High prevalence of affective disorders among adolescents living in Rural Zimbabwe.
High prevalence of affective disorders among adolescents living in Rural Zimbabwe.
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DOI：
10.1007/s10900-010-9261-6
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发表时间：
2010-08
影响因子：
5.9
通讯作者：
Cowan, Frances M.
中科院分区：
文献类型：
--
作者：
Langhaug, Lisa F.;Pascoe, Sophie J.;Mavhu, Webster;Woelk, Godfrey;Sherr, Lorraine;Hayes, Richard J.;Cowan, Frances M.
心理健康状况不佳是全球青年人的重大疾病负担。我们调查了2006年津巴布韦农村青年情感障碍的患病率和决定因素。我们进行了一项横断面调查，1495津巴布韦青年，年龄在15-23岁（中位数18），从12个农村社区在津巴布韦东南部的三个省。使用Shona症状问卷（SSQ）评估心理健康，这是一种当地验证的14项土著情感障碍筛查工具，特别是抑郁症和焦虑症。评分≥8/14的受试者被认为有受影响的风险，评分≥11的受试者被认为有受严重影响的风险。大多数参与者（93.1%）完成了SSQ。其中，51.7%（95%CI：49.0-54.3%）的评分≥8/14，23.8%（95%CI：21.5-26.0%）的评分≥11。情感障碍与家庭贫困（调整后的优势比（AOR）1.9，95%CI：1.4-2.7）、生活在女性户主家庭（AOR 1.3，95%CI：1.0-1.7）、在过去5年内搬过家（AOR 1.4，95%CI：1.0-1.9）和感觉受到羞辱（AOR被他人回避3.7，95%CI：2.5-5.7）独立相关。情感障碍风险与性风险之间存在很强的线性相关性（受累和严重受累的有过性行为的AOR分别为1.5，95%CI：1.0-2.4和2.8，95%CI：1.9-4.2，趋势检验P < 0.001; ≥2个终生伴侣的AOR为2.3，95%CI：1.1-4.8和5.4，95%CI：2.7-10.7，趋势检验P < 0.001）。这项研究表明，津巴布韦农村青年的心理发病率很高，这与性冒险有关。迫切需要采取干预措施，预防、查明和治疗这一弱势群体的心理健康障碍。在艾滋病毒流行的国家，这种干预措施也可能有助于减少艾滋病毒的传播。
Poor mental health accounts for considerable disease burden among young people globally. We investigated the prevalence and determinants of affective disorders among rural Zimbabwean youth in 2006. We undertook a cross-sectional survey among 1495 Zimbabwean youth aged 15–23 (median 18) from 12 rural communities in three provinces in south-eastern Zimbabwe. Mental health was assessed using the Shona Symptom Questionnaire (SSQ), a locally validated 14-item indigenous screening tool for affective disorders, notably depression and anxiety disorders. Participants scoring ≥8/14 were considered at risk of being affected and ≥11 as at risk of being severely affected. Most participants (93.1%) completed the SSQ. Of these, 51.7% (95%CI:49.0–54.3%) scored ≥8/14 and 23.8% (95%CI:21.5–26.0%) scored ≥11. Affective disorders were independently associated with household poverty (adjusted odds ratio (AOR) 1.9, 95%CI:1.4–2.7), living in a female-headed household (AOR 1.3, 95%CI:1.0–1.7), having moved home within last 5 years (AOR 1.4, 95%CI:1.0–1.9) and feeling stigmatized (AOR being shunned by others 3.7, 95%CI:2.5–5.7). There was a strong linear association between risk of affective disorders and sexual risk taking (ever sex AOR 1.5, 95%CI:1.0–2.4, and 2.8, 95%CI:1.9–4.2 for affected and severely affected, respectively, test for trend P < 0.001; ≥2 lifetime partners AOR 2.3, 95%CI:1.1–4.8 and 5.4, 95%CI:2.7–10.7, test for trend P < 0.001). This study indicates high levels of psychological morbidity among rural Zimbabwean youth which was associated with sexual risk taking. Interventions to prevent, identify and treat mental health disorders in this vulnerable population are urgently required. In HIV-endemic countries, such interventions may also help reduce HIV transmission.
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