKBP5), gene encoding arginine vasopressin and oestrogen receptor alpha, 5-hydroxy-tryptamine transporter gene (SLC6A4), and gene encoding brain-derived neurotrophic factor. How about personality? Can the experiences unique to every human being, the history of his or her development and gene-environment interactions, through epigenetic mechanisms, shape the features of our personality? Can we pass on these features to future generations? Hence, is the risk of depression inherent in our biological nature? Can we change our destiny?
Magnitude and Predictors of Antenatal Depression among Pregnant Women Attending Antenatal Care in Sodo Town, Southern Ethiopia: Facility-Based Cross-Sectional Study
Background. Depression affects approximately 10 to 20% of pregnant women globally, and one in ten and two in five women in developed and developing countries develop depression during pregnancy, respectively. However, evidence regarding its magnitude and predictors in Southern Ethiopia is limited. The present study is aimed at assessing the magnitude and predictors of antenatal depression among pregnant women attending antenatal care in Sodo town. Methods. A facility-based cross-sectional study was conducted among 403 antenatal care attendants in Sodo town from November 2 to January 30, 2017. Systematic random sampling was used to select the study population, and data were collected by using a pretested and structured questionnaire. Data were entered using Epi-data 4.2 and then exported and analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were used to assess the association between the dependent variable and independent variables. Variables with value less than 0.05 were considered as statistically significant. Results. A total of 400 pregnant women were interviewed. The magnitude of antenatal depression was 16.3% (95% CI (12.8%, 19.9%)). Husband’s educational status, at the college and above (AOR: 0.09; 95% CI (0.03, 0.34), regular exercise (AOR: 0.16; 95% CI (0.07, 0.36)), planned pregnancy (AOR: 0.16; 95% CI (0.06, 0.44)), use of family planning (AOR: 0.31; 95% CI (0.14, 0.66)), previous history of anxiety (AOR: 2.96; 95% CI (1.30, 6.74)), previous history of obstetric complications (AOR: 19.03; 95% CI (5.89, 61.47)), and current obstetric complications (AOR: 30.38; 95% CI (3.14, 294.19)) were significant predictors of antenatal depression. Conclusion. Nearly one in six pregnant women had antenatal depression. The husband’s educational status, regular exercise, planned pregnancy, use of family planning, previous history of anxiety, previous history of obstetric complications, and current history of obstetric complications were significant predictors of antenatal depression. Screening for depression during routine antenatal care could be essential and recommended to identify early and prevent further morbidities and mortalities due to antenatal depression.
The Role of Adverse Childhood Experience on Depression Symptom, Prevalence, and Severity among School Going Adolescents
Background and Objectives. Adverse childhood experiences include stressful and potentially traumatic events associated with a higher risk of long-term behavioral problems and chronic illnesses. In this study, we had estimated the prevalence of adverse childhood experiences (ACEs) and association with depression symptoms prevalence and severity as a function of ACE counts. Methods. A cross-sectional school-based study was employed. Five hundred forty-six secondary school students were selected using multistage sampling technique from 5 selected secondary schools. We obtained retrospective information on adverse childhood experiences of adolescents by ACEs, self-reported 10-item questionnaire, and current depression prevalence and severity by PHQ-9. Multivariate linear regression models were used to estimate child depression severity by retrospective ACE count. Results. Among the 546 adolescents who participated in this study, 285 (50.7%) of the participants answered yes to at least one or more questions among the total 10 questions of ACEs. Experiences of ACEs increased the risk for depressive symptoms, with unstandardized = 1.123 ( = 1.123, 95% CI (0.872, 1.373). We found a strong, dose–response relationship between the ACE score and the probability of lifetime and recent depressive disorders (). Conclusions. The number of ACEs has a graded relationship to both the prevalence and severity of depressive symptoms. These results suggest that exposure to ACEs is associated with an increased risk of depressive symptoms up to decades after their occurrence. Early recognition of childhood abuse and appropriate intervention may thus play an important role in the prevention of depressive disorders throughout the life span.
Sociodemographic and Clinical Variables of Depression among Patients with Epilepsy in a Neuropsychiatric Hospital in Nigeria
Background. Depression is a major contributor to the global burden of disease. Its occurrence in patients living with epilepsy is not just common but also a serious comorbidity. Patients tend to suffer if the depressive disorder is undetected and thus untreated. The aim of this study is to estimate the prevalence of depressive disorder in patients with epilepsy. Also, the sociodemographic and clinical factors that are associated with the development of depression in people living with epilepsy were examined. Materials and Method. This was a descriptive cross-sectional study of participants living with epilepsy and receiving care at the Federal Neuropsychiatric Hospital, Sokoto, Nigeria. Participants were recruited consecutively as they come for follow-up care. A sociodemographic/clinical questionnaire and General Health Questionnaire version 28 (GHQ-28) were first administered to participants followed by the Composite International Diagnostic Interview (CIDI). The descriptive statistics were generated and analyzed. Logistic regression was also done to determine the predictors of depression in the study participants. All test of probability was set at . Results. A total of 400 participants with epilepsy were examined with GHQ-28 and CIDI. Out of the GHQ-28 examined individuals, 71 people (17.8%) met criteria for caseness while 35 participants (8.8%) were depressed when assessed with CIDI. The predictors of depressive illness in participants living with epilepsy were GHQ caseness (), minority ethnic group (), and a positive family history of mental illness (). Conclusion. Depression is common in people with epilepsy. Physicians should actively assess individuals with epilepsy for symptoms of depression. Special attention should be paid to patients with a family history of epilepsy and those from minority ethnic groups.
Depressive Symptoms among Haramaya University Students in Ethiopia: A Cross-Sectional Study
Background. The prevalence of mental health problems including depression is increasing in severity and number among higher institution students, and it has a lot of negative consequences like poor academic performance and committing suicide. Identifying the prevalence and associated factors of mental illness among higher institution students is important in order to administer appropriate preventions and interventions. In Ethiopia, only a few studies tried to report associated factors of depression among university students. Objective. The objective of this study was to determine the prevalence and factors associated with depressive symptoms among Haramaya University students, Ethiopia. Methods. Institution-based, cross-sectional study design was conducted among 1040 students. A standard, self-administered questionnaire was used to get data from a sample of randomly selected 1040 undergraduate university students using a multistage systematic random sampling technique. The questionnaire used was the Beck Depression Inventory (BDI) scale which is a self-report 21-item scale that is used to assess the presence of depressive symptoms. All 21 items are rated on a three-point scale (0 to 3). Each question is scored on a 0 to 3 scale, and total scores range from 0 to 63, with higher scores reflecting greater levels of depressive symptoms. The questionnaire has been well validated as a measure of depressive symptomatology with scores 1-13 indicating minimal depressive symptoms, 14-19 showing mild depressive symptoms, 20-28 showing moderate depressive symptoms, and 29-63 indicating severe depressive symptoms. Logistic regression analysis was used to identify variables independently associated with depressive symptoms after we dichotomized the depressive symptoms screening tool to “yes/no” depressive symptoms. This means students who did not report any depressive symptoms were given “no” depressive symptoms and who reported at least one (≥1) depressive symptoms were given “yes” (depressive symptoms). Results. A total of 1022 (98.3%) out of 1040 students participated in this study. The mean age of participants was 20.9 years (), and the majority of them (76.0%) were male students. Prevalence of depressive symptoms among undergraduate students was 26.8% (95% CI: 24.84, 28.76). Among those who had reported depressive symptoms: 10%, 12%, 4%, and 1% of students reported minimal, mild, moderate, and severe depressive symptoms, respectively. Multivariable logistic regression analysis in the final model revealed that being a first-year student (AOR 6.99, 95% CI: 2.31, 21.15, value < 0.001), being a second-year student (AOR 6.25, 95% CI: 2.05, 19.07, value < 0.001), and being a third-year student (AOR 3.85, 95% CI: 1.26, 11.78, value < 0.018) and being divorced/widowed (AOR 5.91, 95% CI: 1.31, 26.72, value < 0.021), current drinking alcohol (AOR 2.53, 95% CI: 1.72,3.72, value < 0.001), current smoking cigarettes (AOR 1.71, 95% CI: 1.02, 2.86, value < 0.042), and current use of illicit substances (AOR 2.20, 95% CI: 1.26, 3.85, value < 0.006) were independently associated with depressive symptoms. Having no religion and currently chewing Khat were statistically significantly associated with depressive symptoms in the binary logistic regression analysis but not in the final model. Conclusions. The prevalence of depressive symptoms among university students in this study is high relative to the general population. Sociodemographic factors year of study and current substance use were identified as associated factors of depressive symptoms. Recommendations. This finding suggests the need for the provision of mental health services at the university, including screening, counseling, and effective treatment. Families need to closely follow their students’ health status by having good communication with the universities, and they have to play their great role in preventing depression and providing appropriate treatment as needed. The governments and policy-makers should stand with universities by supporting and establishing matured policies which helps universities to have mental health service centers. Generally, the university and other stakeholders should consider these identified associated factors for prevention and control of mental health problems of university students.