Sibling care, school performance, and depression among adolescent caretakers in Cambodia Siyan Yi a, *, Krishna C. Poudel a , Junko Yasuoka a , Paula H. Palmer b , Songky Yi c , Satoko Yanagisawa d , Masamine Jimba a a Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan b School of Community and Global Health, Claremont Graduate University, 18 East Via Verde, Ste.100, Claremont, CA 91773, USA c Battambang Provincial Department for Education, Youth, and Sports, Road No. 57, Battambang, Cambodia d Aichi Prefectural University, Tougoku, Kamishadami, Moriyama-ku, Nagoya 493-8502, Japan 1. Introduction In many resource-poor countries, the number of trained health workforce is not sufficient and access to healthcare is difficult (Chen et al., 2004; Hongoro and Mcpake, 2004; Narasimhan et al., 2004.). In such situations, home-based care for young children is crucial (Oudenhoven and Moi, 1999). In general, mothers are usually considered as the main home caretakers; however, the responsibility is also shared with other family members, especially the elder siblings of the infants (Oudenhoven and Moi, 1999; Zukow-Golding, 2002). ‘‘Sibling care’’ includes all kinds of socialization, training, and routine responsibilities one child assumes for others. It ranges from a complete and independent full-time care to the perfor- mance of specific tasks (Weisner and Gallimore, 1977). Sibling care is widely observed in horticultural and agricultural societies (Hames and Draper, 2004). Permanent and semi-permanent residences and a large number of people living together assure a secured place in which infants and toddlers can be left in the care of elder siblings (Hames and Draper, 2004). Previous research has found that sibling caretaking can have positive impacts on the development and wellbeing of the caretakers. By caring, teaching, and playing with younger children, elder siblings practice and develop pragmatic knowledge and skills such as counting, cooking, and taking care of babies. These are knowledge and life skills they are just learning, and they will perform later in their life as a spouse and parent (Hames and Draper, 2004; Watson-Gegeo and Gegeo, 1989; Rabain-Jamin et al., 2003). Sibling caretaking also has positive impacts on the caretakers’ personality development. Children taking care of younger children present pro-social attitudes (Watson-Gegeo and Gegeo, 1989; Ember, 1973), develop self-efficacy (Watson- Gegeo and Gegeo, 1989; Rabain-Jamin et al., 2003; UNICEF, 2004), and may enjoy taking care of younger siblings (Business and Financial Services Consulting Group, 2000). They also learn social skills that are appropriate to their culture (Watson-Gegeo and Asian Journal of Psychiatry 5 (2012) 132–136 A R T I C L E I N F O Article history: Received 5 September 2010 Received in revised form 9 March 2012 Accepted 2 April 2012 Keywords: Sibling care School performance Depression Adolescents Cambodia A B S T R A C T In many resource-poor countries, home-based care for young children is crucial. Yet little has been known about the negative impacts of sibling caretaking on mental health conditions of adolescent student caretakers. This study explored associations between sibling caretaking, school performance, and depression among 1943 students randomly selected from 11 junior high and high schools in Cambodia. The Asian Adolescent Depression Scale was used to measure depressive symptoms. In bivariate analyses, we used x 2 test or Fisher’s exact test for categorical variables and t-test or one-way analysis of variance for continuous variables. Multiple linear regression models were then constructed. Of total, 60.1% of our participants took care of their younger sibling(s) regularly during the past one year. The number of siblings under their care ranged from one to nine, and the time they spent for sibling care ranged from one to 10 h per day. After adjustment, increased levels of depressive symptoms remained significantly associated among boys with sibling caretaking (p < 0.001), as well as poor school performance (p = 0.001) and perceived likelihood of dropping out of school in the near future (p = 0.002). Among girls, increased levels of depressive symptoms retained their significant association with sibling caretaking (p < 0.001); also poor school performance (p < 0.001). Sibling care responsibility might have negative impact on school performance and the mental health condition of adolescent caretakers. ß 2012 Elsevier B.V. All rights reserved. * Corresponding author. Tel.: +81 3 5841 3698; fax: +81 3 5841 3422. E-mail address: siyan@doctor.com (S. Yi). Contents lists available at SciVerse ScienceDirect Asian Journal of Psychiatry jo u rn al h om epag e: ww w.els evier.c o m/lo cat e/ajp 1876-2018/$ – see front matter ß 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.ajp.2012.04.002