Risk factors for poor mental health among adolescent mothers in South Africa
Risk factors for poor mental health among adolescent mothers in South Africa
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DOI：
10.1080/13548506.2022.2124295
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发表时间：
2022-09-25
影响因子：
3.8
通讯作者：
Sherr，Lorraine
中科院分区：
文献类型：
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作者：
Roberts，Kathryn Steventon;Smith，Colette;Sherr，Lorraine
在南非，青少年怀孕率和艾滋病毒感染率高构成了突出的公共卫生挑战，对心理健康有潜在影响。重要的是要了解感染艾滋病毒的青少年母亲的心理健康困难的风险因素。本研究旨在确定青少年母亲（包括艾滋病毒感染者和未感染者）中可能常见的精神障碍的患病率，并探讨可能常见精神障碍的假设风险因素。这些分析中使用的青少年母亲（10-19岁; n=1002）的横断面数据来自南非东开普省的年轻母亲队列。所有的母亲完成了一份详细的问卷调查，包括社会人口特征，心理健康和假设的风险因素的标准化措施。Logistic回归模型被用来探讨假设的危险因素和可能的常见精神障碍之间的关联。风险因素被聚集在一个假设的社会生态框架，并进入模型使用逐步序贯的方法。此外，还探讨了与母体艾滋病毒状态的相互作用。青少年母亲中可能的常见精神障碍的患病率为12.6%。与未感染艾滋病毒的青少年母亲相比，感染艾滋病毒的青少年母亲更有可能报告可能的常见精神障碍（16.2% vs 11.2%，X2=4.41，p=0.04）。与可能的常见精神障碍相关的因素是任何虐待暴露（OR=2.54 [95%CI：1.20-5.40]，p=0.01），缺乏感知的社会支持（OR=4.09 [95%CI：2.48-6.74]，p=<0.0001）和社区暴力暴露（OR=2.09 [95%CI：1.33-3.27]，p=0.001）。风险因素和孕产妇艾滋病毒状况之间相互作用的证据有限。暴力暴露和缺乏感知的支持是南非青少年母亲心理健康状况不佳的主要风险因素。预防暴力的干预措施和社会支持可能有助于降低风险。已确定的风险因素跨越个人，人际和社区层面有可能影响青少年孕产妇的心理健康。
In South Africa, high rates of adolescent pregnancy and HIV pose prominent public health challenges with potential implications for mental wellbeing. It is important to understand risk factors for mental health difficulties among adolescent mothers affected by HIV. This study aims to identify the prevalence of likely common mental disorder among adolescent mothers (both living with and not living with HIV) and explores hypothesised risk factors for likely common mental disorder. Cross-sectional data from adolescent mothers (10–19 years; n=1002) utilised within these analyses are drawn from a cohort of young mothers residing in the Eastern Cape Province, South Africa. All mothers completed a detailed questionnaire consisting of standardised measures of sociodemographic characteristics, mental health, and hypothesised risk factors. Logistic regression models were utilised to explore associations between hypothesised risk factors and likely common mental disorder. Risk factors were clustered within a hypothesised socioecological framework and entered into models using a stepwise sequential approach. Interaction effects with maternal HIV status were additionally explored. The prevalence of likely common mental disorder among adolescent mothers was 12.6%. Adolescent mothers living with HIV were more likely to report likely common mental disorder compared to adolescent mothers not living with HIV (16.2% vs 11.2%, X2=4.41, p=0.04). Factors associated with likely common mental disorder were any abuse exposure (OR=2.54 [95%CI:1.20–5.40], p=0.01), a lack of perceived social support (OR=4.09 [95%CI:2.48–6.74], p=<0.0001), and community violence exposure (OR=2.09 [95%CI:1.33–3.27], p=0.001). There was limited evidence of interaction effects between risk factors, and maternal HIV status. Violence exposure and a lack of perceived support are major risk factors for poor mental health among adolescent mothers in South Africa. Violence prevention interventions and social support may help to reduce risk. Identified risk factors spanning individual, interpersonal, and community levels have the potential to impact adolescent maternal mental health.