High cellphone use associated with greater risk of depression among young women aged 15-24 years in Soweto and Durban, South Africa

Janan J Dietrich; Kennedy Otwombe; Tatiana E Pakhomova; Keith J Horvath; Stefanie Hornschuh; Khuthadzo Hlongwane; Kalysha Closson; Mamakiri Mulaudzi; Patricia Smith; Mags Beksinska; Glenda E Gray; Mark Brockman; Jenni Smit; Angela Kaida

doi:10.1080/16549716.2021.1936792

High cellphone use associated with greater risk of depression among young women aged 15-24 years in Soweto and Durban, South Africa

Glob Health Action. 2021 Jan 1;14(1):1936792. doi: 10.1080/16549716.2021.1936792.

Authors

Janan J Dietrich^{1

2}, Kennedy Otwombe¹, Tatiana E Pakhomova³, Keith J Horvath⁴, Stefanie Hornschuh¹, Khuthadzo Hlongwane¹, Kalysha Closson^{3

5}, Mamakiri Mulaudzi¹, Patricia Smith³, Mags Beksinska⁶, Glenda E Gray^{1

7}, Mark Brockman³, Jenni Smit⁶, Angela Kaida³

Affiliations

¹ Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
² African Social Sciences Unit of Research and Evaluation (ASSURE), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa and Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
³ Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
⁴ San Diego State University, Department of Psychology, San Diego, California, United States.
⁵ School of Population and Public Health, University of British Columbia, Vancouver, Canada.
⁶ MatCH Research Unit (MRU), Department of Gynaecology and Obstetrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
⁷ Office of the President, South African Medical Research Council, Cape Town, South Africa.

Abstract

Background: The ubiquity of cellular phone (cellphone) use in young people's daily lives has emerged as a priority area of concern for youth mental health.

Objective: This study measured the prevalence of depression and its association with high cellphone use among youth in Soweto and Durban, South Africa.

Methods: We analysed cross-sectional, baseline survey data among youth aged 16-24 who participated in a dual-site cohort study, 'AYAZAZI', conducted from 2014 to 2017. The primary outcome was depression using the 10-item Center for Epidemiologic Studies Depression Scale, with a score of ≥ 10 indicating probable depression. Cellphone use was measured via self-reported average number of hours of active use, with 'high cellphone use' defined as daily usage of ≥ 8. Multivariable logistic regression models assessed the independent relationship between high cellphone use and probable depression, adjusting for potential confounders.

Results: Of 425 participants with a median age of 19 years (IQR = 18-21), 59.5% were young women. Overall, 43.3% had probable depression, with a higher prevalence among women (49.0% vs. 34.9%, P = .004). Nearly all (94.6%) owned a cellphone. About one-third (29.5%) reported spending ≥ 8 hours per day using their cellphone (39.3% of women vs. 14.9% of men, P < .001). In the overall adjusted model, youth reporting high daily cellphone use had higher odds of probable depression (aOR: 1.83, 95% CI: 1.16-2.90). In gender-stratified models, high daily cellphone use was associated with probable depression among women (aOR: 2.51, 95% CI: 1.47-4.31), but not among men (aOR: 0.87, 95% CI: 0.35-2.16).

Conclusions: Among a cohort of South African youth, we found a high prevalence of probable depression and high cellphone use (30%). The findings indicate a need for intersectoral initiatives focused on meaningful mental health support for South African youth to support positive growth and development.

Keywords: Mental health; South Africa; digital health; mobile health (mHealth); youth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cell Phone Use*
Cohort Studies
Cross-Sectional Studies
Depression* / epidemiology
Female
Humans
Male
Prevalence
South Africa / epidemiology
Young Adult

Grants and funding

AYAZAZI was funded by the Canadian Institutes for Health Research (CIHR) (grant # THA-118569) through the Canadian HIV Vaccine Initiative, with additional support from the South African Medical Research Council. The following authors received salary support awards from the Canada Research Chair program (Kaida, Brockman) and Closson is supported by a CIHR Vanier doctoral award. Dietrich’s work on this manuscript was supported through a South African National Research Foundation (NRF) Thuthuka Post PhD award (2019–2021), for Mulaudzi through a Thuthuka PhD award (2020–2022). Hornschuh was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No-B 8606.R02), Sida (Grant No:54100029), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z). The work reported herein for JJD was also made possible through partial funding by the South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the SAMRC Postdoctoral Programme from funding received from the South African National Treasury as well as the CIPHER GROWING THE LEADERS OF TOMORROW grant from the International AIDS Society. The content hereof is the sole responsibility of the authors and does not represent the official views of The content hereof is the sole responsibility of the authors and does not represent official views of the funding agencies.