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荟萃分析:撒哈拉以南非洲地区青少年精神障碍的患病率

Meta-Analysis: Prevalence of Youth Mental Disorders in Sub-Saharan Africa.

作者信息

Jakobsson Cecilia E, Johnson Natalie E, Ochuku Brenda, Baseke Rosine, Wong Evelyn, Musyimi Christine W, Ndetei David M, Venturo-Conerly Katherine E

机构信息

Shamiri Institute, Nairobi, Kenya.

Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.

出版信息

Glob Ment Health (Camb). 2024 Nov 14;11:e109. doi: 10.1017/gmh.2024.82. eCollection 2024.

Abstract

Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need. We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators. The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence. Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.

摘要

撒哈拉以南非洲(SSA)的青少年获得专业心理健康资源的机会有限。对精神障碍患病率进行全面评估将有助于了解需求的范围。我们在PsycInfo、Pubmed、AfriBib和非洲在线期刊上进行了系统检索,以确定平均年龄小于19岁的SSA青少年中五种疾病(焦虑症、抑郁症、品行障碍、注意力问题和创伤后应激障碍)的患病率。我们计算了每种疾病的随机效应合并患病率,并评估了可能的调节因素。荟萃分析包括63项研究,共55,071名参与者。我们发现以下合并患病率:创伤后应激障碍(PTSD)为12.53%,抑郁症为15.27%,注意力缺陷多动障碍为6.55%,焦虑症为11.78%,品行障碍为9.76%。我们发现各研究之间存在高度异质性,这可能是由于样本或测量工具的差异所致。报告的患病率不能用样本(即特殊或一般人群)来解释,但心理测量工具是否针对SSA青少年进行了验证会影响PTSD和焦虑症报告的患病率。在一项荟萃回归分析中,患病率与疾病类型相关,抑郁症和PTSD的患病率较高。我们发现在单变量荟萃回归中,平均年龄显著调节了患病率,年龄增长与患病率增加相关。我们的研究结果表明,有必要进一步探索患病率差异的原因,并制定支持SSA青少年心理健康的干预措施,特别是针对抑郁症和PTSD的干预措施。局限性包括心理测量工具缺乏标准化以及研究方法的报告有限,这影响了质量评级。重要的是,此次检索仅考虑了两年前发表的英文研究。尽管最近的估计报告略高于我们的患病率估计,但这些综述共同凸显了SSA青少年心理健康问题的患病率及其重要性。

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