14 percent of youths are depressed

Fourteen percent of adolescents in Trinidad and Tobago suffer from depression, says senior lecturer in the Depart-ment of Psychiatry at UWI, Dr Hari Maharajh, speaking at a meeting of the Association of Psychi-atrists in Trinidad and Tobago (APTT). The two topics discussed were “Social and Cultural Aspects of Gender Differences in Depression Among Sec-ondary School Students in Trinidad and Tobago”  and “Social Predictors of Suicidal Behaviour in Adolescents in Trinidad and Tobago”. Maharajh presented his findings from two studies conducted in 2000, in which 1,810 secondary school children, aged 14-20, from 24 schools across the country, were studied.

In his first presentation, Maharajh des-cribed depression as a chronic, persistent disorder of mood, and stated that although it was more common in adult women than men, this was not necessarily the case in children. Studies have shown that the disorder is higher in boys than girls before 11 or 12 years. In adolescents over 13 years, however, more modern studies have shown that girls suffer twice as much from depression. “Therefore there is a shift from childhood to adolescent depression and the maximum gender difference occurs between 15 and 18 years of age,” he said, attributing the change to the transformations that may occur during the latter period, such as poor self esteem, rebellion, drug and alcohol abuse and problems with identity. Other probable reasons were puberty changes, pre-inherited disposition, socio-cultural factors and family environment.

It was concluded from the study that 14 percent of adolescents were depressed, of which 24 percent were male and 76 percent female. This rate compared favourably with other countries. Australia stands at 14.2 percent, while the worldwide rate is 35.7 percent. His study on depression also focussed on ethnicity, religion, type of school, family structure and suicide attempts. Of the 14 percent, there was no real gender difference among In-dians and Africans except among the mixed group, and attendance at church was a protective factor for females against depression, but not males. Additionally, Maha-rajh found that boys from the ‘prestige’ schools and girls from the ‘non-prestige’ schools were the ones more depressed, and vice versa in both cases. For family structure, it was found that persons from reconstituted families (that is, two families which have been joined together by marriage, for example) suffered more than any other family type.

Twice as many of the females in the 14 percent also attempted suicide. Maharajh put the current local ratio of depressed men to women at 1:2.2, and believes the study of the disorder in young people can make a difference. “Adolescent depression can actually lead (its occurrence) in adults. If we look at them, then we could find a pattern from an early age.” In introducing “Social Predictors of Suicidal Behaviour in Adoles-cents in Trinidad and Tobago”, Maharajh stated that TT had the second highest suicide rate in the Caribbean after Cuba, according to the World Health Organisa-tion in 2001. A similar sample of children were used as in the previous report and the social predictors were inclusive of gender, attendance at religious institutions, prayer with the family/ home worship, family structure and alcohol abuse in the family. On the whole, suicide was more common in females than in males.

It was found that more females thought about suicide and attempted it than males, and there was no significant difference between Africans and Indians in suicide ideation and attempt. Families that prayed or worshipped together had a lowered risk compared to that of other families for suicide ideation or attempt, but reconstituted families carried the highest risk of such. Maharajh also pointed out that persons from an intact family (families with both parents) also had a high risk. The use or abuse of alcohol in families also was an important aspect of the study. It was found that in families where this occurred, the thought of suicide was twice as likely, and 2.5 times more probable for suicide attempts among the school children. Maharajh mentioned the difficulties faced in carrying out the studies. It took one year to get approval from the Ministry of Education, supervisors and the like, while many school principals (some from the ‘prestige’ girl schools) were very protective of their students and as such were opposed to the idea of participating in such a study.

He made clear, however, that these studies were not conclusive, but the findings are indeed necessary. “This is valuable information when we seek to implement public health strategies. It is time for us to do our own research and stop using foreign studies and applying them to us.” In his conclusion, he stated his belief that mental illnesses ought to be studied in children and adolescents as early intervention and prevention does make a difference. According to Maha-rajh, currently there is no treatment available for adolescent depression and even though the Mental Health plan of 2000 had made provisions, to date nothing has been done. The studies have been accepted for publication and will be out in journals soon.