Psychological distress and parental involvement among adolescents in 67 low-income and middle-income countries: A population-based study

Background Adolescents with mental illnesses account for a significant proportion of young people globally. Mental illness is a major public health problem because of its harmful effects on adolescents’ development. There is a need to better understand the prevalence and protective factors regarding adolescents’ psychological distress to inform policies for effective prevention. Methods We used data from the Global School-based Student Health Surveys between 2009 and 2017. The data were collected through anonymous self-report questionnaires. This report is based on four questions assessing psychological distress and three questions assessing parental involvement. We calculated the pooled overall and regional estimates by random-effects meta-analysis. Logistic regression models were used to analyse the association between psychological distress and parental involvement. The association between adolescents’ psychological distress and a country's purchasing power parity (PPP) was examined by linear regression analysis. Results We included 167,484 young adolescents (boys, 47.3%; girls, 52.7%) in low-income and middle-income countries. The overall prevalence rates of psychological distress (loneliness, insomnia due to anxiety, suicidal ideation, and no close friends) were 10.7%, 9.1%, 13.6%, and 6.4%, respectively. A high level of parental involvement was associated with good mental health. The relationships of PPP with loneliness and insomnia due to anxiety were positive, but the relationships of PPP with the other two aspects were negative. Limitations The cross-sectional data do not infer causality between psychological distress and parental involvement. Conclusions This study indicated that high levels of parental involvement were significantly associated with a decreased likelihood of psychological distress. In addition, PPP was also related to psychological distress. Specifically, PPP was significantly associated with a decreased likelihood of not having close friends.