A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work

Abstract Introduction Adolescent pregnancy is a highly prevalent and significant public health problem in Kenya, and mental health needs of pregnant adolescent girls have been overlooked. Nearly, 50% of the world’s population comprises children and adolescents and 85% live in lower and middle-income...

Full description

Bibliographic Details
Main Authors: Eric Kimbui, Mary Kuria, Obadia Yator, Manasi Kumar
Format: Article
Language:English
Published: BMC 2018-12-01
Series:Annals of General Psychiatry
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12991-018-0222-2
id doaj-1a2b438fe45b464d964e09c8fb399b49
record_format Article
spelling doaj-1a2b438fe45b464d964e09c8fb399b492020-11-25T01:42:15ZengBMCAnnals of General Psychiatry1744-859X2018-12-0117111510.1186/s12991-018-0222-2A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention workEric Kimbui0Mary Kuria1Obadia Yator2Manasi Kumar3Department of Psychiatry, School of Medicine, College of Health Sciences, University of NairobiDepartment of Psychiatry, School of Medicine, College of Health Sciences, University of NairobiDepartment of Psychiatry, School of Medicine, College of Health Sciences, University of NairobiDepartment of Psychiatry, College of Health Sciences, University of NairobiAbstract Introduction Adolescent pregnancy is a highly prevalent and significant public health problem in Kenya, and mental health needs of pregnant adolescent girls have been overlooked. Nearly, 50% of the world’s population comprises children and adolescents and 85% live in lower and middle-income countries. Objective Pregnant adolescents were interviewed to ascertain certain social determinants of mental health such as social support, partner or parent support, and demographic profile and assessed for depression using EPDS and for severity of depression using BDI, and their alcohol abuse assessed using AUDIT. Methods A cross-sectional descriptive study using a purposive sample of 212 pregnant adolescents visiting Kangemi Health Centre in Nairobi was conducted. Results We found that 60.4% had depressive symptoms scores of 8 and above on EPDS, 51.9% were found to have severe depression score on BDI. About 26.9% were currently consuming alcohol. The more severely depressed participants were demonstrating greater alcohol use. Of the 110 pregnant adolescents who were severely depressed, 39 were currently consuming alcohol. We identified several alcohol use disorder factors associated with depression such as living with an alcoholic, ever and current use of alcohol, alcohol-related harm being experienced, being pressured to take alcohol. On our final multivariate logistic regression, we found that being a student (AOR 5.12, 95% CI 1.19–22.0, P = 0.028); low family income (between 5000 and 10,000 shillings) (AOR 0.22, 95% CI 0.09–0.56, P = 0.02); unplanned pregnancy (AOR 3.41, 95% CI 1.19–9.80, P = 0.023); both negative and ambivalent attitudes of the unborn baby’s father, respectively (AOR 8.72 95% CI 2.88–26.37 P < 0.001; AOR 4.26 95% CI 1.35–13.45, P = 0.013); early age at sexual debut (AOR 0.70, 95% CI 0.55–0.89, P = 0.003); and ever used any psychoactive substances (AOR 3.21, 95% CI 1.31–7.88, P = 0.011). Conclusion and recommendations Alcohol abuse during pregnancy presents a significant public health burden and the associated health risks for the adolescent mother and her baby are enormous. We need to bolster screening for the comorbid disorders such as depression and substance use disorders, particularly alcohol in order to address mental health and psychosocial functioning of adolescents. The underlying adversities and sociocultural challenges need to be better understood and mechanisms that lead to comorbidities require further research. Depression interventions for Kenyan adolescents would need to embed screening, treatment and management of substance abuse.http://link.springer.com/article/10.1186/s12991-018-0222-2Pregnant adolescentsAlcohol abusePeer pressurePartner and family supportDepressionAdversities
collection DOAJ
language English
format Article
sources DOAJ
author Eric Kimbui
Mary Kuria
Obadia Yator
Manasi Kumar
spellingShingle Eric Kimbui
Mary Kuria
Obadia Yator
Manasi Kumar
A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
Annals of General Psychiatry
Pregnant adolescents
Alcohol abuse
Peer pressure
Partner and family support
Depression
Adversities
author_facet Eric Kimbui
Mary Kuria
Obadia Yator
Manasi Kumar
author_sort Eric Kimbui
title A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
title_short A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
title_full A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
title_fullStr A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
title_full_unstemmed A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work
title_sort cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of nairobi: drawing implications for treatment and prevention work
publisher BMC
series Annals of General Psychiatry
issn 1744-859X
publishDate 2018-12-01
description Abstract Introduction Adolescent pregnancy is a highly prevalent and significant public health problem in Kenya, and mental health needs of pregnant adolescent girls have been overlooked. Nearly, 50% of the world’s population comprises children and adolescents and 85% live in lower and middle-income countries. Objective Pregnant adolescents were interviewed to ascertain certain social determinants of mental health such as social support, partner or parent support, and demographic profile and assessed for depression using EPDS and for severity of depression using BDI, and their alcohol abuse assessed using AUDIT. Methods A cross-sectional descriptive study using a purposive sample of 212 pregnant adolescents visiting Kangemi Health Centre in Nairobi was conducted. Results We found that 60.4% had depressive symptoms scores of 8 and above on EPDS, 51.9% were found to have severe depression score on BDI. About 26.9% were currently consuming alcohol. The more severely depressed participants were demonstrating greater alcohol use. Of the 110 pregnant adolescents who were severely depressed, 39 were currently consuming alcohol. We identified several alcohol use disorder factors associated with depression such as living with an alcoholic, ever and current use of alcohol, alcohol-related harm being experienced, being pressured to take alcohol. On our final multivariate logistic regression, we found that being a student (AOR 5.12, 95% CI 1.19–22.0, P = 0.028); low family income (between 5000 and 10,000 shillings) (AOR 0.22, 95% CI 0.09–0.56, P = 0.02); unplanned pregnancy (AOR 3.41, 95% CI 1.19–9.80, P = 0.023); both negative and ambivalent attitudes of the unborn baby’s father, respectively (AOR 8.72 95% CI 2.88–26.37 P < 0.001; AOR 4.26 95% CI 1.35–13.45, P = 0.013); early age at sexual debut (AOR 0.70, 95% CI 0.55–0.89, P = 0.003); and ever used any psychoactive substances (AOR 3.21, 95% CI 1.31–7.88, P = 0.011). Conclusion and recommendations Alcohol abuse during pregnancy presents a significant public health burden and the associated health risks for the adolescent mother and her baby are enormous. We need to bolster screening for the comorbid disorders such as depression and substance use disorders, particularly alcohol in order to address mental health and psychosocial functioning of adolescents. The underlying adversities and sociocultural challenges need to be better understood and mechanisms that lead to comorbidities require further research. Depression interventions for Kenyan adolescents would need to embed screening, treatment and management of substance abuse.
topic Pregnant adolescents
Alcohol abuse
Peer pressure
Partner and family support
Depression
Adversities
url http://link.springer.com/article/10.1186/s12991-018-0222-2
work_keys_str_mv AT erickimbui acrosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT marykuria acrosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT obadiayator acrosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT manasikumar acrosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT erickimbui crosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT marykuria crosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT obadiayator crosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
AT manasikumar crosssectionalstudyofdepressionwithcomorbidsubstanceusedependencyinpregnantadolescentsfromaninformalsettlementofnairobidrawingimplicationsfortreatmentandpreventionwork
_version_ 1725037691006877696