title: What are the factors associated with depressive symptoms among orphans and vulnerable children in Cambodia?
abstract: BACKGROUND
  Compared to general children, orphans and vulnerable children (OVC) are more exposed to negative outcomes in life such as abuse and neglect. Consequently, OVC are more susceptible to depression. This paper investigated factors associated with depressive symptoms among OVC in Cambodia.
  
  
  METHODS
  In this cross-sectional study, data of 606 OVC from the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project were analyzed. The data were collected from five provinces and analyzed separately for boys and girls. Multiple linear regression analysis was used to identify factors independently associated with levels of depressive symptoms.
  
  
  RESULTS
  Both boys and girls who reported having been too sick making them unable to attend school or go to work in the past six months (boys: B = 3.5; 95 % CI = 0.7, 6.2; girls: B = 5.7; 95 % CI = 2.9, 8.5) and who had witnessed violence in the family (boys: B = 5.6; 95 % CI = 1.6, 9.6; girls: B = 5.8; 95 % CI = 1.7, 9.9) had a higher level of depressive symptoms. Girls who were older (B = 8.5; 95 % CI = 3.0, 14.0), who did not have enough food in the past six months (B = -8.7; 95 % CI = -13.7, -3.7) and whose parents were separated, divorced or dead (B = 3.9; 95 % CI = 0.5, 7.2) had a higher level of depressive symptoms. Higher level of school attachment was negatively associated with depressive symptoms in both genders (boys: B = -1.4; 95 % CI = -2.0, -0.9; girls: B = -1.4; 95 % CI = -2.0,-0.9).
  
  
  CONCLUSIONS
  Factors such as physical health and exposure to violence may affect mental health of OVC in Cambodia. As health is of utmost importance, better healthcare services should be made easily accessible for OVC. Schools have the potential to act as a buffer against depressive symptoms. Therefore, efforts should be made to keep OVC in school and to improve the roles of school in Cambodia.
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. kenicong@m.u-tokyo.ac.jp.
authors.forename: Ken Ing Cherng
authors.initials: KI
authors.lastname: Ong
authors.affiliation: Center for Population Health, KHANA, Phnom Penh, Cambodia. ysiyan@khana.org.kh.
authors.forename: Siyan
authors.initials: S
authors.lastname: Yi
authors.affiliation: Center for Population Health, KHANA, Phnom Penh, Cambodia. tsovannary@khana.org.kh.
authors.forename: Sovannary
authors.initials: S
authors.lastname: Tuot
authors.affiliation: Center for Population Health, KHANA, Phnom Penh, Cambodia. cpheak@khana.org.kh.
authors.forename: Pheak
authors.initials: P
authors.lastname: Chhoun
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. shibanuma@gmail.com.
authors.forename: Akira
authors.initials: A
authors.lastname: Shibanuma
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. jyasuoka@m.u-tokyo.ac.jp.
authors.forename: Junko
authors.initials: J
authors.lastname: Yasuoka
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. mjimba@m.u-tokyo.ac.jp.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D054540:Child, Orphaned / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D014754:Violence / Q000523:psychology; D035862:Vulnerable Populations / Q000523:psychology*