Zhang Xiao, Mori Yuko, Abio Anne, Khorasani Zahra Kafami, Gilbert Sonja, Grimland Meytal, Bezborodovs Nikita, Wan Mohd Yunus Wan Mohd Azam, Silwal Sanju, Westerlund Minja, Praharaj Samir Kumar, Ndetei David M, Kaneko Hitoshi, Heinonen Emmi, Sourander Andre
Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
INVEST Research Flagship Center, University of Turku, Turku, Finland.
BMJ Glob Health. 2025 Jul 25;10(7):e019267. doi: 10.1136/bmjgh-2025-019267.
Although 90% of the global adolescent population resides in low and middle-income countries (LMICs), cross-national mental health research has primarily focused on high-income countries. This systematic review aims to examine cross-national studies, including LMICs, focusing on adolescent mental health and psychosocial problems.
Peer-reviewed articles comparing adolescent mental health or psychosocial issues across countries were included if published in English and based on observational study designs. Six databases were searched from inception to January 2024. Risk of bias was assessed using the JBI tool and additional cross-national quality criteria. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines.
The search identified 172 studies including data from over 12 million adolescents across 166 countries. The most used international survey was the Health Behaviour in School-aged Children study, and most studies employed cross-sectional designs with school-based, self-reported questionnaires. Adolescent mental health research involved 166 countries, while 52 countries were not represented in any of the studies. The inclusion of LMICs in cross-national research increased over time. Internalising problems and bullying were well-researched topics, but studies on externalising behaviours were limited. The number of publications increased over time, particularly after 2020. Variations by income level were observed, with traditional bullying more prevalent in LMICs.
This review provides important insights into global patterns and gaps in adolescent mental health research. It highlights the need to address methodological heterogeneity, including the use of validated and culturally adapted measures, comprehensive reporting of sampling procedures, sample sizes, response rates and greater attention to generalisability. In addition, the targeted inclusion of under-represented regions is essential to addressing global disparities and informing effective interventions.
CRD42024505077.
尽管全球90%的青少年人口生活在低收入和中等收入国家（LMICs），但跨国心理健康研究主要集中在高收入国家。本系统综述旨在研究包括LMICs在内的跨国研究，重点关注青少年心理健康和心理社会问题。
纳入以英文发表且基于观察性研究设计的、比较各国青少年心理健康或心理社会问题的同行评审文章。从数据库创建至2024年1月对六个数据库进行了检索。使用JBI工具和其他跨国质量标准评估偏倚风险。按照非元分析综合指南进行叙述性综合分析。
检索到172项研究，包括来自166个国家的1200多万青少年的数据。最常用的国际调查是学龄儿童健康行为研究，大多数研究采用基于学校的横断面设计和自我报告问卷。青少年心理健康研究涉及166个国家，而有52个国家未在任何研究中得到体现。随着时间的推移，跨国研究中LMICs的纳入有所增加。内化问题和欺凌是研究充分的主题，但关于外化行为的研究有限。出版物数量随时间增加，特别是在2020年之后。观察到收入水平差异，传统欺凌在LMICs中更为普遍。
本综述为青少年心理健康研究的全球模式和差距提供了重要见解。它强调需要解决方法学异质性问题，包括使用经过验证和文化适应的测量方法、全面报告抽样程序、样本量、回复率，并更加关注可推广性。此外，有针对性地纳入代表性不足的地区对于解决全球差异和为有效干预提供信息至关重要。
PROSPERO注册号：CRD42024505077。
