PREVALENCE AND CORRELATES OF PSYCHIATRIC MORBIDITY AMONG ADOLESCENTS IN BO, SIERRA LEONE

Abstract

Background Mental disorders have a significant impact on the adolescent’s ability to function. Knowledge of the prevalence and correlates of mental disorders can help to inform appropriate service development for adolescents’ mental health and reduce the possibility of future problems such as the need for special education, criminal activities, and physical illness. Despite the instability experienced in Sierra Leone, very few community studies have investigated the prevalence and correlates of mental disorders among adolescents. This study therefore aimed to estimate the prevalence, pattern and correlates of mental health symptoms and specific probable mental disorders among adolescents living in Bo, Sierra Leone. Methodology This was a descriptive study carried out in Bo, southern Sierra Leone. One community was chosen from the randomly selected wards that make up Bo town. A total of 341 adolescents aged 12-19years were recruited into the study. A socio-demographic questionnaire, the School Health Questionnaire and the Diagnostic Predictive Scales for Youths were used to collect information on the socio-demographic characteristics, psychosocial problems and probable mental disorders among the adolescents using the interviewer-administered method. Data Analysis Socio-demographic characteristics of, as well as the prevalence and pattern of mental disorders among the adolescents were analysed and presented in frequencies. Correlates of mental disorders found were examined using the Chi square statistics at a significant level of 5%. RESULTS The mean age of adolescents who participated in the study was 15.5(±2.2) years while the ratio of males to females was 1:2. Majority (69.1%) of the adolescents were still in school while about a quarter (26.6%) had dropped out of school. Almost half (46.6%) of the adolescents had one or more diagnosis of a probable mental disorder. About one in every six (16.4%) adolescents had probable depressive disorder, over a third (37.5%) had probable oppositional defiant disorder and about one-fifth (20.8%) had probable conduct disorder. A significantly higher proportion of adolescents who reported that they were from polygamous families and that their parents did not understand their problems and worries had depression compared to their counterparts form monogamous homes and whose parents showed understanding (22.6% Vs11.0%, p=0.004; 26.7% vs. 11.9%, p=0.001), . Similarly, adolescents who had once been described as slow or backward had probable oppositional defiant disorder compared to those who had never been described as slow or backward and this was statistically significant (52.9% vs 32.5%, p=0.006). Furthermore, adolescents who reported they did not like their family had higher rates of conduct disorder compared to those who liked their family ((37.5% vs 19.7%; p=0.040). Factors such as being from a monogamous home, living with biological parents and perceived parental understanding of adolescent’s wellbeing were associated with reduced rates of mental disorders (p<0.05) in the adolescents. Conclusion Mental disorders are common among adolescents in Bo, Sierra Leone. A wide range of psychosocial factors including polygamous home setting, being described as backward or slow to learn, alcohol use and cigarette smoking were significantly associated with probable mental disorders while protective factors were found to include perceived parental concern about issues pertaining to the adolescent, monogamous home setting and living with parents. Families and schools play important roles in the overall development of the adolescent. Therefore, practices that promote the mental wellbeing of the adolescents should be encouraged among families and school teachers should be encouraged.