The Relationship Between Family Cohesion and Depression Among School-Going Children With Elevated Symptoms of Behavioral Challenges in Southern Uganda

PURPOSE: Depression is among the leading causes of disability and contributes significantly to the overall disease burden affecting children. Family cohesion has been identified as a protective factor against depression. Examining this relationship is necessary in sub-Saharan Africa, specifically in Uganda–a country characterized by a high prevalence of HIV/AIDS, and high rates of chronic poverty, all of which stress family functioning and elevate child behavioral challenges. This study examined the relationship between family cohesion and depression among school-going children with elevated symptoms of behavioral challenges in southern Uganda. METHODS: At baseline, 2089 children were enrolled in the National Institutes of Health-funded Strengthening Mental Health and Research Training Africa study in Southwestern Uganda. This article analyzed data from 626 children aged 8–13 years with elevated behavioral challenges. We conducted multilevel mixed-effects Poisson regression to determine the association between family cohesion and depression. We controlled for sociodemographic and household characteristics. RESULTS: The mean age was 10.3 years. The overall mean depression score was 3.2 (standard deviation = 2.7, range = 0–15). Family cohesion (β = −0.03, 95% confidence interval [CI]: −0.04, −0.02, p <. 001) and owning essential items by the child (β = −0.13, 95% CI: −0.23, −0.04, p = .005) were protective against depression among children. Additionally, we observed being a single orphan (β = −0.44, 95% CI: −0.03, −0.86, p = .036) and having both parents (β = −0.43, 95% CI: −0.06, −0.81, p = .023) were associated with depression among children. DISCUSSION: Findings from this study reveal that family cohesion was protective against depression. Therefore, it is vital to strengthen family support systems by developing programs aimed at strengthening family relationships as a catalyst for addressing depression among children.