Depressive Symptom and Associated Factors Among School Adolescents of Urban, Semi-Urban and Rural Areas in Bangladesh: A Scenario Prior to COVID-19

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.

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.

Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students

BACKGROUND

Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.

METHODS

Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the "survey" package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.

RESULTS

A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.

CONCLUSION

Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.

Depression symptoms, anxiety, and stress among undergraduate entrance admission seeking students in Bangladesh: a cross-sectional study

Background

Intense academic pressure and unhealthy competition have turned the university entrance exam scenario in Bangladesh into a Pandora's Box, which might cause mental health difficulties among young students. However, there is a severe scarcity of studies concerning such issues of university entrance examination-seeking students in Bangladesh.

Methods

This study aimed to assess the prevalence and associated factors of depression symptoms, anxiety, and stress among undergraduate entrance admission-seeking students in Bangladesh. A cross-sectional study design was followed using an online tool including socio-demographic questions, and the 21-item Bangla Depression, Anxiety and Stress Scale (BDASS-21). The survey form was completed by 452 Bangladeshi students who passed the higher secondary certificate (HSC) examination in 2020 and were planning to get admission to the undergraduate level during the data collection.

Results

The prevalence of mild to extremely severe levels of depression symptoms, anxiety, and stress was 57.7%, 61.4%, and 44.6%, respectively. Females were more likely to have depression, anxiety, and stress symptoms than males. The students from science backgrounds were at higher risk of developing depression and stress symptoms when compared with students from business studies backgrounds. Besides, students with a previous history of mental illness, a preference for getting admitted into the public university, and less monthly family income (<25,000 BDT) were more likely to develop depression, anxiety, and stress symptoms. In addition, students with a previous history of neurological disorders were more likely to develop anxiety symptoms than those without.

Conclusion

This study revealed a high level of depression, anxiety, and stress symptoms among undergraduate entrance admission-seeking students, which calls for in-depth exploratory investigations. Adequate low-intensity interventions should be designed to support this young population.

[Psychological and behavioral problems in children and adolescents during the coronavirus disease 2019 epidemic: a Scoping review]

OBJECTIVES

To investigate the psychological and behavioral problems and related influencing factors in children and adolescents during the coronavirus disease 2019 (COVID-19) epidemic.

METHODS

China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science were searched using the method of subject search for articles published up to March 31, 2022, and related data were extracted for Scoping review.

RESULTS

A total of 3 951 articles were retrieved, and 35 articles from 12 countries were finally included. Most of the articles were from the journals related to pediatrics, psychiatry, psychology, and epidemiology, and cross-sectional survey was the most commonly used research method. Psychological and behavioral problems in children and adolescents mainly included depression/anxiety/stress, sleep disorder, internet behavior problems, traumatic stress disorder, and self-injury/suicide. Influencing factors were analyzed from the three aspects of socio-demographic characteristics, changes in living habits, and ways of coping with COVID-19.

CONCLUSIONS

During the COVID-19 epidemic, the psychological and behavioral problems of children and adolescents in China and overseas are severe. In the future, further investigation and research can be carried out based on relevant influencing factors to improve the psychological and behavioral problems.

Sleep dissatisfaction is a potential marker for nomophobia in adults

INTRODUCTION

NOMOPHOBIA is a term used to describe an anxiety disorder in which people fear being disconnected from their mobile phones. Strong associations between nomophobia and insomnia have previously been documented. However, there is no clear explanation for this relationship between the two disorders. The present study was designed to first determine the diagnostic precision of the Insomnia Severity Index (ISI) various components in detecting or classifying nomophobia; and second, examine the diagnostic performance of the identified ISI components in classifying nomophobia.

METHODS

From a previous study 549 participants completed demographic information, the Nomophobia Questionnaire (NMP-Q), and the ISI. The sample was divided into two parts so that each part represented the original sample, using a 40% (n = 209) allocation for sample 1 and 60% (n = 340) for sample 2. To determine common components between nomophobia and insomnia, an exploratory factor analysis was performed using sample 1 to determine the diagnostic precision of the ISI's various components in detecting or classifying nomophobia. A test of the ISI and a cut-off value (ISI-4 ≥2) was then conducted on Sample 2 to determine whether they would accurately identify significant nomophobia.

RESULTS

Sleep dissatisfaction was a common component of insomnia and nomophobia. Sleep dissatisfaction had excellent diagnostic accuracy in detecting individuals with nomophobia (sensitivity 75.13%, specificity 100%, Youden' index 0.75, area under curve 0.88).

CONCLUSION

Questioning patients sleep dissatisfaction may serve as a marker for both nomophobia and insomnia, both of which may demand more comprehensive evaluation.

Depression and Anxiety among University Students: A Comparison between COVID-19 Pandemic Panic Period and Post-panic Period in Bangladesh

BACKGROUND: In Bangladesh, the rapid spread of COVID-19 virus created a panic situation among the citizen. Specially, the psycho-emotional disorder of the university students is increasing which has not been adequately investigated. AIM: Relating this, the study aimed to assess the psycho-emotional changes of the university students through investigating their level of depression and anxiety during panic and post-panic period of COVID-19 pandemic in Bangladesh. METHOD: A cross-sectional online survey was conducted among the university students in Bangladesh from April to July 2020 (panic period, n = 170) and then from August to November 2020 (post-panic period, n = 170). The Patient Health Questionnaire (PHQ)-9 and Generalized Anxiety Disorder-7 questionnaires were used to assess the depression and anxiety levels of the students, respectively. Various univariate and multivariable statistical techniques were used to analyze the data. RESULTS: The proportion of depression symptoms was 49.4% and 52.4% during the panic period and post-panic period, respectively. Anxiety symptoms were experienced by 38.2% of students during the panic period, and the percentage was nearly identical in the post-panic interval. In post-panic period, depression levels found a slight increase. Urban students reported significantly (p < 0.05) higher levels of depression and anxiety than their counterparts. Female students also exhibited significantly more anxiety symptoms (p < 0.002) than male. Depression symptoms significantly varied by family types and student’s place of residence. CONCLUSIONS: This study compared the depression and anxiety symptoms of the university students during two periods of the COVID-19 pandemic. Although the difference was small, it remains an issue for the university students in Bangladesh due to the disruption to their academic lives.