Mental health dynamics of adolescents: A one-year longitudinal study in Harari, eastern Ethiopia

PLoS One. 2024 Apr 18;19(4):e0300752. doi: 10.1371/journal.pone.0300752. eCollection 2024.

Abstract

Aims: This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year.

Materials and methods: Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant.

Results: The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort.

Conclusions: The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families.

MeSH terms

  • Adolescent
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health*
  • Middle Aged
  • Schools*
  • Surveys and Questionnaires

Grants and funding

Haramaya University provided financial support for our study under the Scientific Research Grant number “HURG-2020-02-01-92”. The financial support was fifty thousand Ethiopian birr. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.