Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
J Adolesc Health. 2024 Dec;75(6):929-938. doi: 10.1016/j.jadohealth.2024.07.016. Epub 2024 Oct 10.
This study aimed to estimate the prevalence of mental health problems and identify potential risk and protective exposures for adolescents in Indonesia.
An innovative sampling approach was applied to simultaneously recruit school- and community-based adolescents aged 16-18 years old from Jakarta (urban megacity) and South Sulawesi (remote province). We used multistage cluster sampling for in-school (N = 1,337) and respondent driven sampling for out-of-school (N = 824) adolescents. Mental health was measured using two validated scales: Kessler-10 and Center for Epidemiologic Studies Depression Scale-Revised. Psychiatric interviews were conducted in a subsample (N = 196) of students from Jakarta to validate the self-report scales.
The estimated population prevalence of psychological distress and depression were 24.3% (95% CI = 21.5-27.2) and 12.6% (10.5-14.4) for in-school and 23.7% (20.7-26.7) and 23.5% (20.4-26.5) for out-of-school adolescents, respectively. In participants who completed a psychiatric interview, common psychiatric morbidities were social anxiety, depression, and suicidality. Compared to in-school females, male in-school adolescents reported a lower prevalence of psychological distress (16.9% (13.1-20.7) vs. 30.4% (26.4-34.4)) and depression (10.1% (7.2-13.1) vs. 14.6 (11.4-17.8)). By contrast, for out-of-school adolescents, males reported a higher prevalence of psychological distress (25.2% (21.6-28.9) vs. 20.2% (15.1-25.3)) and depression (26.3% (22.5-30.1) vs. 16.9% (11.8-21.9)). In-school adolescents who did not seek healthcare despite a perceived need were more likely to report psychological distress and depression.
Adolescent mental health problems are highly prevalent in Indonesia, with substantial variation by gender, geography, and school enrolment. This study and its approach to sampling and measurement may serve as a model to improving mental health surveillance across other settings.
本研究旨在评估印度尼西亚青少年心理健康问题的流行情况，并确定潜在的风险和保护因素。
采用创新的抽样方法，同时招募来自雅加达（城市大都市）和南苏拉威西（偏远省份）的 16-18 岁在校和社区青少年。我们对在校（N=1337）和校外（N=824）青少年使用多阶段聚类抽样，使用两个经过验证的量表测量心理健康：Kessler-10 和修订版流行病学研究中心抑郁量表。在雅加达的学生中进行了一项子样本（N=196）的精神病学访谈，以验证自我报告量表。
在校青少年的心理困扰和抑郁的估计人群患病率分别为 24.3%（95%置信区间[CI]21.5-27.2）和 12.6%（10.5-14.4），校外青少年的心理困扰和抑郁的估计人群患病率分别为 23.7%（95%CI 20.7-26.7）和 23.5%（20.4-26.5）。在完成精神病学访谈的参与者中，常见的精神疾病包括社交焦虑、抑郁和自杀倾向。与在校女生相比，在校男生报告的心理困扰（16.9%（13.1-20.7）与 30.4%（26.4-34.4））和抑郁（10.1%（7.2-13.1）与 14.6%（11.4-17.8））的患病率较低。相比之下，校外青少年中，男性报告的心理困扰（25.2%（21.6-28.9）与 20.2%（15.1-25.3））和抑郁（26.3%（22.5-30.1）与 16.9%（11.8-21.9））的患病率较高。尽管有感知到的需求，但没有寻求医疗保健的在校青少年更有可能报告心理困扰和抑郁。
印度尼西亚青少年的心理健康问题普遍存在，且存在显著的性别、地理位置和入学差异。本研究及其抽样和测量方法可以作为在其他环境中改善心理健康监测的模式。
