Spinhoven Philip, Nungo Susan, van Eijk Anna Maria, Nyothach Elizabeth, Mason Linda, Obor David, Kwaro Daniel, Phillips-Howard Penelope A, Zulaika Garazi
Leiden University, Institute of Psychology, Leiden, The Netherlands.
Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
PLoS One. 2025 May 14;20(5):e0323362. doi: 10.1371/journal.pone.0323362. eCollection 2025.
Many adolescent girls drop out of school in sub-Saharan Africa. Mental health problems in this population and their risk factors are a neglected research area.
This community-based cross-sectional survey studied 904 out-of-school girls in rural western Kenya. Outcome variables were a positive screen for anxiety (GAD-7), depression (PHQ-A), post-traumatic stress disorder (PTSD; PCL-C), and a composite measure for overall symptom severity. Survey data were analysed with univariable and multivariable binary logistic and multiple linear regression analyses using SPSS 29.0.
The prevalence of probable anxiety was 10.6%, of probable depression 15.9%, and of probable PTSD 18.0%. One of the three items on suicidal ideation or past suicide attempt was reported by 40.2% of girls. In multivariable analyses controlling for age, fear of sexual assault and functional limitations due to menstruation were uniquely associated with each of the outcome variables, and exposure to physical violence to each outcome except anxiety. Other risk factors showed a less consistent relationship with outcome. The cross-sectional study design precludes any temporal and causal inference for the reported significant associations.
Out-of-school girls constitute a vulnerable group with high levels of PTSD and suicide risk. Multi-level and multi-sector interventions are needed to help these girls cope with their mental health problems and to address mutable risk factors such as gender-based partner and non-partner sexual and physical violence, poor menstrual hygiene, and poverty.
在撒哈拉以南非洲，许多青春期女孩辍学。这一人群的心理健康问题及其风险因素是一个被忽视的研究领域。
这项基于社区的横断面调查研究了肯尼亚西部农村地区的904名辍学女孩。结果变量包括焦虑（广泛性焦虑障碍-7量表，GAD-7）、抑郁（青少年版患者健康问卷，PHQ-A）、创伤后应激障碍（PCL-C量表）筛查呈阳性，以及总体症状严重程度的综合测量指标。使用SPSS 29.0对调查数据进行单变量和多变量二元逻辑回归及多元线性回归分析。
可能患有焦虑症的患病率为10.6%，可能患有抑郁症的患病率为15.9%，可能患有创伤后应激障碍的患病率为18.0%。40.2%的女孩报告有自杀意念或过去曾有自杀未遂这三项中的一项。在控制年龄的多变量分析中，对性侵犯的恐惧以及因月经导致的功能受限与每个结果变量均有独特关联，而遭受身体暴力与除焦虑外的每个结果均有关联。其他风险因素与结果的关系不太一致。横断面研究设计排除了对所报告的显著关联进行任何时间和因果推断的可能性。
辍学女孩是一个弱势群体，创伤后应激障碍和自杀风险水平较高。需要采取多层次、多部门的干预措施，以帮助这些女孩应对心理健康问题，并解决一些可变的风险因素，如基于性别的伴侣及非伴侣性暴力和身体暴力、不良的经期卫生习惯以及贫困等问题。
