Mental health status of adolescents in-home quarantine: a multi-region, cross-sectional study during COVID-19 pandemic in Bangladesh

Prevalence of emotional and behavioral problems among adolescents in Bangladesh

BACKGROUND

Emotional and behavioral problems among adolescents is a global concern. Previous studies conducted in Bangladesh have highlighted the importance to effectively prevent and address emotional and behavioral problems among adolescents to improve their psychological well-being. Despite these efforts, there remains limited research specifically addressing emotional and behavioral problems, conduct disorders, hyperactivity/attention disorders, and peer relationship problems among adolescents in Bangladesh in terms of age, gender, grade, and location. To address this knowledge gap, the present study aimed to comprehensively investigate the prevalence of emotional and behavioral problems among school-going adolescents in Bangladesh.

METHODS

The study employed a two-stage stratified cluster sampling technique to recruit a total of 1496 participants. The socio-demographic characteristics of the participants, such as age, gender, grade, location, birth order, family type, monthly family income, and parental education were collected. Emotional and behavioral problems were assessed using the Strength and Difficulties Questionnaire (SDQ), while the chi-square test and logistic regression were used to analyze the data with STATA software.

RESULTS

The prevalence of emotional disorder was 9.09% (7.73 - 10.65%). The rate was 21.72% (19.70 - 23.88%) for conduct disorder, 6.21% (5.09 - 7.55%) for hyperactivity, and for peer-relationship problem, the rate was 15.10% (13.37 - 17.01%) among adolescents. Overall, gender, grade, location, monthly family income, and parental education were significantly associated with emotional and behavioral problems. More specifically, adolescent girls (OR = 2.90 for the emotional disorder), grade (8th: OR = 2.07, 9th: OR = 1.95, for the emotional disorder), urban residents (OR = 2.46, for conduct disorder; OR = 2.29, for hyperactivity; OR = 2.03, for peer-relationship problem), poor monthly family income (OR = 2.84, for peer-relationship problem) significantly increased the risk of psychiatric morbidity.

CONCLUSION

The study highlights the need for school-based intervention programs to address adolescent emotional and behavioral problems. By targeting vulnerable individuals, these programs can effectively reduce mental health problems among adolescents.

Depression, anxiety, stress symptoms and their determinants among secondary students with vision impairment in rural Northwestern China during the COVID-19 pandemic

Objective

The measures implemented to control the spread of Coronavirus disease 2019 (COVID-19) could affect children's mental and vision health. Youth particularly from minority and socioeconomically disadvantaged backgrounds were more likely to be impacted by these measures. This study aimed to examine the mental health of children with vision impairment and associated factors in North-western China during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among 2,036 secondary school children living in Ningxia Hui Autonomous Region. Participants completed a survey on sociodemographic and lifestyle information and answered the Chinese version of the 21-item Depression Anxiety Stress Scales (DASS-21) questionnaire. Presenting visual acuity was measured by a trained enumerator. Multivariate logistic regression analysis was used to identify potential risk factors for mental health problems.

Results

Responses from 1,992 (97.8%) children were included in the analysis after excluding those with incomplete mental health outcome data. The prevalence of depression, anxiety and stress symptoms within the dataset were 28.9, 46.4, and 22.3%, respectively. The distribution of children with different stress levels differed significantly between those with and without vision impairment (p = 0.03). Multivariable logistic regression analyses revealed that depression symptoms decreased with higher parental education (OR, 0.76, 95% confidence intervals (CI):0.63-0.96), longer sleep duration (OR, 0.90, 95% CI: 0.81-0.97) and longer study time (OR, 0.82, 95% CI: 0.74-0.91), whereas they increased with higher recreational screen time (OR, 1.19, 95% CI: 1.08-1.32). Anxiety symptoms decreased with higher parental education (OR, 0.80, 95% CI: 0.66-0.96) and increased with higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.27) and being a left-behind child (OR, 1.26, 95% CI: 1.04-1.54). In addition, stress symptoms decreased with longer sleep duration (OR, 0.92, 95%CI: 0.85-0.99) and increased with higher number of siblings (OR, 1.10, 95% CI: 1.01-1.19), higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.28) and older age (OR,1.12, 95% CI: 1.004-1.24).

Conclusion

A considerable proportion of our sample experienced mental health problems during the pandemic. Healthcare planners in China should consider interventions such as reducing recreational screen time, ensuring sufficient sleep, and timely detection of mental health symptoms among socioeconomically disadvantaged groups.

Prevalence of depression and its associated factors among undergraduate admission candidates in Bangladesh: A nation-wide cross-sectional study

BACKGROUND

The undergraduate admission test is one of the most stressful assessments in a student's life, as it is required for admission to any of Bangladesh's public universities or medical colleges. Those taking the admissions test are under a lot of pressure to perform well. This study aimed to determine the prevalence of clinical depression among Bangladeshi admission candidates and the factors that contribute to it.

METHODOLOGY

Patient Health Questionnaire (PHQ-9) and other socio-demographic information were collected from 5263 students from all over Bangladesh. Apart from descriptive statistics and chi-square tests, an ordinal logistic regression model was also applied to determine the factors associated with depression.

RESULTS

The study revealed that among the undergraduate admission applicants, 74% of individuals were affected by depression, while 26% experienced moderate depression, 26% experienced moderately severe depression, and 22% experienced severe depression. The level of depression among females was 1.8 times higher than the male admission candidates. Our analyses found that gender (p <0.001), exercise (p <0.001), pre-marital relationships (p <0.001), daily study time less than 3 hours (p <0.001), practice of religion (p <0.001), victim of blackmail (p <0.001), family unrest (p <0.001), major illness (p <0.001), COVID-19 infection (p <0.001), GPA in higher secondary (p <0.001), mental problem (p <0.001), all categories of the variable confidence level for exam preparation (p <0.001) had a significant impact on increasing depression.

CONCLUSION

The research found a severe rate of depression among Bangladeshi undergraduate admission candidates. Interactive mental health care programs must include family and teachers to tackle the problem. To alleviate mental stress and depression, students should learn to nurture their mental health.

Burden of mental health disorders and synthesis of community-based mental health intervention measures among adolescents during COVID-19 pandemic in low middle-income countries: A systematic review and meta-analysis

BACKGROUND

COVID-19 pandemic and the resultant lockdown could have negatively impacted adolescent mental health. The synthesised burden of mental health illness among adolescents during or after the pandemic is unknown in Low Middle-Income Countries (LMICs). The objective was to ascertain the pooled prevalence of mental health disorders among adolescents aged 10 - 19 years and to systematically review & conduct a descriptive synthesis of community-based mental health intervention measures in addressing adolescent mental health disorders during the COVID-19 pandemic in LMICs.

METHODS

The literature was searched in Embase, PubMed, and Scopus and selected the relevant studies. The data was extracted from the selected studies, and its quality was assessed using adapted Newcastle-Ottawa Quality Assessment Scales. Meta-analysis was performed using random effects model to pool the prevalence of mental health disorders. Statistical heterogeneity was evaluated through Cochran's Q test & I2 statistic.

RESULTS

Thirty-five studies were selected out of 7955 identified studies. Most of the studies (n = 7, each) were from India and Iran. The majority of research works were community-based (n = 18), conducted in 2020 (23 articles), and participant interviews were conducted through online mode (n = 21). Varied instruments were used to measure the burden of mental health in different settings. Pooled prevalence (95% confidence intervals) of anxiety, depression and stress was found to be 43.69 (18.58-68.80)%, 47.02 (31.72-62.32)% and 39.97 (30.53-49.40)%, respectively, with high heterogeneity between the studies. No studies reported community-based mental health interventions.

CONCLUSION

There has been a higher prevalence of anxiety, depression, stress, and other mental health illnesses, among adolescents in LMICs during the COVID-19 pandemic. It is important to note that no existing literature directly addresses community-based interventions for these common mental health illnesses. It is imperative to prepare the health system for early identification and management of common mental health illness among the adolescent age group in the event of any future disaster.

Psychometric properties of three online-related addictive behavior instruments among Bangladeshi school-going adolescents

BACKGROUND

Due to the ease of access to the internet in modern society users have become more prone to experiencing addictive behaviors online. The present study aimed to develop and investigate the psychometric properties of the Bangla Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Gaming Disorder Test (GDT), and Bergen Social Media Addiction Scale (BSMAS) due to a lack of existing sound psychometric tools in Bangladesh.

METHODS

A cross-sectional paper-and-pencil survey was carried out among 428 school-aged adolescents who were active gamers (90.89% males; Meanage: 16.13±1.85 years; age range: 10-19 years). Participants were recruited using convenience sampling across four selected schools in Dhaka City, Bangladesh. Data collected included sociodemographic information, frequency of internet use and gaming behaviors, psychological states (i.e., Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder [GAD-7]), disordered gaming and social media use (i.e., IGDS9-SF, GDT, and BSMAS). Psychometric testing was conducted to examine the validity and reliability levels of the Bangla IGDS9-SF, GDT, and BSMAS.

RESULTS

The newly adapted Bangla IGDS9-SF, GDT, and BSMAS exhibited adequate levels of internal consistency. All total scores were significantly correlated with depression, anxiety, frequencies of internet use/online activities and gaming, supporting criterion and convergent validity. CFA indicated excellent construct validity as all instruments had a good fit to the data.

CONCLUSIONS

The findings suggest that the Bangla IGDS9-SF, GDT, and BSMAS are sound psychometric instruments due to their satisfactory psychometric properties including internal consistency, criterion validity, convergent validity, and construct validity.

The mental health of adolescents following the COVID-19 pandemic in Bangladesh

This paper highlights the current situation of the COVID-19 pandemic and adolescents' mental health in Bangladesh. It contains a thorough literature review that summarizes relevant articles and newspapers on the mental health of adolescents. In Bangladesh, the COVID-19 pandemic is worsening adolescent mental health issues. To maintain the safety and security of adolescents mental health issues are becoming increasingly frequent in Bangladesh as a result of lockdowns, financial stress, and livelihood scarcity; this trend cannot be ignored. This study will aid policymakers, government officials, and non-government officials in the development of more effective social safety net measures.

Supporting adolescents' mental health during COVID-19 by utilising lessons from the aftermath of the Great East Japan Earthquake

Historical data can determine how adolescents recover from difficult situations such as the Coronavirus disease 2019 (COVID-19) pandemic. This study analysed 3 years of data obtained from high-school students who had been affected by the 2011 Great East Japan Earthquake and consequently evidenced the importance of increasing resilience among affected adolescents. This involved identifying factors contributing to resilience through a model that assessed for each tsunami disaster. This model was determined by assessing the correlation between survivors' resilience scores and their measured psychological and lifestyle scores. This approach showed that, in all tsunami damage models, resilience was most affected by the depressed emotions. Thus, our approach suggests that interventions for improving the depressed mood may improve resilience in adolescents during the COVID-19 pandemic.

Mental health status of early married girls during the COVID-19 pandemic: A study in the southwestern region of Bangladesh

BACKGROUND

Due to unemployment, the prolonged lockdown during the COVID-19 pandemic caused panic and deepened poverty, especially among lower-class and marginal people. The related financial crises led to harmful practices such as the early marriage of adolescent girls, which deteriorated these girl's mental state.

AIMS

This study attempted to assess the prevalence of mental health problems among early married girls and determine the associated predictors of the growing mental health burden.

METHODS

This cross-sectional survey was conducted during the third wave of the COVID-19 pandemic in Dumuria Upazila in the Khulna district of Bangladesh. Data were collected purposively from 304 girls who were married off during the COVID-19 pandemic, this was carried out between 22 July and 31 August 2022 by administering a semi-structured interview schedule, with mental health measured by the depression, anxiety, and stress scale 21 (DASS 21). The data were analyzed using IBM SPSS Statistics (version 25), and multiple linear regression was executed in order to predict mental health problems among early married girls.

RESULTS

The findings show that the overall prevalence of depression, anxiety, and stress among early married girls during the COVID-19 pandemic in Bangladesh was 60.9% (95% CI: 0.554-0.663), 74.7% (95% CI: 0.698-0.796), and 23.7% (95% CI: 0.189-0.285). The prevalence was relatively higher among girls from the Sanatan (Hindu) religion and younger girls than among Muslim and older girls, respectively. The multiple linear regressions indicate that age, age at marriage, duration of the marriage, spousal occupation, intimate partner violence (IPV), and subjective happiness were the critical predictors of mental health problems among early married girls.

CONCLUSION

Early marriage, along with various adverse outcomes, i.e., IPV, maladjustment, and poor subjective happiness, has resulted in heightened mental health problems for young girls. Policymakers should implement coercive measures to prevent early marriage, especially during social, economic, political, and health crises; in addition, more research is recommended in order to explore the mechanisms that make early married girls psychologically vulnerable and thus formulate protective and preventive programs for addressing such vulnerabilities.