Depression and Psychosocial Risk Factors Associated With Pregnant Adolescentsmixed Method Study Based at Kangemi Health Centre,Nairobi

Abstract

Background: - Adolescent pregnancy within urban resource deprived settlements predisposes young people to adverse mental health and psychosocial risks. Among the key mental health challenges is depression; a significant mental health concern worldwide and also in Kenya. Depression jeopardizes the psychological wellbeing and prospects of future productivity of the adolescent, her infant and the whole family system. Objective: - To determine the prevalence of depression and related psychosocial risks in pregnant adolescent reporting at Kangemi Health Centre. Study Design: A cross-sectional descriptive study using mixed methods. Methodology: - Administration of socio-demographic questionnaire to measure levels of poverty, social support and education, alcohol/substance abuse, sexual/domestic violence, STI/HIV/AIDS, Edinburgh post-partum scale (EPDS) and the PHQ-9 to measure depression and severity and grounded theory in-depth qualitative interviews with pregnant adolescents and their mothers/guardian for a retrospective analysis and description of their individual experiences and challenges. Data analysis:- A mixed method review entailing descriptive and inferential statistical methods available in the SPSS version 20 was used to summarize the quantitative data. The results were presented in descriptive statistical formats such as pie charts and frequency tables. Qualitative data was analyzed by conducting a thematic content analysis and some excerpts presented verbatim. 15 Results: - Seventy eight percent (78%) of pregnant adolescents in the Kangemi area suffer from depression with 21% found to have mild depression, 24% had moderate depression,17% had moderate severe depression and 16% had severe depression. Logistic regression analysis on psycho-social risk factors associated with depression showed factors such as being a student OR=0.39, 95% CI (0.36-042), low education level OR=0.19,95% CI (0.18-0.20) single adolescents OR= 0.25 95% CI (0.23-0.27), low income earners OR=0.25 95% CI (0.7-0.43), Parents/partner’s reaction to pregnancy OR=33 95% CI (0.30-0.37) and lack of social support OR=0.45 95% CI (0.42-0.48) were significantly associated with severe depression. Conclusion: - Interventions targeting psycho-social risk factors should be a prevention strategy for depression in pregnant adolescents.