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The association of single and double orphanhood with symptoms of depression among children and adolescents in Namibia

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Abstract

Despite high orphanhood and HIV prevalence rates in Southern Africa, no research has focused on mental health among orphaned children in Namibia. This study examined the association of orphan status and depressive symptoms in children and adolescents in Namibia. A back-translated Rukwangali and Silozi version of the children’s depression inventory (CDI) was administered to 157 students (grades 1–10) in three schools in Kavango and Caprivi regions. Logistic regression was used to assess the relationship between type of orphanhood (single and double) and scores ≥ 19 on the CDI. Participants (Mage = 14.9 year, SD = 3.1; 80 females, 77 males) included 84 non-orphans, 50 single orphans, and 23 double orphans. The mean total score on the CDI for the whole sample was 13.2 (SD = 6.0, range = 2–33, median = 12.0). Using the standard cut-point of ≥19 on the CDI, 21.9% of single and double orphans and 11.9% of non-orphans exhibited depressive symptoms. Double orphans were significantly more likely to score ≥ 19 on the CDI than non-orphans (odds ratio [OR] = 3.23, 95% confidence interval [CI] = 1.07–9.79, P = 0.037). Single orphans were also more likely to score at least 19 on the CDI, although this was not significant (OR = 1.62, 95% CI = 0.61–4.32, P = 0.331). The study provides evidence that orphanhood is associated with ill mental health and that high rates of psychological distress are present in approximately 1 in 6 children and adolescents in Namibia. Mental health assessments are needed to validate cut-points locally and measure levels of impairment among children and adolescents, particularly orphans. Given the small sample size and limited power of the study, it is important that future studies address the issue of mental health among orphans in Namibia to inform the development of concrete policies and services for this population.

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Acknowledgments

We thank the students for participating in the study and the Ministry of Basic Education, Sport and Culture for permission to conduct it. We are also grateful to Cecilia Makindani and Catherine Silume for assistance with data collection, which was carried it out in affiliation with Cornell University and the University of Namibia. Two anonymous reviewers provided useful comments on an earlier draft. The first author received support for this study from the National Science Foundation (Grant No. 0221244), the American Association of University Women, the Woodrow Wilson Foundation (J&J), and Cornell University. This article was written while the first author was a Richard H. Tomlinson Postdoctoral Fellow in the Division of Social and Cultural Psychiatry at McGill University.

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Correspondence to Mónica Ruiz-Casares PhD.

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Ruiz-Casares, M., Thombs, B.D. & Rousseau, C. The association of single and double orphanhood with symptoms of depression among children and adolescents in Namibia. Eur Child Adolesc Psychiatry 18, 369–376 (2009). https://doi.org/10.1007/s00787-009-0739-7

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  • DOI: https://doi.org/10.1007/s00787-009-0739-7

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