1. Introduction
According to World Health Organization (WHO) definition, mental health is a state of well-being in which every individual could potentially cope with the stressors and work productively for his/her own community (1). About one fifth of the world's children and adolescents from different cultures have mental disorders or problems and about half of mental disorders begin at the first years of adolescence (2).
Iran has very young population. In recent years, researchers paid some attention to adolescents, so that several studies conducted regarding mental health among this age group living in different cities of Iran (3-6). In a school-based study in Tehran, 19.5% of adolescents aged between 17 and 18 years old suffered from mental health problem (3). An epidemiological survey of psychiatric disorders in Iran has been reported the prevalence of psychiatric disorders as 9.07% among Iranian adolescents aged 18 -25 years (6). It seems that the rate of mental health problems of adolescents in different cities of Iran might be different. In addition, mental health in young adolescents could be regarded as a risk factor for psychological disorders such as antisocial behaviors, criminal activities, suicidal behaviors, substance abuse, depression, and eating disorders (2, 7), so estimating the rate of mental health problems among adolescents becomes very important task.
2. Objectives
This study aimed to assess mental health of high school students in Bandar Abbass, Iran.
3. Patients and Methods
In this cross-sectional study a total of 440 students from the high schools of Bandar Abbas were selected through randomly cluster sampling. Thirty students filled out the questionnaires incompletely. So, totally 410 questionnaires were analyzed (response rate = 93.2%).
The 12-item General Health Questionnaire (GHQ-12) was used as data collection instrument. GHQ-12 has been used in many investigations in various cultural regions (8, 9) including Iran (3, 10). Furthermore, this scale has been successfully used among adolescents in different populations (11, 12). The psychometric properties of Iranian version of GHQ scale have been approved in previous evidence (4). The findings of this study were based on the original scoring used by Goldberg (13). The score of 3.7 was used as the cut off point for the differentiation between individuals with and without psychiatric morbidity (4).
Data were analyzed using SPSS16 software. Analysis of the data included comparisons of the mean scores and distribution of the participants around the cutoff point of GHQ-12, comparing male and female students, different age groups and different studying grades.
4. Results
The mean age of participants was 16.5 (SD = 1.34) year ranging from 15 to 18. 50.2% of them were male.
The mean GHQ-score of all participants was 2.99 (SD = 2.5), and 35.4% of them obtained the cutoff point score of ≥ 3.7 ( Tables 1 and 2 ). The mean GHQ-scores of males and females were 3.27 (SD = 2.4) and 2.71 (SD = 2.6) respectively and there was significant difference between them (P < 0.02) ( Table 1 ). Comparing with female adolescents, more males received the scores above cut off point ≥ 3.7 - 39.3% versus 31.4% - that was statistically different (P < 0.05) ( Table 2 ).
Table 1Mean Scores of GHQ-12 in Terms of Gender, Age and Grade
aT-test
bANOVA
Table 2Distribution of the Students According to Cut off Point Score of GHQ-12
| Variable | ≤ 3.7 No. (%) | > 3.7 No. (%) | Value | P |
|---|---|---|---|---|
| Gender | ||||
| Male | 125 (60.7) | 81 (39.3) | 0.05 a | |
| Female | 140 (68.6) | 64 (31.4) | ||
| Age | ||||
| 15 | 52 (52.5) | 47 (47.5) | 16.56 | 0.001 b |
| 16 | 57 (60.6) | 37 (39.4) | ||
| 17 | 73 (65.2) | 39 (34.8) | ||
| 18 | 83 (79) | 22 (21) | ||
| Grade | ||||
| 9 | 57 (54.8) | 47 (45.2) | 15.29 | 0.002 b |
| 10 | 71 (59.2) | 49 (40.8) | ||
| 11 | 75 (68.8) | 34 (31.2) | ||
| 12 | 62 (80.5) | 15 (19.5) | ||
| Total | 265 (64.6) | 145 (35.4) |
aFisher's Exact test (1-sided)
bPearson Chi-square
In addition, there were significant differences in different age groups of students in terms of mean GHQ-scores (P < 0.003). The mean GHQ-score of 15-years old students were higher than other students. Also more students in this age group received scores above the cutoff point than other age groups ( Tables 1 and 2 ). Moreover, there were significant differences in mean GHQ-scores of different study grads (P < 0.001). ( Tables 1 and 2 ).
5. Discussion
Overall, this study showed the high proportion (35.4 %) of the students with a GHQ-12 score above cut off point that is consistent with previous studies in Iran (3, 6, 14). In a study in Tehran 19.5% of adolescents between 17 and 18 years old suffered from some psychiatric morbidity (3). Adolescence is a stressful period of growth, this period of life poses many challenges to the adolescents such as finding identity and values respect for self and others, taking increasing responsibility for him/her, and an increase in problem-solving skills (3).
Mental health problem was more prevalent among male students than female students. This result is not consistent with previous studies that reported psychiatric disorders were more common among females than males (3, 5, 6, 14-18). According to latest systematic review (19), male college students were at higher risk for suicide and female students were to screen positive for major depression and anxiety symptoms. Although existed evidences revealed mental health clearly varies across certain demographic and social factors (19), social supports and life stressors (1, 19), present study investigated just some limited demographic variables like age, gender and study grade. Therefore increased attention in this regard in future work is strongly recommended.
Although previous study justified the high prevalence of mental health problems among students in high grades of high school, because of the experienced stress due to university entrance exam (3), there are other studies that showed this problem exist among other age group between 18-25 years old (4). These studies supported the high rate of mental health problems among Iranian adolescents and young adults that could be paid attention by policy makers. In conclusion the findings of this study could be considered for designing fundamental future research regarding the status of adolescents’ mental health in Iran.
