School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines.
Lancet. 2024 Apr 27;403(10437):1671-1680. doi: 10.1016/S0140-6736(23)02641-7. Epub 2024 Apr 5.
Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam.
As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs.
Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam).
NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries.
The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company.
精神障碍是导致青少年健康负担的全球主要原因。然而，在低收入和中等收入国家，青少年精神障碍的流行数据很少，而且往往具有有限的普遍性。本研究旨在为肯尼亚、印度尼西亚和越南的青少年精神障碍生成具有全国代表性的流行率估计值。
作为国家青少年心理健康调查（NAMHS）的一部分，这是一项多国横断面研究，于 2021 年 3 月至 12 月在肯尼亚、印度尼西亚和越南进行了全国范围内的家庭调查。根据专门设计的抽样框架，从随机选择的家庭中对 10-17 岁的青少年及其主要照顾者进行了访谈，该抽样框架旨在得出具有全国代表性的结果。使用儿童诊断访谈表第 5 版评估了六种精神障碍（社交恐惧症、广泛性焦虑障碍、重度抑郁症、创伤后应激障碍、品行障碍和注意缺陷多动障碍）。还评估了过去 12 个月的自杀行为和自我伤害。计算了过去 12 个月和过去 4 周的每种精神障碍和任何精神障碍（即评估的六种精神障碍）的流行率。还计算了过去 12 个月自杀行为（即自杀意念、计划和尝试）和自我伤害的发生率，并显示了与过去 12 个月任何精神障碍流行率的关联的调整比值比（aOR）。应用逆概率加权生成具有相应 95%置信区间的全国估计值。
最终样本包括来自肯尼亚的 5155 户家庭（即青少年和主要照顾者对）、来自印度尼西亚的 5664 户家庭和来自越南的 5996 户家庭。在肯尼亚，2416 名（46.9%）青少年为男性，2739 名（53.1%）为女性；在印度尼西亚，2803 名（49.5%）青少年为男性，2861 名（50.5%）为女性；在越南，3151 名（52.5%）为男性，2845 名（47.4%）为女性。过去 12 个月任何精神障碍的流行率为肯尼亚 12.1%（95%CI 10.9-13.5）、印度尼西亚 5.5%（4.3-6.9）和越南 3.3%（2.7-4.1）。过去 4 周的流行率为肯尼亚 9.4%（8.3-10.6）、印度尼西亚 4.4%（3.4-5.6）和越南 2.7%（2.2-3.3）。所有三个国家过去 12 个月的自杀行为流行率都较低，自杀意念的范围从印度尼西亚的 1.4%（1.0-2.0）和越南的 1.0-1.9%到肯尼亚的 4.6%（3.9-5.3%），自杀计划的范围从印度尼西亚的 0.4%（0.3-0.8）和越南的 0.2-0.6%到肯尼亚的 2.4%（1.9-2.9%），自杀企图的范围从印度尼西亚的 0.2%（0.1-0.4）和越南的 0.1-0.3%到肯尼亚的 1.0%（0.7-1.4%）。所有三个国家过去 12 个月的自我伤害流行率也较低，范围从印度尼西亚的 0.9%（0.6-1.3）到肯尼亚的 1.2%（0.9-1.7）。然而，过去 12 个月有任何精神障碍的青少年与没有任何精神障碍的青少年相比，自杀行为和自我伤害的流行率明显更高（例如，自杀意念的调整比值比范围从印度尼西亚的 7.1[3.1-15.9]到越南的 14.7[7.5-28.6]）。
NAMHS 提供了肯尼亚、印度尼西亚和越南的青少年精神障碍首次全国流行率估计值。这些数据可以为低收入和中等收入国家的精神卫生和更广泛的卫生政策提供信息。
美国昆士兰大学（TUQIA）通过 Pivotal Ventures 提供支持，Pivotal Ventures 是梅琳达·盖茨基金会的一个公司。
