Emerging burdens of adolescent psychosocial health problems: a population-based study of 202 040 adolescents from 68 countries

Background Psychosocial health problems are major public health burdens for adolescents. Identifying risk factors is essential to containing negative health implications. Aims This study aimed to estimate the burden of psychosocial health problems among adolescents, and identify potential risk and protective factors. Method We used the Global School-based Student Health Survey data from 68 countries across six World Health Organization regions. We computed the overall, national- and regional-level weighted estimates of the mean number of psychosocial health problems. Adjusted Poisson regression models examined the factors associated with psychosocial health problems. Results Our sample totalled 202 040 adolescents aged 11–17 years (mean age 14.6 [s.d. 1.18] years), composed of 95 589 (47.31%) boys and 104 191 (51.57%) girls (2260 (1.12%) missing answers). Samoa had the highest mean number of psychosocial health problems (mean 2.64 [s.d. 1.41]), and Niue had the lowest (mean 0.33 [s.d. 0.72]). In the pooled analysis, the following factors were associated with higher rates of psychosocial health problems in adolescents globally: ≥13 years of age, being female, experiencing food insecurity, experiencing physical violence, having been bullied, engagement in physical altercation, experiencing serious injury, missing school without parental permission, lack of parental support or monitoring, parents who were not understanding of their child's problems and high sedentary behaviour. Being female, food insecurity, bullying, physical attacks or serious injury were all significantly associated with higher rates of psychosocial health problems in each of the six regions separately. Conclusions The prevalence of psychosocial health problems is high among adolescents, although there are country-level variations. Health promotion strategies should consider the identified factors to promote adolescents’ health and well-being.