Depressive symptoms in adolescents in Jamaica / Síntomas depresivos en adolescentes de Jamaica

BACKGROUND: Depression in adolescents is often overlooked and misdiagnosed; however, it is an important mental health problem which is associated with major functional impairments across daily domains of living, and considerable morbidity. The aim of this research is to examine the prevalence of self-reported depressive symptoms among Jamaican adolescents, and the associated sociodemographic factors. SUBJECTS AND METHOD: This cross-sectional study included 3003 students between 10 and 15 years old in Jamaica. Survey methodology was used in the collection of the data. RESULTS: Of the sample of students, 47% were males. One hundred and thirty-four (4.5%) reported having depressive symptoms. The factors significantly associated with depressive symptoms were negative community attributes (B = 1.1; p = 0.001), protective factors within the home (B = 0.72; p = 0.000), gender (B = 1.92; p = 0.000), and learning problems (B = 3.1; p = 0.000). CONCLUSION: Results indicate rates of depressive symptomatology reported among adolescents in Jamaica are consistent with rates reported in the literature.

ANTECEDENTES: La depresión en los adolescentes es a menudo pasada por alto y mal diagnosticada, a pesar de que constituye un problema de salud mental importante. El mismo se halla asociado con deterioros funcionales mayores en todos los dominios de la vida diaria, y conlleva una morbosidad considerable. El objetivo de esta investigación es examinar la prevalencia de síntomas depresivos autoreportados entre adolescentes jamaicanos, así como pasar revista a los factores sociodemográficos asociados. MÉTODO: Este estudio transversal incluyó 3003 estudiantes jamaicanos entre 10 y 15 años de edad. La metodología de encuestas fue usada en la recogida de datos. RESULTADOS: De la muestra de estudiantes, 47% eran varones. Ciento treinta y cuatro (4.5%) reportaron tener síntomas depresivos. Los factores significativamente asociados con los síntomas de depresión fueron atributos comunitarios negativos (B = 1.1; p = 0.001), factores de protección en el hogar (B = 0.72; p = 0.000), género (B = 1.92; p = 0.000), y problemas de aprendizaje (B = 3.1; p = 0.000). CONCLUSIÓN: Los resultados indican que las tasas de sintomatología depresiva reportadas entre los adolescentes en Jamaica concuerdan con las tasas reportadas en la literatura.

Suicide ideation in Jamaican youth: sociodemographic prevalence, protective and risk factors / Ideación suicida en la juventud jamaicana: prevalencia sociodemográfica, factores de riesgo y factores de protección

OBJECTIVE: To determine the prevalence of suicidal ideation and examine the association between suicidal ideation and sociodemographic characteristics, protective and risk factors among Jamaican youth. METHOD: In this cross-sectional study, an interviewer administered school-based survey was conducted among 2997 students 10-15 years old in Jamaica. Although there were a number of questions on suicide, this paper focusses on one question "During the past year, did you ever seriously consider attempting suicide?" as the measure of suicidal ideation. RESULTS: The prevalence rate of suicidal ideation was 9.7%. Logistic regression analysis revealed that significant correlates of suicidal ideation were being female (odds ratio = 1.49), being depressed (odds ratio = 5.78), living in a rural area (odds ratio = 0.62), likes oneself (odds ratio = 0.58), indulging in aggressive behaviour (odds ratio = 1.43), has considered harming others (odds ratio = 3.11), protective factors in the home (odds ratio = 0.62), involvement in risky behaviour (odds ratio = 1.56) and being teased/bullied (odds ratio = 1.69). CONCLUSION: These findings have implication for prevention and treatment of suicidal behaviour in children and adolescents.

OBJETIVO: Determinar la prevalencia de ideación suicida y examinar la asociación entre la ideación suicida y las características sociodemográficas, así como los factores de protección y riesgo entre la juventud jamaicana. MÉTODO: En este estudio transversal, un entrevistador administró una encuesta escolar entre 2997 estudiantes de 10-15 años de edad en Jamaica. Aunque había varias preguntas sobre el suicidio, el documento se centraba en la siguiente, con el objeto de medir la ideación suicida: "¿Consideraste alguna vez seriamente cometer suicidio el año pasado?" RESULTADOS: La tasa de prevalencia de ideación suicida fue 9.7%. El análisis de regresión logística reveló que los correlatos significativos de ideación suicida fueron: ser mujer (cociente de probabilidades OR = 1.49), estar deprimido (cociente de probabilidades OR = 5.78), vivir en un área rural (cociente de probabilidades OR = 0.62), gustarse a sí mismo (cociente de probabilidades OR = 0.58), permitirse un comportamiento agresivo (cociente de probabilidades OR = 1.43), considerar hacer daño a otros (cociente de probabilidades OR = 3.11), factores de protección en la casa (cociente de probabilidades OR = 0.62), involucrarse en conductas arriesgadas (cociente de probabilidades OR = 1.56) y ser víctima de burla o acoso abusivo (cociente de probabilidades OR = 1.69). CONCLUSIÓN: Estos hallazgos tienen implicaciones en cuanto a prevenir y tratar la conducta suicida en niños y adolescentes.

Jamaican youth health status 2005 / Nivel de salud de la juventud jamaicana en el 2005

The purpose of this survey is to determine health-seeking behaviour, nutritional status and lifestyles of adolescents aged 10-15 years. A random sample of 3003 (1 422 males and 1 581 females) school-children, aged 10-15 years, was studied in a cross-sectional, interviewer-administered school-based survey conducted in all school types islandwide in a nationally representative sample of Jamaican children currently attending school. Some 3003 youths, 1422 males and 1581 females were interviewed. Males and females had similar healthcare-seeking behaviour but fewer students attending schools in rural areas reported having their eyes or hearing checked, or had seen a dentist than those attending urban schools. Some twelve per cent of adolescents were overweight/ obese. More females than males and more urban than rural students were overweight or obese. More boys (86.3%) were physically active in the last week than girls (75%). Physical activity peaked at age 13 years and was lowest at ages 11 and 14-15 years. Some 13% of adolescents 10-15 years old reported having had sexual intercourse, with boys being four times as likely as girls to report sexual activity (OR- 4.97; C.I. - 3.82, 6.47). The median age of sexual debut was 15.43 years for boys and over 15 years for girls. One-third of adolescents drank alcohol and 3% smoked marijuana in the past year. More boys than girls used drugs (p < 0.01). Some 14% of adolescents felt lonely, sad or wanted to cry most of the time/always. One-tenth seriously considered suicide. This study concluded that most adolescents attending primary and secondary schools in Jamaica were not involved in risky behaviour. However, it reveals some critical areas of concern with regard to nutritional status and physical activity, emotional well-being, drug use and sexual activity.

El propósito de este estudio es determinar el comportamiento de búsqueda de la salud, el nivel nutricional, y los estilos de vida de adolescentes de 10-15 años. Una muestra aleatoria de 3003 (1422 varones y 1581 hembras) escolares de 10-15 años de edad, fue sometida a una encuesta transversal aplicada por el entrevistador. La encuesta con sede en la escuela, fue conducida en todos los tipos de escuela a lo largo de la isla en una muestra nacionalmente representativa de niños y niñas jamaicanos que asisten a la escuela actualmente. Se entrevistaron unos 3003 jóvenes, 1422 varones y 1581 hembras. Los varones y las hembras tenían comportamientos de búsqueda de la salud similares pero el número de estudiantes que reportó haber tenido chequeos de la vista o de la audición, o haber visto a un dentista, fue menor entre aquellos que asistían a las escuelas en áreas rurales que entre los que asistían a escuelas urbanas. Alrededor del doce por ciento de los adolescentes eran obesos o estaban pasados de peso. Más hembras que varones y más estudiantes urbanos que rurales estaba pasados de peso o eran obesos. Más muchachos (86.3%) que muchachas (75%) estaban físicamente activos en la última semana. La actividad física alcanzó su punto máximo en la edad 13 años y el más bajo en las edades 11 y 14-15 años. Alrededor de 13% de adolescentes de 10-15 años reportaron haber tenido relaciones sexuales, siendo el caso que la tendencia a reportar actividad sexual fue cuatro veces mayor en los muchachos que en las muchachas (OR- 4.97; C.I. - 3.82, 6.47). La edad promedio de la iniciación sexual fue de 15.43 años para los muchachos y mayor de 15 años para las muchachas. Un tercio de los adolescentes bebió alcohol y un 3% fumó marihuana el año pasado. Más muchachos que las muchachas consumían drogas (p < 0.01). Alrededor del 14% de los adolescentes se sentían solos, tristes o sentían deseos de llorar la mayor parte del tiempo/siempre. La décima parte de ellos consideró seriamente la posibilidad de suicidio. Este estudio concluyó que la mayoría de los adolescentes que asisten a las escuelas primarias y secundarias en Jamaica no estuvieron involucrados en conductas de riesgo. Sin embargo, se ponen de manifiesto algunas áreas críticas de preocupación con respecto al nivel nutricional y la actividad física, el bienestar emocional, el uso de drogas y la actividad sexual.

The impact of side effects on family planning use among female clients of the public health services in Jamaica

A one-year longitudinal study was undertaken in Kingston, Jamaica, to examine (i) the experience of side effects among female contraceptive users, (ii) the role of side effects in method continuation, and (iii) counselling regarding side effects. The study consisted of 463 women who utilized public health centres in Kingston and were either new users of contraceptives or who were switching contraceptive methods. They were recruited over a two-month period in 1998 and followed up for one year. All follow-up, interviews were done at the women's homes and complete interviews were obtained for 323 women. Information was collected about socio-economic characteristics, contraceptive history, service factors, experience with method and length of use. Forty-eight per cent of the women experienced side effects with the method accepted on recruitment to the study. Common side effects were irregular bleeding no period, headaches, nausea/dizziness and weight gain/loss. These side effects occurred mainly among pill and injection users. The occurrence of side effects had a negative impact on continuation rates. Forty-seven per cent of the women stated that they had received counselling regarding side effects. The level and impact of side effects among family planning acceptors at public health centres in Jamaica is of significance to the family planning programme. Method options need to be widened and counselling needs to be improved to ensure that women fully understand the issue of side effects and make informed choices about contraception.

A behaviour risk factor survey in Jamaica

A population based probability sample of 958 persons (454 males and 504 females) aged 15 to 49 years was surveyed in Jamaica in late 1993 for lifestyle and behaviour risk factors. Demographic characteristics of the sample were comparable to the general population, 60of persons visited a private doctor the last time that they were ill. Based on self-reporting, 18of the women and 8of the men were hypertensive and 4.8of the women and 3.3of the men were diabetic. 26of the men and 8of the women had never had their blood pressure taken. 40of the women had never had a Papanicolaou smear, 29had never had a breast examination and 33said that they were overweight compared with 18of men. Smoking cigarettes and marijuana was more common among men (36) than women (11), as were drinking alcohol (79of men, 41of women) and heavy alcohol use (30of men, 9of women). Injuries requiring medical attention in the previous five years were reported by 40of the men and 15of the women. 34of the men and 12of the women regularly carried a weapon and 18of the sample had participated in or witnessed at least one violent act in the previous month. Most of the people interviewed used a contraceptive method; 10were not sexually active. Significantly more men than women had two or more sexual partners in the previous year (54vs 17, p < 0.001) or reported ever having a sexually transmitted disease (29vs 9, p < 0.001). Younger persons were more sexually active and more likely to use condoms during their most recent sexual intercourse. Higher socio-economic status and educational level generally had a more positive effect on health behaviour. This survey provides vital information relevant to planning health promotion campaigns and assessing their success.

Polio immunization and serological status in children and adolescents in Jamaica 1985

A survey of immunization status and serological immunity to polio was carried out in 5 parishes in Jamaica in 1985. A sample of 2,506 children and adolescents aged 1 - 19 years was chosen by selecting clusters of children in enumeration districts (EDs) in each parish from the 1980 Census. Immunization status was verified by examining immunization records. Serological assay for antibodies to Polio Types 1, 2 =, and 3 was done. A positive neutralization test at dilution of 1:8 was done. A positive neutralization test at dilution of 1:8 was taken as immunity to the polio virus. Of the 1,819 children whose immunization status was confirmed, coverage with 3 or more doses of roral polio vaccine was highest in the 1 - 4 year age group with with 79.7% and lowest in the 15 - 19-year age group with 37.4%. Of the 2,506 children 81.4%, 94.7% and 72.3% were seropositive for Polio Types 1, 2 and 3 respectively. There was a significant difference in the prevalence of seropositives between individuals with and those without a history of vaccinations. No urban/rural or sex differences were noted. The study indicated a higher level of immunization status than previous surveys and a high level of serological immunity to polio