Anxiety, depression, and post-traumatic stress and associated risk factors among out-of-school girls in western Kenya

Spinhoven, Philip, Nungo, Susan, vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Nyothach, Elizabeth, Mason, Linda, Obor, David, Kwaro, Daniel, Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X and Zulaika, Garazi (2025) 'Anxiety, depression, and post-traumatic stress and associated risk factors among out-of-school girls in western Kenya'. PLoS ONE, Vol 20, Issue 5, e0323362.

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Abstract

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.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 305 Mental health of special population groups WM Psychiatry > WM 140 Mental disorders (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0323362
Depositing User:	Jane Rawlinson
Date Deposited:	30 May 2025 13:23
Last Modified:	30 May 2025 13:23
URI:	https://archive.lstmed.ac.uk/id/eprint/26693

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