本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(23)02641-7

摘要内容如下：

背景

精神障碍是全球青少年健康负担的主要原因。然而，低收入和中等收入国家青少年精神障碍的患病率数据很少，其普遍性往往有限。本研究旨在生成肯尼亚、印度尼西亚和越南青少年精神障碍的全国代表性患病率估计值。

方法

作为国家青少年心理健康调查（NAMHS）的一部分，一项多国横断面研究于2021年3月至12月在肯尼亚、印度尼西亚和越南进行了具有全国代表性的家庭调查。根据专门设计的抽样框架，从随机选择的家庭中对10-17岁的青少年及其主要照顾者进行了访谈，以得出具有全国代表性的结果。6种精神障碍（社交恐惧症、广泛性焦虑症、重度抑郁症、创伤后应激障碍、品行障碍和注意力缺陷多动障碍）采用儿童诊断访谈表第5版进行评估。还评估了过去12个月的自杀行为和自残行为。计算每种精神障碍在过去12个月和过去4周的患病率，以及任何精神障碍（即所评估的六种精神障碍）的总体患病率。计算过去12个月中自杀行为（即意念、计划和企图）和自我伤害的患病率，以及调整后的优势比（AOR），以显示与过去12个月中任何精神障碍患病率的关联。应用逆概率加权来生成具有相应95%CI的国家估计值。

调查结果

最终样本包括来自肯尼亚的5155个家庭（即青少年和主要照顾者配对）、来自印度尼西亚的5664个家庭和来自越南的5996个家庭。在肯尼亚，2416名（46.9%）青少年为男性，2739名（53.1%）为女性；在印度尼西亚，2803名（49.5%）青少年为男性，2861名（50.5%）为女性；在越南，3151人（52.5%）为男性，2845人（47.4%）为女性。过去12个月内任何精神障碍的患病率在肯尼亚为12.1%（95%CI 10.9-13.5），在印度尼西亚为5.5%（95%CI 4.3-6.9），在越南为3.3%（95%CI 2.7-4.1）。过去4周的患病率在肯尼亚为9.4%（8.3-10.6），在印度尼西亚为4.4%（3.4-5.6），在越南为2.7%（2.2-3.3）。这三个国家在过去12个月中的自杀行为发生率都很低，从印度尼西亚（1.0-2.0）和越南（1.0-1.9）的1.4%到肯尼亚（3.9-5.3）的4.6%。印度尼西亚（0.3-0.8）和越南（0.2-0.6）的自杀计划率为0.4%，肯尼亚为2.4%（1.9-2.9）；印度尼西亚（0.1-0.4）和越南（0.1-0.3）的自杀未遂率为0.2%，肯尼亚为1.0%（0.7-1.4）。这三个国家在过去12个月中自我伤害的发生率也很低，从印度尼西亚的0.9%（0.6-1.3）到肯尼亚的1.2%（0.9-1.7）。然而，在过去12个月中有任何精神障碍的人在过去12个月中自杀行为和自我伤害的发生率显著高于没有精神障碍的人（例如，自杀意念的AOR范围从印度尼西亚的7.1[3.1-15.9]到越南的14.7[7.5-28.6]）。

解释

NAMHS首次提供了肯尼亚、印度尼西亚和越南的全国青少年精神障碍患病率估计数。这些数据可以为低收入和中等收入国家的精神卫生和更广泛的卫生政策提供信息。

英文原文如下：

Abstracts

BACKGROUND  Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam.

METHODS  As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs.

FINDINGS  Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam).

INTERPRETATION  NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries.

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