TY - JOUR
T1 - Anxiety, depression, and post-traumatic stress and associated risk factors among out-of-school girls in western Kenya
AU - Spinhoven, Philip
AU - Nungo, Susan
AU - van Eijk, Anna Maria
AU - Nyothach, Elizabeth
AU - Mason, Linda
AU - Obor, David
AU - Kwaro, Daniel
AU - Phillips-Howard, Penelope A.
AU - Zulaika, Garazi
N1 - Publisher Copyright:
© 2025 Spinhoven et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/5/14
Y1 - 2025/5/14
N2 - Background Many adolescent girls drop out of school in sub-Saharan Africa. Mental health problems in this population and their risk factors are a neglected research area. Methods This community-based cross-sectional survey studied 904 out-of-school girls in rural western Kenya. Outcome variables were a positive screen for anxiety (GAD-7), depression (PHQ-A), post-traumatic stress disorder (PTSD; PCL-C), and a composite measure for overall symptom severity. Survey data were analysed with univariable and multivariable binary logistic and multiple linear regression analyses using SPSS 29.0. Findings The prevalence of probable anxiety was 10.6%, of probable depression 15.9%, and of probable PTSD 18.0%. One of the three items on suicidal ideation or past suicide attempt was reported by 40.2% of girls. In multivariable analyses controlling for age, fear of sexual assault and functional limitations due to menstruation were uniquely associated with each of the outcome variables, and exposure to physical violence to each outcome except anxiety. Other risk factors showed a less consistent relationship with outcome. The cross-sectional study design precludes any temporal and causal inference for the reported significant associations. Conclusion Out-of-school girls constitute a vulnerable group with high levels of PTSD and suicide risk. Multi-level and multi-sector interventions are needed to help these girls cope with their mental health problems and to address mutable risk factors such as gender-based partner and non-partner sexual and physical violence, poor menstrual hygiene, and poverty.
AB - Background Many adolescent girls drop out of school in sub-Saharan Africa. Mental health problems in this population and their risk factors are a neglected research area. Methods This community-based cross-sectional survey studied 904 out-of-school girls in rural western Kenya. Outcome variables were a positive screen for anxiety (GAD-7), depression (PHQ-A), post-traumatic stress disorder (PTSD; PCL-C), and a composite measure for overall symptom severity. Survey data were analysed with univariable and multivariable binary logistic and multiple linear regression analyses using SPSS 29.0. Findings The prevalence of probable anxiety was 10.6%, of probable depression 15.9%, and of probable PTSD 18.0%. One of the three items on suicidal ideation or past suicide attempt was reported by 40.2% of girls. In multivariable analyses controlling for age, fear of sexual assault and functional limitations due to menstruation were uniquely associated with each of the outcome variables, and exposure to physical violence to each outcome except anxiety. Other risk factors showed a less consistent relationship with outcome. The cross-sectional study design precludes any temporal and causal inference for the reported significant associations. Conclusion Out-of-school girls constitute a vulnerable group with high levels of PTSD and suicide risk. Multi-level and multi-sector interventions are needed to help these girls cope with their mental health problems and to address mutable risk factors such as gender-based partner and non-partner sexual and physical violence, poor menstrual hygiene, and poverty.
U2 - 10.1371/journal.pone.0323362
DO - 10.1371/journal.pone.0323362
M3 - Article
C2 - 40367187
AN - SCOPUS:105005173567
VL - 20
JO - PLoS ONE
JF - PLoS ONE
IS - 5
M1 - e0323362
ER -
