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      Internalizing and externalizing mental health problems affect in-school adolescent’s health-related quality of life in eastern Ethiopia: A cross-sectional study

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          Abstract

          Aims

          This study aimed to examine the association between mental health problems and health-related quality of life (HrQoL) among in-school adolescents 13–19 years in the Harari region, eastern Ethiopia.

          Materials and methods

          A cross-sectional study was conducted on 3227 in-school adolescents aged 13 to 19 using multistage sampling. The KIDSCREEN-10 questionnaire assessed health-related quality of life (HrQoL), while a self-administered version of the strength and difficulty questionnaire (SDQ) examined mental health issues. Data were double entered, validated, and cleaned using EpiData version 3.1 and analyzed using STATA 14.1. An ordinal logistic regression model investigated the link between the outcome variable and the predictors. The results were reported using an odds ratio with a 95% confidence interval (CI), and a p-value of less than 0.05 was considered statistically significant.

          Results

          A quarter of the adolescents (23%) reported poor health-related quality of life; adolescents with internalizing and externalizing mental health problems had the lowest health-related quality of life. After controlling for potential confounders, adolescents with abnormal (AOR = 0.48, 95% CI: 0.39, 0.59) and borderline (AOR = 0.59, 95% CI: 0.45, 0.78) levels of internalizing problems had a 52% and 41% lower probability of having high HrQoL than those with normal levels. Furthermore, individuals with abnormal (AOR = 0.59, 95% CI: 0.45, 0.77) and borderline (AOR = 0.64, 95% CI: 0.45, 0.92) levels of externalizing difficulties had a 41% and 36% lower chance of having a high health-related quality of life.

          Conclusions

          Nearly a quarter of in-school adolescents had poor health-related quality of life. High scores for internalizing and externalizing mental health problems significantly impacted the adolescents’ health-related quality of life. This emphasizes the need to address mental health issues in the school setting to improve adolescents’ overall quality of life.

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          Most cited references45

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          Child and adolescent mental health worldwide: evidence for action.

          Christian Kieling, Helen Baker-Henningham, Myron Belfer … (2011)
          Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. We also discuss barriers to, and approaches for, the implementation of such strategies in low-resource settings. Action is imperative to reduce the burden of mental health problems in future generations and to allow for the full development of vulnerable children and adolescents worldwide. Copyright © 2011 Elsevier Ltd. All rights reserved.
          Article 0 comments Cited 464 times – based on 0 reviews     Review now
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            When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): data from British parents, teachers and children.

            George Ploubidis, Anna Goodman, Donna Lamping (2010)
            The Strengths and Difficulties Questionnaire (SDQ) is a widely used child mental health questionnaire with five hypothesised subscales. There is theoretical and preliminary empirical support for combining the SDQ's hypothesised emotional and peer subscales into an 'internalizing' subscale and the hypothesised behavioral and hyperactivity subscales into an 'externalizing' subscale (alongside the fifth prosocial subscale). We examine this using parent, teacher and youth SDQ data from a representative sample of 5-16 year olds in Britain (N = 18,222). Factor analyses generally supported second-order internalizing and externalizing factors, and the internalizing and externalizing subscales showed good convergent and discriminant validity across informants and with respect to clinical disorder. By contrast, discriminant validity was poorer between the emotional and peer subscales and between the behavioral, hyperactivity and prosocial subscales. This applied particularly to children with low scores on those subscales. We conclude that there are advantages to using the broader internalizing and externalizing SDQ subscales for analyses in low-risk samples, while retaining all five subscales when screening for disorder.
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              The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version.

              R. Goodman, H. Meltzer, V. Bailey (1998)
              The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher- or parent-rated SDQ scores compared favourably with the average cross-informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.
              Article 0 comments Cited 240 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Gari Hunduma:
                ORCID: https://orcid.org/0000-0002-6660-841X
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – original draft
                Yadeta Dessie: Role: ConceptualizationRole: Data curationRole: MethodologyRole: ValidationRole: Writing – review & editing
                Biftu Geda: Role: Data curationRole: MethodologyRole: SoftwareRole: ValidationRole: Writing – review & editing
                Tesfaye Assebe Yadeta: Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Negussie Deyessa: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: Writing – review & editing
                Sebsibe Tadesse: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS One
                Journal ID (publisher-id): plos
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 4 August 2022
                Publication date Collection: 2022
                Volume: 17
                Issue: 8
                Electronic Location Identifier: e0272651
                Affiliations
                [1 ] School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                [2 ] School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                [3 ] Department of Nursing, School of Health Sciences, Madda Walabu University, Robe, Ethiopia
                [4 ] Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                Wachemo University, ETHIOPIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-6660-841X
                Article
                Publisher ID: PONE-D-22-10505
                DOI: 10.1371/journal.pone.0272651
                PMC ID: 9352091
                PubMed ID: 35925999
                SO-VID: 22f7f7b9-c29b-4ce1-ba8e-ab73a5daaa69
                Copyright © © 2022 Hunduma et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 9 April 2022
                Date accepted : 22 July 2022
                Page count
                Figures: 1, Tables: 2, Pages: 14
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100004845, Haramaya University;
                Award ID: HURG-2020-02-01-92
                Award Recipient :
                ORCID: https://orcid.org/0000-0002-6660-841X
                After successfully defending the study proposal, this work was sponsored by the University of Haramaya Scientific Research Grant number (HURG-2020-02-01-92). The funder had no involvement in the study's design, data collection, analysis, interpretation, or the manuscript's writing.
                Categories
                Subject: Research Article
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Children
                Subject: Adolescents
                Subject: People and Places
                Subject: Population Groupings
                Subject: Families
                Subject: Children
                Subject: Adolescents
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Quality of Life
                Subject: Social Sciences
                Subject: Sociology
                Subject: Education
                Subject: Schools
                Subject: People and Places
                Subject: Geographical Locations
                Subject: Africa
                Subject: Ethiopia
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: Social Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: Medicine and Health Sciences
                Subject: Public and Occupational Health
                Subject: Behavioral and Social Aspects of Health
                Subject: Research and Analysis Methods
                Subject: Mathematical and Statistical Techniques
                Subject: Statistical Methods
                Subject: Regression Analysis
                Subject: Physical Sciences
                Subject: Mathematics
                Subject: Statistics
                Subject: Statistical Methods
                Subject: Regression Analysis
                Custom metadata
                Data Availability All relevant data are within the manuscript and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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