Depression among Adolescents in Malaysia: A Comparison of Findings Between National Health and Morbidity Survey (NHMS) 2012 and 2017

Introduction Mental health problem affected 20% of adolescents worldwide, most commonly depression or anxiety . This study aims to compare the prevalence of depression and factors related to depression among adolescents in Malaysia from two surveys.

Methodology A sub-analysis of data from two nationwide surveys using multistage cluster random sampling design was done among secondary school students aged 13-17 years in Malaysia from 234 (NHMS 2012) and 212 (NHMS 2017) randomly selected schools. We used a validated self-administrated bilingual Depression, Anxiety, Stress Scale (DASS-21) questionnaire to evaluate for depression. Descriptive analysis was applied using SPSS.

Results The prevalence of depression among adolescents was 17.7% (95% CI:16.71,18.67) in 2012 and slightly increased to 18.3% (95% CI:17.20,19.38) in 2017. The state with the highest prevalence of depression was Sarawak (20.9%) in the NHMS 2012 and Selangor (22.6%) in NHMS 2017. In 2012, the prevalence of depression was higher among females (18.5%) whereas in 2017, the prevalence was higher among males (18.9%). Table 1: Prevalence of Depression among adolescents by Sociodemographic in Malaysia.

Discussion 1. The increasing number of ‘ever used drugs’ among adolescents from the two studies supported by Junette & Trishna (2011) found that the risk for depression may also increase by two - to threefold in the presence of comorbidities such as substance abuse and anxiety disorders. 2. This comparison of two studies showed quite similar findings as increasing trend of the prevalence of psychiatric morbidity among adolescents was from 13.0% in NHMS 1996, to 19.4% in 2006 and 20.0% in 2011. 3. A trend study in United States also reported that the prevalence rate of severe adolescent depression varied from 8.7% in 2005 to 11.3% in 2014. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. 4. This comparison also showed the rates of prepubertal depression are similar for boys and girls; however, depression rates double in females after puberty.

Conclusion There was an increase in the prevalence of depression among adolescents in NHMS 2017 compared to the NHMS 2012. Depression remains a problem among adolescents especially those with risky behaviours. Intervention strategies should be targetted on adolescents with risky behaviours and those from broken family.