Adolescent Parenthood and Mental Health in South-Western Uganda: Psychosocial Vulnerabilities, Depression Prevalence, and Associated Factors

Abstract

Background Adolescent parenthood is associated with adverse psychosocial, economic, and mental health outcomes; however, evidence on adolescent parents remains limited. This study investigated these factors among adolescent parents in South-Western Uganda. Methods A cross-sectional study was conducted among 195 adolescent parents, including 155 (79.5%) adolescent mothers and 40 (20.5%) adolescent fathers in South-Western Uganda. The participants were aged 15-19 years. Data were collected using structured interviewer-administered questionnaires. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) with a score ≥10 indicating depressive symptoms, while common mental disorders (CMD) were assessed using the Shona Symptoms Questionnaire 14 (SSQ-14) with a score ≥8 indicating CMDs. Sociodemographic, socioeconomic, psychosocial, and attitude-related information was also collected. Descriptive statistics were used to summarize participant characteristics. Modified Poisson regression with robust standard errors was used to identify factors independently associated with depressive symptoms. Results Participants experienced substantial social and economic vulnerability characterized by school discontinuation, unstable livelihoods, low household assets, food insecurity, and limited support systems. The prevalence of depressive symptoms was 48.2% (n=92), while 72.6% (n=138) screened positive for other common mental disorders. Adolescent mothers had significantly higher depressive symptom prevalence than adolescent fathers (n=79, 52.0% vs n=13, 33.3%; p = 0.048), and severe depressive symptoms were observed only among adolescent mothers. Exposure to violence and mistreatment was common, with many adolescents reporting humiliation, threats, assault, and forced sex/rape. In multivariable analysis, unemployment (adjusted prevalence ratio (aPR) = 2.90, 95% CI: 1.17-7.14), household asset count = 0 (aPR = 2.57, 95% CI: 1.10-6.00), mistreatments by relatives (aPR = 1.52, 95% CI: 1.14-2.02), and mistreatment by neighbours (aPR = 1.43, 95% CI: 1.06-1.95) were independently associated with depressive symptoms. Conclusion Adolescent parents in South-Western Uganda experience a high burden of depressive symptoms and common mental disorders within contexts of poverty, violence, stigma, and limited social support. Adolescent mothers appear particularly vulnerable to severe depressive symptoms and forced sex/rape. Comprehensive adolescent-responsive interventions integrating mental health services, economic empowerment, violence prevention, educational reintegration, and community stigma reduction are urgently needed