title: The association of single and double orphanhood with symptoms of depression among children and adolescents in Namibia.
abstract: Despite high orphanhood and HIV prevalence rates in Southern Africa, no research has focused on mental health among orphaned children in Namibia. This study examined the association of orphan status and depressive symptoms in children and adolescents in Namibia. A back-translated Rukwangali and Silozi version of the children's depression inventory (CDI) was administered to 157 students (grades 1-10) in three schools in Kavango and Caprivi regions. Logistic regression was used to assess the relationship between type of orphanhood (single and double) and scores > or = 19 on the CDI. Participants (Mage = 14.9 year, SD = 3.1; 80 females, 77 males) included 84 non-orphans, 50 single orphans, and 23 double orphans. The mean total score on the CDI for the whole sample was 13.2 (SD = 6.0, range = 2-33, median = 12.0). Using the standard cut-point of > or =19 on the CDI, 21.9% of single and double orphans and 11.9% of non-orphans exhibited depressive symptoms. Double orphans were significantly more likely to score > or = 19 on the CDI than non-orphans (odds ratio [OR] = 3.23, 95% confidence interval [CI] = 1.07-9.79, P = 0.037). Single orphans were also more likely to score at least 19 on the CDI, although this was not significant (OR = 1.62, 95% CI = 0.61-4.32, P = 0.331). The study provides evidence that orphanhood is associated with ill mental health and that high rates of psychological distress are present in approximately 1 in 6 children and adolescents in Namibia. Mental health assessments are needed to validate cut-points locally and measure levels of impairment among children and adolescents, particularly orphans. Given the small sample size and limited power of the study, it is important that future studies address the issue of mental health among orphans in Namibia to inform the development of concrete policies and services for this population.
authors.affiliation: Department of Psychiatry, McGill University and CSSS de Montagne, Montreal, Canada. monica.ruizcasares@mail.mcgill.ca
authors.forename: Mónica
authors.initials: M
authors.lastname: Ruiz-Casares
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
authors.forename: Cécile
authors.initials: C
authors.lastname: Rousseau
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D054540:Child, Orphaned / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D016001:Confidence Intervals; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D009276:Namibia / Q000453:epidemiology; D016017:Odds Ratio; D011610:Psychosocial Deprivation; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology