The prevalence and factors associated with depression among undergraduates at Makerere University who have experienced intimate partner violence

Abstract

Background: Depression among university students is a growing public health concern, particularly in those who have experienced intimate partner violence (IPV). Understanding the prevalence and associated factors is crucial to inform targeted interventions. This study aimed to determine the prevalence and factors associated with major depressive disorder (MDD) among undergraduates who had experienced intimate partner violence. Methods: A quantitative cross-sectional study was conducted among undergraduate students at Makerere University in Kampala, Uganda. An online structured questionnaire was used to collect quantitative data among 420 undergraduates aged at least 18 years with a history of IPV. Consecutive sampling technique was employed and students from all 10 colleges of the university were enrolled. The Patient Health Questionnaire-9 (PHQ-9) was used to assess for depression (PHQ-9 score ≥10). Modified Poisson regression with robust standard errors was employed to examine the associations between MDD and independent variables. Results: The overall prevalence of MDD among participants was 32.4%, with the highest prevalence in those who had experienced sexual IPV (32.4%). Females IPV survivors compared to males were 45% more likely to have depression. Those with a family history of mental illness were 1.4 times more likely to report depression, harmful alcohol use increased risk of depression by 56% and experiences of childhood adversity such as bullying witnessing and experience of violence in the household increased risk of depression two to threefold. Academic stress experienced nearly every day was also significantly associated with MDD IRR = 2.11, 95% CI: 1.06 – 4.18, p = 0.007. Conclusion: Depression is prevalent among undergraduates at Makerere University exposed to IPV. Associated factors include female sex, a family history of mental illness, harmful alcohol use and academic stress. These findings underscore the need to integrate structured and accessible mental health services into the university health policy frameworks, mandate education on mental health and substance use, and gender-based violence prevention embedded in orientation sessions and curricula; establish clear survivor-centered reporting and support systems including psychological first aid and trauma-focused therapy; encourage student-led mental health and anti-violence peer support groups, especially for survivors; regulate alcohol access on campus and promote harm reduction strategies. Lastly, universities should put in place policies that promote a safe and inclusive campus environment with a focus on zero tolerance for violence or harassment backed by clear disciplinary measures.