Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context

Summary: Background: Adolescence is a sensitive phase of human development where individuals, aged 10–19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (L...

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Main Authors: Chethana Mudunna, Medhavi Weerasinghe, Thach Tran, Josefine Antoniades, Lorena Romero, Miyuru Chandradasa, Jane Fisher
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:The Lancet Regional Health - Southeast Asia
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772368225000034
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author Chethana Mudunna
Medhavi Weerasinghe
Thach Tran
Josefine Antoniades
Lorena Romero
Miyuru Chandradasa
Jane Fisher
author_facet Chethana Mudunna
Medhavi Weerasinghe
Thach Tran
Josefine Antoniades
Lorena Romero
Miyuru Chandradasa
Jane Fisher
author_sort Chethana Mudunna
collection DOAJ
description Summary: Background: Adolescence is a sensitive phase of human development where individuals, aged 10–19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (LMIC). Most of the world's young people live in LMICs. This systematic review aims to assess the available evidence on the nature, prevalence and determinants of MHPs experienced by adolescents in south Asia. Methods: Following PRISMA guidelines, searches were conducted in four online databases (Ovid Medline, Ovid EMBASE, Ovid Global Health, Ovid PsycInfo), titles, abstracts, and full-texts were screened, data extracted and quality assessed. Extracted data were categorised into school-based studies (SBS) and non-school-based studies (NSBS). Data were further stratified according to country, MHPs and narratively synthesised. Findings: Of the 5847 records identified in the searches, 117 met inclusion criteria. Most (n = 87) were SBS. Key MHPs reported across countries include anxiety disorders and depression. Wide ranges of prevalence rates were reported for anxiety in Indian SBS (1.5–81.6%) and NSBS (1.8–88.1%), and for depression, Pakistani SBS (21–79%) and Indian NSBS (0.4–98.5%). Determinants include individual characteristics; violent victimisation; poor family/home/school environment/peer relationships; already experiencing MHPs and substance use/abuse. Increased physical activity, adequate nutrition, safe/positive homes/family environment, being unmarried females, higher maternal education, peer support/friendship, higher education level and engaging in extra-curricular activities were protective of mental well-being. Interpretation: Prevalence of MHPs among south Asian adolescents appears high. Determinants include social, cultural, environmental and socioeconomic factors often beyond individual control. Mental health policies and programs and research appropriate to the cultural context, that address social determinants of MHPs and evidence gaps, are needed to tackle the significant mental health burden among south Asian adolescents. Funding: Authors CM and MW are supported by a Monash University Research Training Program Scholarship. JF is supported by the Finkel Professorial Fellowship funded by the Finkel Family Foundation.
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series The Lancet Regional Health - Southeast Asia
spelling doaj-art-aa98742504994d4c802a852db927000a2025-02-11T04:35:37ZengElsevierThe Lancet Regional Health - Southeast Asia2772-36822025-02-0133100532Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in contextChethana Mudunna0Medhavi Weerasinghe1Thach Tran2Josefine Antoniades3Lorena Romero4Miyuru Chandradasa5Jane Fisher6Global and Women's Health, Monash School of Public Health and Preventative Medicine, 553 St Kilda Road, Melbourne, Victoria, Australia, 3004Global and Women's Health, Monash School of Public Health and Preventative Medicine, 553 St Kilda Road, Melbourne, Victoria, Australia, 3004Global and Women's Health, Monash School of Public Health and Preventative Medicine, 553 St Kilda Road, Melbourne, Victoria, Australia, 3004National Ageing and Research Institute, 34-54 Poplar Road, Parkville, Victoria, Australia, 3052; School of Humanities & Social Sciences, La Trobe University, Bundoora, Victoria, Australia, 3083The Ian Potter Library, Alfred Health, 55 Commercial Road, Melbourne, Victoria, Australia, 3000Department of Psychiatry, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama, 11010, Sri LankaGlobal and Women's Health, Monash School of Public Health and Preventative Medicine, 553 St Kilda Road, Melbourne, Victoria, Australia, 3004; Corresponding author.Summary: Background: Adolescence is a sensitive phase of human development where individuals, aged 10–19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (LMIC). Most of the world's young people live in LMICs. This systematic review aims to assess the available evidence on the nature, prevalence and determinants of MHPs experienced by adolescents in south Asia. Methods: Following PRISMA guidelines, searches were conducted in four online databases (Ovid Medline, Ovid EMBASE, Ovid Global Health, Ovid PsycInfo), titles, abstracts, and full-texts were screened, data extracted and quality assessed. Extracted data were categorised into school-based studies (SBS) and non-school-based studies (NSBS). Data were further stratified according to country, MHPs and narratively synthesised. Findings: Of the 5847 records identified in the searches, 117 met inclusion criteria. Most (n = 87) were SBS. Key MHPs reported across countries include anxiety disorders and depression. Wide ranges of prevalence rates were reported for anxiety in Indian SBS (1.5–81.6%) and NSBS (1.8–88.1%), and for depression, Pakistani SBS (21–79%) and Indian NSBS (0.4–98.5%). Determinants include individual characteristics; violent victimisation; poor family/home/school environment/peer relationships; already experiencing MHPs and substance use/abuse. Increased physical activity, adequate nutrition, safe/positive homes/family environment, being unmarried females, higher maternal education, peer support/friendship, higher education level and engaging in extra-curricular activities were protective of mental well-being. Interpretation: Prevalence of MHPs among south Asian adolescents appears high. Determinants include social, cultural, environmental and socioeconomic factors often beyond individual control. Mental health policies and programs and research appropriate to the cultural context, that address social determinants of MHPs and evidence gaps, are needed to tackle the significant mental health burden among south Asian adolescents. Funding: Authors CM and MW are supported by a Monash University Research Training Program Scholarship. JF is supported by the Finkel Professorial Fellowship funded by the Finkel Family Foundation.http://www.sciencedirect.com/science/article/pii/S2772368225000034Mental healthSouth AsiaAdolescentLMICMental health problemPrevalence
spellingShingle Chethana Mudunna
Medhavi Weerasinghe
Thach Tran
Josefine Antoniades
Lorena Romero
Miyuru Chandradasa
Jane Fisher
Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
The Lancet Regional Health - Southeast Asia
Mental health
South Asia
Adolescent
LMIC
Mental health problem
Prevalence
title Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
title_full Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
title_fullStr Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
title_full_unstemmed Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
title_short Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic reviewResearch in context
title_sort nature prevalence and determinants of mental health problems experienced by adolescents in south asia a systematic reviewresearch in context
topic Mental health
South Asia
Adolescent
LMIC
Mental health problem
Prevalence
url http://www.sciencedirect.com/science/article/pii/S2772368225000034
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