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Against the background of a lack of screening instruments for measuring depressive symptoms in Colombian adolescents and preadolescents, this study aims to establish the internal consistency reliability, component structure and the concurrent and discriminant validity of the Kutcher Adolescent Depression Six-Item Scale (KADS-6) among preadolescent school students in Sincelejo, Colombia. Participated 710 youth (10.8 years of age ± .75 years) divided into two groups to cross-validate analyses that were undertaken to determine the internal consistency reliability, as well as the concurrent and discriminant validity, of the KADS-6 among preadolescents. Results show that over 95% of the sample did not report problems understanding any of the items on the KADS-6. The KADS-6 had acceptable levels of internal consistency reliability, concurrent and discriminant validity and was unidimensional. In conclusion, The KADS-6 is well understood by Colombian preadolescents and has adequate psychometric properties in adolescents, rendering it acceptable for use with Colombian preadolescents.

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BACKGROUND: The extent to which depression is associated with somatic complaints in children from the English-speaking Caribbean and Latin America is not well established. OBJECTIVE: We sought to explore the association between depressive and somatic symptoms among children from the English-speaking Caribbean and Latin America, while accounting for age, sex, socioeconomic status, cultural background, and anxiety score. METHOD: 1541 elementary school children, ages 9-12 years, from the English-speaking Caribbean and Latin America completed the Adolescent Depression Rating Scale (ARDS), the Numeric 0-10 Anxiety Self-Report Scale and the Children's Somatic Symptom Inventory-24 (CSSI-24). T-tests and ANOVA's were used to compare CSSI-24 and ARDS scores among countries, and the CSSI-24 scores of children with (ARDS ≥ 4) and without likely clinically significant depression. Regression analyses assessed possible predictors of CSSI-24 score. RESULTS: Depressive and somatic symptom scores were highest among the Jamaican children and lowest among the Colombian children (p < .001). Children with likely clinically significant depression exhibited higher mean somatic symptom scores (p < .001). Depressive symptom scores predicted somatic symptom scores (p < .001). CONCLUSIONS: Depressive symptoms were a strong predictor of reporting somatic symptoms. Knowledge of this association may facilitate better recognition of depression among youth.

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OBJECTIVE: To analyse the possible direct and interactive associations of sex, age and parenting styles with symptoms of depression and anxiety. METHODS: In this cross-sectional study, 710 students ranging from 8 to 13 years (mean age 10.8 years [ 0.75]), the most of them males (n = 422, 59.4%), completed three screening instruments: a parenting practices scale and two self-reports for evaluating anxiety and depressive symptoms. Two hierarchical multiple regression analyses were performed. RESULTS: Authoritative (38.6%) and neglectful (38%) parenting styles were predominant. Symptoms of depression -F (3, 706) = 3.12, p = .03- and anxiety -F (3, 706) = 2.83, p = .4- differed by parenting styles. Students with a neglectful parenting style reported significant lower generalized anxiety symptoms than those whose parents used authoritative parenting. CLINICAL IMPLICATIONS: Children ages 8 to 13 years-old with authoritative parenting style should be evaluated for possible presence of generalized anxiety symptoms.

Objetivos: Analizar las posibles asociaciones entre sexo, edad y estilos de crianza con síntomas de depresión y ansiedad. Método: En este estudio transversal participaron 710 estudiantes entre 8 y 13 años (con una edad promedio de 10.8 [DE = 0.75]), la mayoría hombres (n = 422, 59.4%), los cuales respondieron tres instrumentos de cribado: una escala de prácticas parentales y dos autoinformes para evaluar síntomas de ansiedad y de depresión. Se llevaron a cabo dos regresiones múltiples. Resultados: Los estilos parentales predominantes fueron el autoritativo (38.6%) y el negligente (38%). Los síntomas depresivos -F (3, 706) = 3.12, p = .03- y ansiosos -F (3, 706) = 2.83, p = .4- se relacionaron de manera diferente entre los estilos parentales. El estilo parental negligente se asoció con menos ansiedad generalizada que el estilo parental autoritativo. Implicaciones clínicas: Los niños de 8 a 13 años con estilo de crianza autoritario podrían ser evaluados para detectar la posible presencia de síntomas de ansiedad generalizada.

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The extent to which students' level of depressive and anxiety symptoms and student engagement were predicted by parental emotional support, monitoring and harsh parenting was investigated using a series of multiple regression analyses. Grade six students from public primary schools (n = 293; 49% females, 51% males; mean age = 10 years) in Barbados completed the Revised Children's Anxiety and Depression Scale, a Parenting Questionnaire and an adapted Student Engagement scale. Students' level of depressive symptoms were predicted by parental emotional support and harsh parenting, but not by parental monitoring. With the exception of harsh parenting, neither parental emotional support nor parental monitoring were significant predictors of the anxiety levels of students. Student engagement was predicted by all three types of parenting practices. Limitations, recommendations for future research and practical implications of the study are discussed.

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This project investigated the association between Jamaican school-age children's perception of their communities and their levels of depressive symptoms. A cross-sectional survey of sixth-grade students from schools in Kingston, Jamaica was conducted. Results of correlational analyses indicated that there were significant associations between neighbourhood factors and depressive symptoms while multiple regression analyses suggested that neigbourhood factors and social class were predictive of children's depressive symptoms. It appears that the perception of neighbourhood factors, particularly neighbourhood quality and network are associated with depressive symptom while neighbourhood factors may mediate the relationship between low social class and depressive symptoms.

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OBJECTIVE: To examine the performance of the Mini-Mental State Examination (MMSE) in community-dwelling older persons in a developing country (Jamaica) undergoing rapid population aging. METHODS: An embedded validity study was conducted utilizing participants from a nationally representative sample of 2782 older persons. Standardized MMSE scores were obtained for study participants. A random selection of 170 persons with MMSE scores greater than 20 and 170 persons with scores 20 or less was done. Field staff were trained to apply the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for the diagnosis of dementia. In total, 300 participants (167 participants with MMSE score of 20 or less, 133 participants with scores greater than 20) were assessed and categorized according to dementia status. Performance characteristics of the MMSE tool were determined for study participants and appropriate adjustment and analyses subsequently applied to facilitate extrapolation to the nationally representative sample. RESULTS: The mean MMSE scores for participants with score of 20 and less was 17.1 (standard deviation [SD] = 3.2) and 24.5 (SD = 2.8) for those with scores greater than 20. Dementia was identified in 34 participants. The receiver operating characteristic curve for MMSE scores in relation to dementia diagnosis had an area under the curve value of 0.935 (95% confidence interval, 0.893-0.977). The optimal MMSE cut-point was 18/19 and was consistently so regardless of age category, gender, educational level, and number of chronic illnesses. CONCLUSION: There is merit in using the MMSE examination as a screening tool for dementia in Jamaica. The findings of this study coupled with widespread use and familiarity among practitioners give credence to the MMSE as a reasonable screening tool for dementia in Jamaica-rapidly aging society.

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OBJECTIVES: We sought to explore factors associated with depressive symptom severity among older persons (≥60 years of age) and to compare the depressive symptoms commonly experienced by older elderly (≥75 years) with those commonly experienced by younger elderly (<75 years). DESIGN: Secondary analysis was conducted on data from a nationally representative survey. SETTING: Four parishes in Jamaica. PARTICIPANTS: A total of 2,943 older community dwellers participated. MEASUREMENTS: The survey included the Zung Self-rating Depression Scale (ZSDS), the Mini Mental State Examination (MMSE), and items on age, sex, and educational level. Linear regression analysis was used to determine the association between ZSDS score and: age, sex, MMSE score, and educational level. Logistic regression analysis was used to determine, for each ZSDS item, whether particular responses were more associated with older or younger elderly. RESULTS: Higher ZSDS scores were associated with increasing age (B = 0.13, p < 0.001), lower MMSE score (B = -0.42, p < 0.001), the female sex (B = 3.52, p < 0.001), and lower educational level (B = -1.27, p < 0.001). The ZSDS items that were endorsed significantly more (p < 0.05) by older elderly related to negative evaluations about their functionality and value. Hopelessness was also more prominent among the older elderly. The items that were endorsed significantly more (p < 0.05) by the younger elderly had less of a focus. CONCLUSION: Among older persons, increasing age was associated with marginally higher levels of depressive symptoms. Female gender, cognitive deficits, preoccupations about value and functionality, and feelings of hopelessness may serve as useful screening parameters.

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BACKGROUND: Antenatal depression is associated with adverse maternal and infant well-being. However, compared to postpartum depression, it has been less frequently explored globally or in Jamaica. This study aimed to determine the prevalence of, and factors associated with, antenatal depressive symptoms among Jamaican women in order to inform policy and build interventions that could improve their management and reduce their negative consequences. METHODS: This secondary analysis of data from the second Jamaican Birth Cohort Study (JA-Kids Birth Cohort) included 3,517 women enrolled during pregnancy. Information was extracted from interviewer-administered questionnaires which recorded social, demographic, medical and obstetric information during pregnancy. The Edinburgh Postnatal Depression scale (EPDS) was used to screen for depression, with scores ≥13 considered indicative of a high likelihood of depression. Bivariate analysis examined associations between depressive symptoms and: age, income, financial difficulties, perceived social support, perceived partner infidelity, previous child-bearing unions and children with the current partner. Obstetric factors were also explored and included gravidity, prior adverse pregnancy outcome and complications from previous pregnancies. Variables that predicted the likelihood of depression based on an EPDS cut score of 13 were evaluated using logistic regression. RESULTS: One in five participants (19.6%; 95% CI 18.3-20.9%) had a high likelihood of antenatal depression (EPDS ≥13). Significant predictors of high depressive symptom severity included four indicators of poor perceived social and partner support [ORs (95% CI) ranged from: 1.61 (1.07-2.43); p = 0.024 to 3.14(1.69-5.84); p< 0.001], perceived partner infidelity [1.86 (1.36, 2.54); p<0.001], exposure to violence [2.36 (1.66-3.38); p<0.001] and financial difficulties [1.39 (1.07, 1.80); p = 0.013]. CONCLUSIONS: Women's perceived social and partner support were strongly associated with depressive symptom severity. Within the Jamaican cultural context of unstable reproductive unions, efforts are needed to involve fathers in the antenatal care process to strategically improve the psychological well-being of new mothers which may positively influence long term developmental outcomes for their babies.

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BACKGROUND: We aimed to determine the prevalence of alcohol use among older Jamaicans as well as to explore among this population the relationships between alcohol use and: age, sex, depressive symptoms, and life satisfaction. Although the nature of these relationships among the proposed study population were uncertain, in other settings alcohol use has tended to decline with increasing age, occur more commonly among men than women, and show non-linear relationships with depressive symptoms and life satisfaction. METHODS: Data gathered by two-stage cluster sampling for a nationally representative health and lifestyle survey of 2,943 community-dwelling older Jamaicans, aged 60 to 103 years, were subjected to secondary analysis using the Student's t-test and χ 2 test as appropriate. RESULTS: Current alcohol use was reported by 21.4% of the participants. It steadily declined with age and was six times more prevalent among men (37.6%) than women (6.2%). These findings were statistically significant as were associations of current alcohol use with comparatively lower levels of depressive symptoms. Current alcohol use was also more prevalent among persons who were either highly satisfied or highly dissatisfied with their lives, compared to others who had levels of life satisfaction between these two extremes. CONCLUSIONS: Current alcohol use among older Jamaicans occurs primarily among men, declines with increasing age, and is associated with a relatively low likelihood of depression. It is also associated with very high and very low levels of life satisfaction.

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BACKGROUND: Past research suggests that perceived neighbourhood conditions may influence adolescents' emotional health. Relatively little research has been conducted examining the association of perceived neighbourhood conditions with depressive symptoms among Caribbean adolescents. This project examines the association of perceived neighbourhood conditions with levels of depressive symptoms among adolescents in Jamaica, the Bahamas, St. Kitts and Nevis, and St. Vincent. METHODS: Adolescents attending grade ten of the academic year 2006/2007 in Jamaica, the Bahamas, St. Vincent, and St. Kitts and Nevis were administered the Neighbourhood Characteristics Questionnaire along with the BDI-II. Social cohesion, attachment to the neighbourhood, neighbourhood quality, neighbourhood crime, and neighbourhood disorder scales were created by summing the relevant subscales of the Neighbourhood Characteristics Questionnaire. Multiple regression analyses were used to examine the relationships of perceived neighbourhood conditions to depressive symptoms. RESULTS: A wide cross-section of tenth grade students in each nation was sampled (n = 1955; 278 from Jamaica, 217 from the Bahamas, 737 St. Kitts and Nevis, 716 from St. Vincent; 52.1% females, 45.6% males and 2.3% no gender reported; 12 to 19 years, mean = 15.3 yrs, sd = .95 yr). Nearly half (52.1%) of all adolescents reported mild to severe symptoms of depression with 29.1% reporting moderate to severe symptoms of depression. Overall, Jamaican adolescents perceived their neighbourhoods in a more positive manner than those in the Bahamas, St. Vincent and St. Kitts and Nevis. Results of a series of hierarchical multiple regression analyses suggested that a different pattern of neighbourhood factors for each island were associated with depressive symptoms. However, neighbourhood factors were more highly associated with depressive symptoms for Jamaican students than for students in the other three islands. CONCLUSIONS: Neighbourhood factors appear to be partially associated with adolescents' self-reports of depressive symptoms. However, other factors may mitigate this relationship.

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