Participants characteristics
The characteristics of the participants are shown in Table 1. There were a total of 1932 participants from the University of Dar es Salaam with males representing 48.2% (n = 931) and females 51.8% (n = 1001). The median age for all participants was 22, with males showing a median age of 23 and females 22.
Table 1 Sociodemographic characteristics for all participants (N = 1932)
Variables
|
All (n,%)
|
Male (n,%)
|
Female (n,%)
|
Number of participants
|
1932 (100)
|
931 (48.2)
|
1001 (51.8)
|
Age median (range)
|
22 (18 to 53)
|
23 (18 to 53)
|
22 (18 to 49)
|
Relationship status
|
|
Single
|
1093 (56.5)
|
563 (29.1)
|
530 (27.4)
|
Dating
|
709 (36.7)
|
304 (15.7)
|
405 (20.9)
|
Married
|
93 (4.8)
|
51 (2.6)
|
42 (2.2)
|
Divorced/separated
|
10 (0.5)
|
6 (0.3)
|
4 (0.2)
|
Widow(er)
|
3 (0.1)
|
0
|
3 (0.1)
|
Not identified
|
24 (1.2)
|
7 (0.4)
|
17 (0.9)
|
Overview findings for mental health illnesses
Participants were asked whether any member of their family suffers from any mental health challenges with 368 (19.0%) indicating yes, 793 (41.0%) indicating no and 760 (39.3% ) not sure. As shown in Table 2, the mean PHQ-9, GAD-7 and PSS scores represent moderate levels of depression, anxiety and stress. Female students showed mean levels of moderate depression, anxiety and stress, whereas males showed moderate, mild and moderate mean levels for depression, anxiety and stress respectively.
Table 2 Mean scores for PHD-9, GAD-7 and PSS for all participants (N = 1932)
Variables
|
All (n=1932)
|
Male (n=931)
|
Female (n=1001)
|
Scale score, mean (SD)
|
|
|
|
PHQ-9
|
11.8 (7.2)
|
10.9 (7.3)
|
12.7 (7.1)
|
GAD-7
|
9.6 (6.2)
|
8.9 (6.1)
|
10.2 (6.0)
|
PSS
|
19.8 (8.9)
|
19.0 (7.2)
|
20.5 (7.5)
|
As shown in Table 3, there was a higher prevalence of students that indicated symptoms of stress (moderate to high perceived, 81.0%) when compared to depression (moderate to severe, 54.6%) and anxiety (moderate to severe, 47.4%).
Table 3 Levels of depression, anxiety and stress among student participants (N = 1932)
Variables (scores)
|
All (n,%)
|
Male (n,%)
|
Female (n,%)
|
Depression
|
|
None (0-4)
|
349 (18.1)
|
213 (11.0)
|
136 (7.0)
|
Mild (5-9)
|
525 (27.2)
|
248 (12.8)
|
277 (14.3)
|
Moderate (10-14)
|
341 (17.7)
|
150 (7.8)
|
191 (9.9)
|
Moderately severe (15-19)
|
322 (16.7)
|
156 (8.1)
|
166 (8.6)
|
Severe (20-27)
|
391 (20.2)
|
163 (8.4)
|
228 (11.8)
|
Anxiety
|
|
Minimal (0-4)
|
484 (25.1)
|
277 (14.3)
|
207 (10.7)
|
Mild (5-9)
|
527 (27.3)
|
257 (13.3)
|
270 (14.0)
|
Moderate (10-14)
|
411 (21.3)
|
182 (9.4)
|
229 (11.9)
|
Severe (15-21)
|
505 (26.1)
|
212 (11.0)
|
293 (15.2)
|
Stress
|
|
Low (0-13)
|
367 (19.0)
|
190 (9.8)
|
177 (9.2)
|
Moderate (14-26)
|
1215 (62.9)
|
593 (30.7)
|
622 (32.2)
|
High perceived (27-40)
|
350 (18.1)
|
148 (7.7)
|
202 (10.5)
|
Depression
The PHQ-9 scores determined the level of depression among participants. A total of 1579 showed mild to severe levels of depression with males accounting for 37.1% (n=717) and females 44.6% (n=862). This accounted for a prevalence of 81.7%. The distribution of various symptoms of depression were determined with long and continuous mood swings showing the highest frequency followed by feeling sad or down a lot of the time, as seen in Table 4.
Table 4 Prevalence of symptoms for depression among students
|
n (%)
|
Male (n, %)
|
Female (n, %)
|
Feeling numb /uninterested
|
509 (32.2)
|
222 (14.0)
|
287 (18.2)
|
Long and continuous mood swings
|
705 (44.6)
|
302 (19.1)
|
403 (25.5)
|
Changes in weight by losing or gaining a lot
|
473 (30.0)
|
179 (11.3)
|
294 (18.6)
|
Different sleeping patterns
|
533 (33.7)
|
233 (14.7)
|
300 (19.0)
|
Feeling sad or down a lot of the time
|
604 (38.2)
|
256 (16.2)
|
348 (22.0)
|
Feeling of not wanting to talk to family or friends
|
360 (22.8)
|
151 (9.6)
|
209 (13.2)
|
Feeling worthless as a person
|
434 (27.5)
|
184 (11.7)
|
250 (15.8)
|
A lack of feeling of emotion
|
418 (26.5)
|
188 (11.9)
|
230 (14.6)
|
Feeling exhausted
|
376 (23.8)
|
147 (9.3)
|
229 (14.5)
|
Having difficulty concentration/losing interest
|
406 (25.7)
|
169 (10.7)
|
237 (15.0)
|
Feelings of despair
|
394 (25.0)
|
167 (10.6)
|
227 (14.4)
|
Postnatal depression after giving birth
|
228 (14.4)
|
112 (7.1)
|
116 (7.3)
|
Thoughts of ending one's life or hurting oneself
|
177 (11.2)
|
72 (4.5)
|
105 (6.7)
|
As seen in Figure 2, the different sources for causing participants to express mild to severe depression was determined, with thinking about the future (23%), academic (22.5%) and financial (20.7%) issues being the top for both male and female students.
Anxiety
The GAD-7 scores determined the level of anxiety among participants. A total of 1443 showed mild to severe levels of anxiety with males accounting for 45.1 % (n=651) and females 54.9% (n=792). This accounted for a prevalence of 74.7%. The symptoms that are associated with anxiety were determined and an elevated heart rate was show to be expressed by the largest number of participants followed by inability to concentrate as well as the inability to stop thinking about problems constantly, as seen in Table 5.
Table 5 Prevalence of symptoms for anxiety among participants (N =1443)
|
n (%)
|
Male (n, %)
|
Female (n, %)
|
Feeling nervous, restless or tense
|
539 (37.4)
|
229 (15.9)
|
310 (21.5)
|
Feelings of danger or panic
|
348 (24.1)
|
147 (10.2)
|
201 (13.9)
|
Elevated heart rate
|
731 (50.6)
|
306 (21.2)
|
425 (29.4)
|
Unable to stop thinking about problems constantly
|
616 (42.7)
|
261 (18.1)
|
355 (24.6)
|
Greatly avoiding things that can trigger anxiety
|
385 (26.7)
|
162 (11.2)
|
223 (15.5)
|
Unable to stay calm and still
|
412 (28.5)
|
178 (12.3)
|
234 (16.2)
|
Unable to concentrate
|
630 (43.6)
|
254 (17.6)
|
376 (26.0)
|
Sweating
|
238 (16.5)
|
115 (8.0)
|
123 (8.5)
|
Trembling
|
290 (20.1)
|
101 (7.0)
|
189 (13.1)
|
Feeling weak/tired
|
460 (31.9)
|
189 (13.1)
|
271 (18.8)
|
Rapid breathing
|
333 (23.1)
|
132 (9.1)
|
201 (14.0)
|
As seen in Figure 3, the different sources for causing participants to express mild to severe depression was determined, with thinking about the future (20%), academic (22%) and financial (19%) issues being the top for all students.
Stress
The PSS scores determined the level of stress among participants. A total of 1565 showed moderate to high levels of stress with males accounting for 47.3 % (n=741) and females 52.7% (n=824). This accounted for a prevalence of 81.0%. However the symptoms associated with stress were determined with students feeling exhausted or having trouble sleeping the majority followed by the inability to perform responsibilities, as seen in Table 6.
Table 6 Prevalence of symptoms for stress among participants (N = 1565)
|
n (%)
|
Male (n, %)
|
Female (n, %)
|
Chest pains
|
475 (30.4)
|
197 (12.6)
|
278 (17.8)
|
Tense muscles/clenching jaw
|
258 (16.5)
|
126 (8.1)
|
132 (8.4)
|
Intimacy/trouble having sex
|
273 (17.4)
|
128 (8.2)
|
145 (9.2)
|
Dizziness and headaches
|
589 (37.6)
|
248 (15.8)
|
341 (21.8)
|
Feeling exhausted or trouble sleeping
|
682 (43.6)
|
293 (18.7)
|
389 (24.9)
|
Stomach/digestive issues
|
328 (20.9)
|
127 (8.1)
|
201 (12.8)
|
Feeling aches and pain
|
331 (21.1)
|
143 (9.1)
|
188 (12.0)
|
Memory issues
|
409 (26.1)
|
193 (12.3)
|
216 (13.8)
|
Feeling overwhelmed
|
537 (34.3)
|
219 (14.0)
|
318 (20.3)
|
Help to keep calm (alcohol, drugs or cigarettes)
|
280 (17.9)
|
141 (9.0)
|
139 (8.9)
|
Nervous habits like pacing or nail biting
|
476 (30.4)
|
204 (13.0)
|
272 (17.4)
|
Unable to perform responsibilities
|
618 (39.5)
|
273 (17.4)
|
345 (22.0)
|
As seen in Figure 4, the different sources for causing participants to express moderate to high stress was determined, with thinking about the future (20%), academic (21%) and financial (1%) issues being the top for all students.
The number of students coming forward to seek counselling or advice at UDSM is increasing. A total of 890 students indicated seeking assistance for their mental health issues through professionals such as psychologists and counselors, as shown in Table 7. There were other students that sought help by other means with friends (30.6%) and parents (25.0%) being the highest, as shown in Table 8.
Table 7 Methods students at UDSM for assistance from mental health issues
|
n (%)
|
Psychological/Clinical psychologist
|
300 (33.7)
|
Counselor/Therapist
|
323 (36.3)
|
Medical doctor
|
267 (30.0%)
|
Table 8: Other methods students used to help treat mental health issues
|
(%)
|
Religious leader
|
13.6
|
Witch doctor
|
1.0
|
Traditional health practitioner
|
1.4
|
Spouse
|
6.6
|
Parents
|
25.0
|
Sibling
|
11.8
|
Friend
|
30.6
|
Relative
|
9.9
|