Kaggwa Mark Mohan, Arinaitwe Innocent, Nduhuura Elicana, Muwanguzi Moses, Kajjimu Jonathan, Kule Moses, Ajuna Noble, Machacha Ivan, Nkola Rahel, Najjuka Sarah Maria, Wamala Nicholas Kisaakye, Bongomin Felix, Griffiths Mark D, Rukundo Godfrey Zari, Mamun Mohammed A
Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
African Centre for Suicide Prevention and Research, Mbarara, Uganda.
Front Psychiatry. 2022 Apr 14;13:842466. doi: 10.3389/fpsyt.2022.842466. eCollection 2022.
The COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda.
A cross-sectional study was conducted among undergraduates [ = 540; 363 males; mean age = 23.3 (± 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation.
The prevalence of moderate to severe depression was 20% ( = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% ( = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13-2.81, = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10-3.84, = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32-0.79, = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03-0.73, = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10-21.12, = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08-3.16, = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23-0.70, = 0.001).
Approximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.
新冠疫情对全球学生的心理社会幸福感和心理健康产生了负面影响。尽管学生易患抑郁症和有自杀念头，但在乌干达开展的相关研究较少。本研究旨在确定乌干达本科大学生中抑郁症和自杀念头的患病率及其相关因素。
采用在线问卷对从四所大学招募的本科生（n = 540；363名男性；平均年龄 = 23.3（±2.64）岁）进行横断面研究，问卷内容涉及社会人口学因素、抑郁症及其他相关因素。使用患者健康问卷（PHQ - 9）评估抑郁症，用第9项评估过去2周内的自杀念头。进行多变量逻辑回归分析以确定与抑郁症和自杀念头相关的因素。
中度至重度抑郁症的患病率为20%（n = 108）（临界值：基于PHQ - 9为10/27），过去2周内有自杀念头的患病率为13.89%（n = 75）（临界值：基于PHQ - 9第9项为1/3）。抑郁症筛查呈阳性的个体中约一半有自杀念头。与抑郁症相关的因素有：存在人际关系问题[调整优势比（aOR）= 1.79，95%置信区间（CI）= 1.13 - 2.81，P = 0.012]，以及有性虐待史（aOR = 2.06，95% CI = 1.10 - 3.84，P = 0.023）。与降低抑郁症风险相关的因素有：对当前学业成绩满意（aOR = 0.50，95% CI = 0.32 - 0.79，P = 0.003），以及处于学业的第五年（aOR = 0.16，95% CI = 0.03 - 0.73，P = 0.018）。与自杀念头相关的因素有：吸烟和/或吸食大麻（aOR = 4.83，95% CI = 1.10 - 21.12，P = 0.037），以及有学费经济限制（aOR = 1.85，95% CI = 1.08 - 3.16，P = 0.024）。然而，对当前学业成绩满意会降低自杀念头的可能性（aOR = 0.40，95% CI = 0.23 - 0.70，P = 0.001）。
约五分之一的本科大学生患有中度至重度抑郁症，尤其是那些存在人际关系问题和有性虐待史的学生。自杀念头在吸烟者和有学费经济限制的学生中很常见。因此，建议大学当局采取措施，为有学费经济限制、人际关系和性虐待问题的学生提供心理支持。此外，所有抑郁症学生都应接受自杀倾向筛查。
