Depression and Anxiety Among Adolescents in Northern Sudan: A School-Based Cross-Sectional Study

Background and Objective: Adolescents' mental health, including depression and anxiety, represent a global public health problem. However, there is a paucity of data on depression and anxiety among adolescents in Sudan. Therefore, the current study aimed to investigate the prevalence and associated factors for depression and anxiety among adolescents in Northern Sudan. Methods: This school-based cross-sectional study was conducted at randomly selected schools from August to September 2022 in Almatamah, River Nile State, Sudan. Sociodemographic and clinical data were collected using a face-to-face questionnaire. Depression and anxiety were measured using the questionnaire tools of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7), respectively. Univariate and multivariate binary analyses were performed to determine the associated factors of depression and anxiety using the adjusted odd ratios (AOR) and 95.0% confidence interval (CI). Results: Of 384 adolescents, 178 (46.4%) and 206 (53.6%) were boys and girls, respectively. The median (interquartile range [IQR]) of age was 15.1 (14.0-16.3) years old. Of the total adolescents, 311 (81.0%), 42 (10.9%), 20 (5.2%), 7 (1.8%), and 4 (1.0%) had no, mild, moderate, moderate to severe, and severe depression, respectively. Of the total, 31 (8.1%) adolescents had moderate or severe depression (depression score ≥ 10). In multivariable binary analysis, female gender (AOR = 5.35, 95% CI 1.67-17.09) and anxiety (AOR = 25.98, 95% CI 7.68-87.90) were associated with increased odds of depression; there was no association between age, father's education, and BMI for age Z-score and depression. Of the 384 adolescents, 320 (83.3%), 47 (12.2%), 11 (2.9%), and 6 (1.6%) had no mild, moderate, and severe anxiety, respectively. Of the total, 17 (4.4%) had moderate and or severe anxiety (anxiety score ≥ 10). In multivariable logistic regressions, while family history of mental disorder (AOR = 6.31, 95% CI 1.36-29.27), being anemic (AOR = 3.95, 95% CI 1.19-13.12), and depression (AOR = 29.03, 95% CI 7.52-112.05) were associated with increased odds of anxiety; there was no association between age, gender, father's occupation, and BMI for age Z-score and anxiety. Conclusions: The findings indicate that 1 in 10 adolescents in Northern Sudan experiences at least one mental disorder, encompassing depression, anxiety, or a combination of both. Notably, female adolescents are at a higher risk for depression, while factors such as a family history of mental disorders and anemia significantly contribute to anxiety levels. To address these pressing mental health concerns, it is imperative to implement inclusive and holistic programs that incorporate nutritional support, integrate mental health education into school curricula, and introduce community-based interventions aiming to enhance mental well-being among all adolescents, irrespective of gender.