Psychological distress in adolescents: prevalence and its relation to high-risk behaviors among secondary school students in Mbarara Municipality, Uganda

BACKGROUND: Psychological distress among adolescents negatively affects their academic performance, relationships with family and friends, and ability to participate fully in the community. Stressful life events in low-income countries and risk-taking behavior of adolescents have raised concerns regarding the impact of psychological distress among adolescents. Therefore, the present study estimated the prevalence of psychological distress and examined the high-risk behaviors associated with psychological distress among Ugandan adolescents. METHODS: A community based cross-sectional study was conducted among secondary school students in Mbarara Municipality, Uganda. Multistage cluster sampling was used to recruit 921 adolescents from 12 schools. Psychological distress was assessed using the 10-item Kessler Psychological Distress Scale (K10). Logistic regression was used with p-value estimating regression coefficient and 95% confidence interval for odds ratio and adjusted odds ratio (AOR). RESULTS: The prevalence of psychological distress using the K10 was 57%. Logistic regression analyses showed that risky sexual behavior [AOR = 1.52; 95% confidence interval (CI) 1.02–2.28], substance use (AOR = 2.06; 95% CI 1.49–2.84) were associated with psychological distress. Students in mixed schools (comprising both sexes) (AOR = 1.94; 95% CI 1.19–3.15) and adolescents with chronic illness (AOR = 1.68; 95% CI 1.18–2.38) were more likely to report psychological distress. CONCLUSION: The prevalence of psychological distress among school-going adolescents is high. Risky sexual behavior, substance use as well as chronic illness were associated with psychological distress. In addition, the type of school was significantly associated with psychological distress. The findings suggest the need for policy makers and stakeholders in health and education sectors to institute measures that will address mental health issues among adolescents.