Abstract
BACKGROUND: Orphans and vulnerable adolescents (OVAs) living in child care homes (CCHs) are vulnerable to depressive symptoms due to a poor environment and a lack of receiving good care and love from their parents. This study aimed to estimate the presence of depressive symptoms and determine factors associated with it among OVAs living in CCHs in Nepal. METHODS: A cross-sectional study was conducted to collect the information from OVAs aged 13-17 years living in 22 CCHs from five districts of Nepal. The CCHs were selected by a simple random method. A validated questionnaire and the Beck Depression Inventory-II (BDI-II) were used to assess depressive symptoms among the participants. Those with mild to severe BDI-II scores were defined as having clinically relevant depressive symptoms. Logistic regression was used to detect associations between variables at the significance level α = 0.05. RESULTS: A total of 602 adolescents participated in the study; 51.0% were females, the average age was 14.7 years, and 32.2% were members of indigenous groups. The overall presence of clinically relevant depressive symptoms was 33.2%. After controlling for all potential confounding factors, five factors were found to be associated with depress among OVAs. Females were 1.96 times more likely to develop depressive symptoms than males (95% CI = 1.36-2.83). Those adolescents who used alcohol were 3.42 times more likely to develop depressive symptoms than those who did not (95% CI = 1.16-10.12). Those who had health problems were 2.00 times more likely to develop depressive symptoms than those who did not (95% CI = 1.36-2.94). Those who had low social support were 1.81 times more likely to develop depressive symptoms than those who had high social support (95% CI = 1.08-3.03), and those who had been bullied were 1.97 times more likely to develop depressive symptoms than those who were not bullied (95% CI = 1.23-3.15). CONCLUSION: The magnitude of clinically relevant depressive symptoms in adolescents living in CCHs was found to be high in Nepal. There is an urgent need for effective intervention to curtail this problem among OVAs in CCHs in Nepal, with a focus on females, alcohol users, those with physical health problems and with less social support, and those who are bullied.