International Journal of Mental Health Systems | |
Depression among AIDS-orphaned children higher than among other orphaned children in southern India | |
Lalit Dandona2  SP Ramgopal1  G Anil Kumar1  Rakhi Dandona1  SG Prem Kumar1  | |
[1] Public Health Foundation of India, ISID Campus, 4, Institutional Area, Vasant Kunj, New Delhi 110 070, India;Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA | |
关键词: India; Depression; Mental health; Orphaned children; AIDS; HIV; | |
Others : 801099 DOI : 10.1186/1752-4458-8-13 |
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received in 2013-10-29, accepted in 2014-03-26, 发布年份 2014 | |
【 摘 要 】
Background
Systematic data on mental health issues among orphaned children are not readily available in India. This study explored depression and its associated risk factors among orphaned children in Hyderabad city in south India.
Methods
400 orphaned children drawn equally from AIDS and non-AIDS orphan groups aged 12–16 years residing in orphanages in and around Hyderabad city in southern India were recruited to assess depression and associated risk factors using the Center for Epidemiologic Studies-Depression Scale (CES-DC). Variation in the intensity of depression was assessed using multiple classification analysis (MCA).
Results
397 (99%) orphans provided complete interviews in the study of whom 306 (76.5%) were aged 12 to 14 years, and 206 (51.8%) were paternal orphans. Children orphaned by AIDS were significantly more likely to report being bullied by friends or relatives (50.3%) and report experiencing discrimination (12.6%) than those orphaned due to other reasons (p < 0.001). The overall prevalence of depression score >15 with CES-DC was 74.1% (95% CI 69.7-78.4) with this being significantly higher for children orphaned by AIDS (84.4%, 95% CI 79.4 – 89.5) than those due to other reasons (63.6%, 95% CI 56.9 – 70.4). Mean depression score was significantly higher for children orphaned by AIDS (34.6) than the other group (20.6; p < 0.001). Among the children orphaned by AIDS, the bulk of depression score was clustered in 12–14 years age groups whereas in the children orphaned by other reasons it was clustered in the 15–16 years age group (p = 0.001). MCA analysis showed being a child orphaned by AIDS had the highest effect on the intensity of depression (Beta = 0.473).
Conclusions
Children orphaned by AIDS had significantly higher depressive symptoms than the other orphaned children. These findings could be used for further planning of mental health interventions to meet the mental health needs of orphaned children, that could include preventive, diagnostic and treatment services.
【 授权许可】
2014 Kumar et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140708003213669.pdf | 352KB | download | |
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Figure 1. | 44KB | Image | download |
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【 参考文献 】
- [1]UNICEF: The state of World’s Children 2012. New York: United Nations Children’s Fund (UNICEF); 2012.
- [2]UNICEF: Facts on Children. http://www.unicef.org/media/media_45451.html webcite
- [3]WHO: World Health Report - A safer future: global public health security in the 21st century. Geneva: World Health Organisation (WHO); 2007.
- [4]Kojoué KL: Orphans, AIDS, and the Millennium Development Goals: models and capacity to act. Sante 2009, 19:134-139.
- [5]Delva W, Vercoutere A, Loua C, Lamah J, Vansteelandt S, De Koker P, Claeys P, Temmerman M, Annemans L: Psychological well-being and socio-economic hardship among AIDS orphans and other vulnerable children in Guinea. AIDS Care 2009, 21:1490-1498.
- [6]UNICEF: Africa’s Orphaned and Vulnerable Generations: Children affected by AIDS. New York: United Nations Children’s Fund (UNICEF); 2006.
- [7]Baggaley R, Sulwe J, Chilala M, Mashambe C: HIV related stress at school and at home in Zambia. AIDS Analysis Africa 1997, 7:14-15.
- [8]Young L, Ansell N: Young AIDS migrants in South Africa: policy implications for empowering children. AIDS Care 2003, 15:337-345.
- [9]Tsiwo-Chigubi-G: Exploring self-esteem of orphans whose parents died of HIV/AIDS; examined through the extended family/kinship caregivers’ economic wellbeing, social support and child-rearing practices in Zimbabwe. Diss Abstr Int 2005, 62:1301.
- [10]Haine RA, Ayers TS, Sandler IN, Wolchik SA: Evidence-Based Practices for Parentally Bereaved Children and Their Families. Prof Psychol Res Pr 2008, 39:113-121.
- [11]Dowdley L: Childhood bereavement following parental death. J Child Psychol Psychiatry 2000, 41:819-830.
- [12]Foster G, Williamson J: A review of current literature on the impact of HIV/AIDS on children in sub-Saharan Africa. AIDS 2000, 14:S275-S284.
- [13]Li X, Naar-King S, Barnett D, Stanton B, Fang X, Thurston C: A developmental psychopathology framework of the psychosocial needs of children orphaned by HIV. J Assoc Nurses AIDS Care 2008, 19:147-157.
- [14]Cluver L, Gardner F: The mental health of children orphaned by AIDS: a review of international and southern African research. J Child Adolesc Ment Health 2007, 19:1-17.
- [15]Bachman Desilva M, Skalicky AM, Beard J, Cakwe M, Zhuwau T, Simon JL: Longitudinal evaluation of the psychosocial wellbeing of recent orphans compared with non-orphans in a school-attending cohort in KwaZulu-Natal, South Africa. Int J Ment Health Promot 2012, 14:162-182.
- [16]Chi P, Li X: Impact of parental HIV/AIDS on children’s psychological well-being: a systematic review of global literature. AIDS Behav 2013, 17:2554-2574.
- [17]Gupta AK, Rawat N, Rai K, Rana S, Chakraborty S: Orphan and vulnerable children infected or affected by HIV/AIDS in Delhi – situational analysis and state government’s initiative of household economic strengthening. Vulnerable Child Youth Stud 2013, 8:161-170.
- [18]Makame V, Ani C, Grantham-McGregor S: Psychological wellbeing of orphans in Dar es Salaam, Tanzania. Acta Paediatr 2002, 91:459-465.
- [19]Faulstich ME, Carey MP, Ruggiero L, Enyart P, Gresham F: Assessment of depression in childhood and adolescence: an evaluation of the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Am J Psychiatry 1986, 143:1024-1027.
- [20]Weissman MM, Orvaschel H, Padian N: Children’s symptom and social functioning self-report scales: Comparison of mothers’ and children’s reports. J Nerv Ment Dis 2008, 168:736-740.
- [21]National AIDS Control Organization. National AIDS Control Programme: UNGASS Country Progress Report 2008 India. New Delhi: NACO; 2008.
- [22]Kumar A: AIDS orphans and vulnerable children in India: problems, prospects, and concerns. Soc Work Public Health 2012, 27:205-212.
- [23]UNAIDS: Global report on the AIDS epidemic 2010. Geneva: UNAIDS; 2010.
- [24]National AIDS Control Organization: National AIDS Control Programme: Response to the HIV epidemic in India. New Delhi: NACO; 2007.
- [25]Dandona L, Dandona R: Drop of HIV estimate for India to less than half. Lancet 2007, 370:1811-1813.
- [26]Ghanashyam B: India failing children orphaned by AIDS. Lancet 2010, 375:363-364.
- [27]UNGA: Political Declaration on HIV/AIDS- Resolution adopted by the General Assembly. New York: United Nations General Assembly; 2006.
- [28]UNICEF: The framework for the protection, care and support of orphans and vulnerable children living in a world with HIV and AIDS. New York: United Nations Children’s Fund (UNICEF); 2004.
- [29]Sherr L, Varrall R, Mueller J, Richter L, Wakhweya A, Adato M, Belsey M, Chandan U, Drimie S, Haour-Knipe Victoria Hosegood M, Kimou J, Madhavan S, Mathambo V, Desmond C, JLICA Workgroup 1 Members: A systematic review on the meaning of the concept ‘AIDS Orphan’: confusion over definitions and implications for care. AIDS Care 2008, 20:527-536.
- [30]Cluver L, Gardner F: The psychological well-being of children orphaned by AIDS in Cape Town, South Africa. Ann Gen Psychiatry 2006, 5:8. BioMed Central Full Text
- [31]Horowitz JL, Garber J: The Prevention of Depressive Symptoms in Children and Adolescents: A Meta-Analytic Review. J Consult Clin Psychol 2006, 74:401-415.
- [32]Kaggwa EB, Hindin MJ: The psychological effect of orphanhood in a matured HIV epidemic: an analysis of young people in Mukono, Uganda. Soc Sci Med 2010, 70:1002-1010.
- [33]Nyamukapa CA, Gregson S, Lopman B, Saito S, Watts HJ, Monasch R, Jukes MC: HIV-associated orphanhood and children’s psychosocial distress: theoretical framework tested with data from Zimbabwe. Am J Public Health 2008, 98:133-141.
- [34]Patel V, Flisher AJ, Hetrick S, McGorry P: Mental health of young people: a global public-health challenge. Lancet 2007, 369:1302-1313.
- [35]Turner-Cobb JM, Gore-Felton C, Marouf F, Koopman C, Kim P, Israelski D, Spiegel D: Coping, social support, and attachment style as psychosocial correlates of adjustment in men and women with HIV/AIDS. J Behav Med 2002, 25:337-353.
- [36]Paradies Y: A systematic review of empirical research on self-reported racism and health. Int J Epidemiol 2006, 35:888-901.
- [37]Williams DR, Neighbors HW, Jackson JS: Racial/ethnic discrimination and health: Findings from community studies. Am J Public Health 2003, 93:200-208.
- [38]Murphy DA, Moscicki AB, Vermund SH, Muenz LR: Psychological distress among HIV(+) adolescents in the REACH study: Effects of life stress, social support, and coping, The Adolescent Medicine HIV/AIDS Research Network. J Adolesc Health 2000, 27:391-398.
- [39]Institute for Health Metrics and Evaluation: The Global Burden of Disease: Generating Evidence, Guiding Policy. Washington: Institute for Health Metrics and Evaluation (IHME); 2010.
- [40]Ruiz-Casares M, Thombs BD, Rousseau C: The association of single and double orphanhood with symptoms of depression among children and adolescents in Namibia. Eur Child Adolesc Psychiatry 2009, 18:369-376.
- [41]UNAIDS: Children on the Brink 2002: A Joint Report on Orphan Estimates and Program. New York: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2003.
- [42]NACO: Country coordinating mechanism for the global fund to fight AIDS, tuberculosis and malaria- India, proposal: Expansion of effective public and private sector interventions in HIV, tuberculosis and malaria prevention and treatment in India. New Delhi: National AIDS Control Organisation (NACO), Ministry of Health and Family Welfare, Government of India; 2006.
- [43]UNICEF: Information by country: India. http://www.unicef.org/infobycountry/india.html webcite
- [44]International Institute for Population Sciences: National Family Health Survey (NFHS-3), 2005–2006: India. Mumbai: International Institute for Population Sciences, Macro International; 2007.
- [45]Ministry of Health and Family Welfare: Government of India. The Draft Mental Health Care Bill, 2011. The Draft Mental Health Care Bill, 2011; 2011.
- [46]UNICEF: Children and AIDS: Fifth stocktaking report. New York: United Nations Children’s Fund (UNICEF); 2010.
- [47]Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A: Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003, 60:837-44.
- [48]Cluver LD, Orkin M, Gardner F, Boyes ME: Persisting mental health problems among AIDS-orphaned children in South Africa. J Child Psychol Psychiatry 2012, 53:363-370.