DEPRESSIVE SYMPTOMS AND ASSOCIATION WITH SOCIO-DEMOGRAPHIC FACTORS AND OCCUPATIONAL FUNCTIONING AND A PILOT PRE-POST OCCUPATIONAL THERAPY INTERVENTION FOR ADOLESCENT DEPRESSION

Abstract

According to the Centers for Disease Control and Prevention, there are approximately 1.9 million children and adolescents diagnosed with depression globally, and the prevalence is suspected to be on the rise. Literature has shown that impairment in occupational participation and functioning can have a negative impact on young people’s activities of daily living, academics, self-care, sleep, leisure, and mood. It is therefore important to explore the effects of an occupational therapy intervention on in-school adolescents with depressive symptoms on their mood, occupational functioning, and social participation. METHOD This was a two-stage study involving a cross-sectional survey and a one-group pre-post intervention study. For the cross-sectional survey, a random sampling technique was used to recruit 345 students from four schools (two public and two private schools) in Abeokuta to determine the prevalence and correlates of depression. The students completed the Beck Depression Inventory (BDI) along with a socio-demographic questionnaire. For the pre-post intervention Phase of the study, the students from the cross-sectional phase who scored 18 and above on the BDI were identified and the 10 highest scorers from each of the four schools were selected (40 students). These students completed the following additional instruments; the Canadian Occupational Performance Measure (COPM), Short Mood and Feelings Questionnaire (for depression) and Wellness and Life Satisfaction Questions. The original study design was for 20 students to receive a manualized occupational therapy intervention while 20 were to be controls. However, due to Covid-19 lockdown which led to closure of schools, only 10 students in one intervention school received the intervention for 5 weeks and completed baseline and post-intervention data. Due to the massive disruption caused by the lockdown, it was not possible to resume the study when schools resumed. It was therefore agreed with my supervisors that the data from the 10 studentswho received the intervention and completed baseline and post intervention data will be treated as a pre-post intervention design (as opposed to the original two-group controlled design). RESULT Out of 345 students recruited in this study, 141 (40.9%) were males, while 204 (59.1%) were females. The mean age was 14.86 ± 1.24 years. A total of 90 participants had a BDI score of 18 and above which shows a 26.1% prevalence of depression. The mean BDI score was 11.61 ± 10.23. There was a statistically significant association between depressive symptoms and gender such that girls had more depressive symptoms than boys (Mean 12.68 ± 10.72 vs 10.06 ± 9.29). There was no association between depressive symptoms and occupational functioning, knowledge of depression and measure of wellness. For the intervention Phase, there were statistically significant post-intervention reductions in depressive symptoms and improvements in occupational functioning and social participation with large effect sizes. Participants reported a high level of satisfaction with the intervention can be inferred from a mean satisfaction rating score of 28 out of a maximum of 30. The majority of the participants stated that they liked the games and how it related to helping them cope with stress and control their emotions. CONCLUSION In this study, the prevalence of depression was 1 in 4 in-school adolescents, which suggests a significant burden. Findings from this study show that occupational therapy intervention is feasible and effective in decreasing depressive symptoms, and improving occupational functioning and social participation in adolescents. The intervention was also well received by the participants