Depressive symptoms are common among rural Malawian adolescents.

BackgroundDepressive conditions cause about 25 million disability adjusted life years in low-income countries annually. The incidence of depression rises after puberty, and the young age distribution in these countries may cause a high burden of adolescent depression. We aimed to assess the prevalence of reported depressive symptoms among rural adolescents in Malawi. Additionally, we assessed the association between birth weight, childhood growth, gender, and pubertal maturity and depressive symptoms. MethodsWe followed 767 children from the foetal period until 15-years-of-age. We used the Short Mood and Feelings Questionnaire (SMFQ) to examine reported depressive symptoms at 15years. The questionnaire was translated to local language and then back-translated until inaccuracies were not detected. Anthropometry was conducted at 1, 24, 120, and 180months of age. We performed regression models with imputed data to assess associations between the independent variables and depressive symptoms. As a sensitivity analysis, we ran the same regression models with participants with no missing data. ResultsA total of 523 participants were seen at 15years. The mean SMFQ score was 15 with 90% (95%CI 87-92%) of the participants scoring 11 points, the traditional cut-off for screening for depression. Birth weight, growth, gender, and pubertal maturity were not associated with the SMFQ score in the primary imputed analyses. In the sensitivity analysis, birth weight was associated with the SMFQ score in all models. ConclusionsThe prevalence of reported depressive symptoms was high among the studied population. It is uncertain how well the traditional cut-off of 11 points identifies children with clinically significant depressive symptoms in our sample. Our data do not support a hypothesis of an association between growth, gender, or pubertal maturity and depressive symptoms. Nevertheless, our results highlight the importance of the awareness of mental health problems in low-income countries.