The Prevalence of Anxiety and Depression Symptoms and Syndromes in Kenyan Children and Adolescents

ABSTRACT

Background: Community studies on children and adolescents in Western settings suggest prevalence rates of anxiety and depressive symptoms that require intervention. Aim: To establish equivalent prevalence rates in a Kenyan (developing country) situation. Method: Self-administered questionnaires for socio-demographic data; three Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV)-based instruments for anxiety symptoms and syndromes in children; one instrument for depression and one culture sensitive instrument for depression and anxiety were administered in three different sets to 3 775 randomly sampled students drawn from a stratified sample of 34.7of all public secondary schools in Nairobi; Kenya. Results: The prevalence rates of anxiety and depression symptoms and syndromes varied widely depending on sex and age and also on the emphasis of the different instruments used; and also according to the cut-off points for the various syndromes and instruments. Clinical diagnostic scores for depression were recorded in 43.7of all the students. Using the cut-off points for the Multidimensional Anxiety Scale for Children (MASC); anxiety was recorded in 12.9of all students. Nearly half (40.7) of the respondents who completed the Short Leyton Obsessional Inventory for Children and Adolescents had positive scores for obsessive disorder; 81.1were positive for compulsive disorder and an average of 69.1had positive scores for both obsessive and compulsive disorders combined. Amongst those who completed the Ndetei-Othieno-Kathuku (NOK) scale for Depression and Anxiety; 49.3had positive scores for moderate to severe anxiety with or without depression. The Screen for Child Anxiety Related Disorders - Revised (SCARED-R) yielded high levels (50-100) for the different syndromes; with obsessive-compulsive disorder at 99.3; just below separation anxiety and school phobia at 100. Suicidal thoughts and plans were prevalent at 4.9-5.5. Conclusion: Anxiety and depression were found at prevalence rates no less than is found in the West. This calls for appropriate clinical practices and policies