Abstract
Depression and anxiety are important sources of morbidity globally, but we have little knowledge of risk groups and risk factors for both classes of disorders in Tanzania and other low-resource settings. We aimed to identify sociodemographic markers and risk and protective factors associated with symptoms of anxiety and depression among 1249 young men belonging to social groups known as “camps” in Dar es Salaam. Anxiety and depression were measured using the HSCL-25. Twenty-two percent of men reported clinically significant symptoms of depression and 20% reported clinically significant symptoms of anxiety. Men living apart from family reported greater symptoms of anxiety and depression than men living with family, and employment was associated with a greater likelihood of clinically significant symptoms of both anxiety and depression. Childhood experience of violence was strongly associated with both anxiety and depression. Social support was associated with lower levels of anxiety and depression, and with a lower likelihood of clinically significant levels of anxiety and depression. Youth not living with family and the working poor may be important populations for future investigation. Interventions targeting survivors of childhood violence and social support-based interventions should be tested to address the burden of anxiety and depression in this setting.
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Baxter, A., Vos, T., Scott, K., Ferrari, A., & Whiteford, H. (2014). The global burden of anxiety disorders in 2010. Psychological Medicine, 44(11), 2363–2374.
Boden, J. M., & Fergusson, D. M. (2011). Alcohol and depression. Addiction, 106(5), 906–914.
Borgatti, S., Everett, M., & Freeman, L. (2002). Ucinet for windows: software for social network analysis version 3.6. Harvard: Analytic Technologies.
Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225.
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A. (2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health, 11(1), 828.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.
Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J., Vos, T., & Whiteford, H. A. (2013). Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Medicine, 10(11), e1001547.
Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography, 38(1), 115–132.
Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso-Mateos, J. L., Tobiasz-Adamczyk, B., Koskinen, S., Rummel-Kluge, C., & Haro, J. M. (2016). The role of socio-economic status in depression: results from the COURAGE (aging survey in europe). BMC Public Health, 16(1), 1098–1098.
Gaynes, B. N., Pence, B. W., Atashili, J., O’Donnell, J. K., Njamnshi, A. K., Tabenyang, M. E., Arrey, C. K., Whetten, R., Whetten, K., & Ndumbe, P. (2015). Changes in HIV outcomes following depression care in a resource-limited setting: results from a pilot study in Bamenda, Cameroon. PLoS One, 10(10), e0140001.
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., Pickering, R. P., & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on alcohol and related conditions. Archives of General Psychiatry, 61(8), 807–816.
Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psychology, 1, 293–319.
Hovens, J. G. F. M., Wiersma, J. E., Giltay, E. J., van Oppen, P., Spinhoven, P., Penninx, B. W. J. H., & Zitman, F. G. (2010). Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls. Acta Psychiatrica Scandinavica, 122(1), 66–74.
Hudson, C. G. (2005). Socioeconomic status and mental illness: tests of the social causation and selection hypotheses. American Journal of Orthopsychiatry, 75(1), 3–18.
Iheanacho, T., Obiefune, M., Ezeanolue, C. O., Ogedegbe, G., Nwanyanwu, O. C., Ehiri, J. E., Ohaeri, J., & Ezeanolue, E. E. (2015). Integrating mental health screening into routine community maternal and child health activity: experience from prevention of mother-to-child HIV transmission (PMTCT) trial in Nigeria. Social Psychiatry and Psychiatric Epidemiology, 50(3), 489–495.
Jaycox, L. H., Kataoka, S. H., Stein, B. D., Langley, A. K., & Wong, M. (2012). Cognitive behavioral intervention for trauma in schools. Journal of Applied School Psychology, 28(3), 239–255.
Jenkins, R., Mbatia, J., Singleton, N., & White, B. (2010). Common mental disorders and risk factors in urban Tanzania. International Journal of Environmental Research and Public Health, 7(6), 2543–2558.
Kaaya, S. F., Fawzi, M. C., Mbwambo, J. K., Lee, B., Msamanga, G. I., & Fawzi, W. (2002). Validity of the Hopkins symptom Checklist-25 amongst HIV-positive pregnant women in Tanzania. Acta Psychiatrica Scandinavica, 106(1), 9–19.
Kajula, L., Balvanz, P., Kilonzo, M. N., Mwikoko, G., Yamanis, T., Mulawa, M., Kajuna, D., Hill, L., Conserve, D., & Reyes, H. L. M. (2016). Vijana vijiweni II: A cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam. BMC Public Health, 16(1), 1.
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78(3), 458–467.
Kessler, R. C., Gruber, M., Hettema, J. M., Hwang, I., Sampson, N., & Yonkers, K. A. (2008). Co-morbid major depression and generalized anxiety disorders in the national comorbidity survey follow-up. Psychological Medicine, 38(03), 365–374.
Kirmayer, L. J., & Ryder, A. G. (2016). Culture and psychopathology. Current Opinion in Psychology, 8, 143–148.
Kushner, M. G., Abrams, K., & Borchardt, C. (2000). The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clinical Psychology Review, 20(2), 149–171.
Lakey, B., & Orehek, E. (2011). Relational regulation theory: a new approach to explain the link between perceived social support and mental health. Psychological Review, 118(3), 482–495.
Lee, B., Kaaya, S. F., Mbwambo, J. K., Smith-Fawzi, M. C., & Leshabari, M. T. (2008). Detecting depressive disorder with the Hopkins symptom Checklist-25 in Tanzania. The International Journal of Social Psychiatry, 54(1), 7–20.
Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology, 157(2), 98–112.
McCulloh, I., Armstrong, H. (Helen Leslie), & Johnson, A. N. (2013). Social network analysis with applications. Hoboken, New Jersey: Wiley & Sons, Inc.
McEwen, B. S. (2004). Protection and damage from acute and chronic stress: allostasis and allostatic overload and relevance to the pathophysiology of psychiatric disorders. Annals of the New York Academy of Sciences, 1032(1), 1–7.
Myklestad, I., Roysamb, E., & Tambs, K. (2012). Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trondelag health study. Social Psychiatry and Psychiatric Epidemiology, 47(5), 771–782.
Nseluke, M. T., & Siziya, S. (2011). Prevalence and socio-demographic correlates for mental illness among inmates at Lusaka central prison, Zambia. Medical Journal of Zambia, 38(2), 3–7.
Pappin, M., Wouters, E., Booysen, F. L. R., & Lund, C. (2015). Public sector antiretroviral treatment programme in South Africa: health care workers’ attention to mental health problems. AIDS Care, 27(4), 458–465.
Parloff, M. B., Kelman, H. C., & Frank, J. D. (1954). Comfort, effectiveness, and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry, 111(5), 343–352.
Paul, K. I., & Moser, K. (2009). Unemployment impairs mental health: meta-analyses. Journal of Vocational Behavior, 74(3), 264–282.
Petersen, I., Hancock, J. H., Bhana, A., & Govender, K. (2014). A group-based counselling intervention for depression comorbid with HIV/AIDS using a task shifting approach in South Africa: a randomized controlled pilot study. Journal of Affective Disorders, 158, 78–84.
Pfeiffer, P. N., Heisler, M., Piette, J. D., Rogers, M. A., & Valenstein, M. (2011). Efficacy of peer support interventions for depression: a meta-analysis. General Hospital Psychiatry, 33(1), 29–36.
Robert, S. A., & House, J. S. (2003). Socioeconomic inequalities in health: Integrating individual-, community-, and societal-level theory and research. The handbook of social studies in health and medicine (p. 115). London; Thousand Oaks, Calif.: Sage Publications.
Roche, K. M., Bingenheimer, J. B., & Ghazarian, S. R. (2016). The dynamic interdependence between family support and depressive symptoms among adolescents in Ghana. International Journal of Public Health, 61(4), 487–494.
Sipsma, H., Ofori-Atta, A., Canavan, M., Osei-Akoto, I., Udry, C., & Bradley, E. H. (2013). Poor mental health in Ghana: who is at risk? BMC Public Health, 13(1), 1.
Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliott, M. N., & Fink, A. (2003). A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. Journal of the American Medical Association, 290(5), 603–611.
Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161.
Vyas, S., & Kumaranayake, L. (2006). Constructing socio-economic status indices:h to use principal components analysis. Health Policy and Planning, 21(6), 459–468.
Wagner, G. J., Ngo, V., Glick, P., Obuku, E. A., Musisi, S., & Akena, D. (2014). Integration of depression treatment into HIV care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial. Trials, 15, 248.
Weir, S. S., Pailman, C., Mahlalela, X., Coetzee, N., Meidany, F., & Boerma, J. T. (2003). From people to places: focusing AIDS prevention efforts where it matters most. AIDS, 17(6), 895–903.
Whittier, A. B., Gelaye, B., Deyessa, N., Bahretibeb, Y., Kelkile, T. S., Berhane, Y., & Williams, M. A. (2016). Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital. Journal of Affective Disorders, 197, 58–65.
Winokur, A., Winokur, D. F., Rickels, K., & Cox, D. S. (1984). Symptoms of emotional distress in a family planning service: stability over a four-week period. The British Journal of Psychiatry: The Journal of Mental Science, 144, 395–399.
World Health Organization. (2014). Mental health atlas. Geneva: World Health Organization.
Yamanis, T. J., Maman, S., Mbwambo, J. K., Earp, J. A. E., & Kajula, L. J. (2010). Social venues that protect against and promote HIV risk for young men in Dar Es Salaam, Tanzania. Social Science & Medicine, 71(9), 1601–1609.
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This research was made possible by funding from The National Institute of Mental Health (R01MH098690).
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The study was approved by the ethical review committees at the University of North Carolina at Chapel Hill and Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. Individual written informed consent was obtained from all study participants.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
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Hill, L.M., Kajula, L.J. & Maman, S. Correlates of Anxiety and Depression among Young Men Living in Dar Es Salaam, Tanzania. Int J Ment Health Addiction 18, 917–931 (2020). https://doi.org/10.1007/s11469-018-9993-6
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DOI: https://doi.org/10.1007/s11469-018-9993-6