Numerous studies have been conducted on the prevalence of psychiatric disorders in adolescents worldwide. Findings often revealed a very wide range of prevalence rates among these studies, for example Robert and Attkison, after reviewing 52 studies, reported a prevalence rate ranging from 1 to 51%.[13
This very wide prevalence rate was due to many factors, mainly the difference in case definition, methodology, and how the information was obtained (self-reported questionnaire, information from parents or teachers, by interview or others). Usually studies based on self-reported questionnaires, which depended mainly on symptoms rather than psychiatric diagnosis, resulted in a higher prevalence rate than others.[2
In our study we used a self-reported questionnaire (GHQ-28), which might have contributed to the overall high prevalence rate (48% in this age group).
This result was close to the results of other studies, which used the same tool. Winefield and Goldney reported a case prevalence rate of 40%,[16
] found a prevalence of 43% (both used GHQ-28), and Mc Pherson and Hall found a 48% prevalence rate (used GHQ-12).[18
] Okash A, reported 51.7% psychiatric morbidity among Egyptian adolescents.[19
] In Sudan Younis described a prevalence of up to 29% in children in the primary care setting.[20
There are many other methods for diagnosing psychological disorders, for example, the CPS-depression scale, but this scale is used only for depression, Camacho et.al
., found that the prevalence of major depression (only major depression) among adolescents was 11.5%.[21
The other possible reasons for the high prevalence rate in our study were, first; the sociodemographic characteristics of this population. Being settled tribal families, they had gone through tremendous cultural and social changes within a relatively short period of time, and the urbanization was associated with increased psychiatric disorder rates.[22
] The large family size and low educational level of the parents were associated with increased psychiatric disorder rates.[8
] Second, this study was done on a specific group of adolescents (those in the final year of high school), which is a critical period in a student's life – a lot of stress to get a high degree in school added to this. The study was carried out few weeks prior to the midterm examinations, which could have been a factor contributing to added stress and probably resulting in a higher prevalence.
Previous studies showed that older adolescents had higher psychiatric disorder rates,[8
] and that was the case in our study too, although it was not statistically significant.
Our results supported the previous studies that females had higher psychiatric disorder rates than males[11
] (female 51% versus males 41%), also the severity of psychiatric disorders was significantly (P
= 0.017) higher in females than males, which supported the results of other studies.[8
Regarding family size, polygamous family, and birth order, they all failed to show a statistically significant relationship between the rates of psychiatric disorders in the adolescent, however, Panyayong demonstrates that one of the factors that is significantly associated with psychiatric disorders is family size with more than four children.[23
When it came to academic performance, our results showed a significant relationship between the degree of school performance and rate of psychiatric disorders (P
= 0.021); students with high degrees (excellent) had the lowest rate of psychiatric disorders, this might be because high degree students were mentally more stable and had more self-confidence than the others. Fleming, Offord, and Boyle and other studies have also described a considerable relationship between mental health and school performance.[24
] Surprisingly there was no significant association between the rate of psychiatric disorders and school failure, although students aged 21 – 24 years (likely frequent failures) were found to have a high rate of psychiatric disorders — only 4% of the sample size with 86% rate of psychiatric disorders — which might question the reliability of answering this variable (failure is a sensitive issue and admitting it may be difficult, especially when answering a self-reported questionnaire).
Many studies confirmed the association between psychiatric disorders and smoking;[8
] our study showed a high prevalence rate of psychiatric disorders within smokers, but this association was marginally statistically significant. This was probably due to the fact that the questionnaires were filled inside the school; this might have prevented some students from answering the part on smoking openly.
Although the sample size was appropriate for the school population it was relatively small and might be the reason for the failure of illustrating the relationship between psychiatric disorders and some of the variables studied. Another limitation was that in this study we used GHQ-28, which was a self-reported questionnaire that depended on symptoms rather than specific psychiatric diagnosis for case detection, which might have overestimated the prevalence of psychiatric disorders. Finally, the narrow age range and academic level of the study sample might limit the generalization of the results of the adolescents’ age group.