Prevalence of depression and associated factors among school-going adolescents with hearing impairment in Kampala District, Uganda

Abstract

Background: Depression remains one of the most common and disabling mental disorders among adolescents globally. Well as its burden has been widely studied, little is still known about how it affects school-going adolescents with hearing impairment, a group that often faces unique social emotional and structural challenges. Despite their increased vulnerability, adolescents with hearing impairment continue to be overlooked in most mental health research. This study set out to determine the prevalence of depression and explore the factors associated with it with the aim of informing inclusive mental health policy and interventions. Objectives: To determine the prevalence of depression and factors associated with it among school-going adolescents with hearing impairment in Kampala district, Uganda. Methods: This cross-sectional study was conducted among adolescents aged 10 to 17 years with hearing impairment, attending three primary schools of the deaf in Kampala. Proportionate sampling across the schools was followed by simple random sampling. Depression was assessed using the Mini International Neuropsychiatric Interview for children and adolescents (MINI-KID), adapted for use among adolescents with hearing impairment. A structured socio-demographic questionnaire was administered. Data was analyzed with Stata version 17 and modified Poisson regression with robust standard errors was used to examine associations. Results: The study included 116 adolescents with HI in Kampala, with a mean age of 14.5 years (SD=1.9), of whom 60 (51.7%) were female. The point prevalence of depression was 34.5%, with lifetime prevalence at 60.3%. Suicidal ideation was reported by 21%. Depression was more common among females (55.7%) and older adolescents (14-17 years) (62.9%), though these differences were not statistically significant. Living in father-only households and witnessing excessive disciplinary practices were significantly associated with depression. Conclusion: This study found a high prevalence of depression and suicidal ideation among adolescents with HI. Depression was more common among females and older adolescents, exacerbated by family structure and punitive disciplinary practices. Urgent interventions are needed, including mental health support for students with HI, supportive family structures, implementing inclusive education policies, mental health training for teachers, and improved access to sign language-trained professionals to support this vulnerable group.