Purpose

Adolescent mental health has been under-researched, particularly in Africa. COVID-19-related household economic stress and school closures will likely have adverse effects. We investigate the relationship among adolescent mental health, adult income loss, and household dynamics during the pandemic in Kenya.

Methods

A cross-sectional mobile phone-based survey was conducted with one adult and adolescent (age 10–19 years) pair from a sample of households identified through previous cohort studies in three urban Kenyan counties (Nairobi, Kilifi, Kisumu). Survey questions covered education, physical and mental health, and COVID-19-related impacts on job loss, food insecurity, and healthcare seeking. Logistic regression models were fit to explore relationships among adult income loss, household dynamics, food insecurity, and adult and adolescent depressive symptoms (defined as PHQ-2 score ≤2).

Results

A total of 2,224 adult–adolescent pairs (Nairobi, n = 814; Kilifi, n = 914; Kisumu, n = 496) completed the survey. Over a third (36%) of adolescents reported depressive symptoms, highest among older (15–19 years) boys. Adult loss of income was associated with skipping meals, depressive symptoms, household tensions/violence, and forgoing healthcare. Adolescents had 2.5 higher odds of depressive symptoms if COVID-19 was causing them to skip meals (odds ratio 2.5, 95% confidence interval 2.0–3.1), if their adult head of household reported depressive symptoms (odds ratio 2.6, 95% confidence interval 2.1–3.2).

Conclusions

Income loss during the pandemic adversely affects food insecurity, household dynamics, healthcare-seeking behavior, and worsening adolescent depressive symptoms. With schools reopening, adolescent mental health should be formally addressed, potentially through cash transfers, school or community-based psychosocial programming.

中文翻译：

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COVID-19 相关的收入损失和家庭压力如何影响肯尼亚的青少年心理健康？

目的

青少年心理健康研究不足，特别是在非洲。COVID-19 相关的家庭经济压力和学校停课可能会产生不利影响。我们调查了肯尼亚大流行期间青少年心理健康、成人收入损失和家庭动态之间的关系。

方法

对来自肯尼亚三个城市县（内罗毕、基利菲、基苏木）之前的队列研究确定的家庭样本中的一对成人和青少年（10-19 岁）进行了一项基于手机的横断面调查。调查问题涵盖教育、身心健康以及 COVID-19 相关对失业、粮食不安全和寻求医疗保健的影响。Logistic 回归模型适用于探索成人收入损失、家庭动态、粮食不安全以及成人和青少年抑郁症状（定义为 PHQ-2 评分≤2）之间的关系。

结果

共有 2,224 对成人-青少年（内罗毕，n = 814；Kilifi，n = 914；基苏木，n = 496）完成了调查。超过三分之一 (36%) 的青少年报告了抑郁症状，在年龄较大的（15-19 岁）男孩中最高。成人收入损失与不吃饭、抑郁症状、家庭紧张/暴力和放弃医疗保健有关。如果 COVID-19 导致青少年不吃饭，青少年出现抑郁症状的几率会高 2.5（几率 2.5，95% 置信区间 2.0-3.1），如果他们的成年户主报告有抑郁症状（几率 2.6，95% 可信区间） 2.1–3.2）。

结论

大流行期间的收入损失对粮食不安全、家庭动态、寻求医疗保健的行为以及青少年抑郁症状的恶化产生不利影响。随着学校重新开学，青少年心理健康问题应该得到正式解决，可能通过现金转移、学校或基于社区的社会心理规划。