Mental Health Problems and Symptoms among Male Adolescents Attending a Teen Health Clinic

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ABSTRACT

The purpose of this study was to examine the frequency and nature of mental health problems and symptoms among a group of 51 inner-city male adolescents attending a teen health clinic at a large county hospital in the southwestern part of the United States. They were administered a problem area checklist and a problem symptom checklist. The problem area checklist covered a range of mental health issues, including peer/friendship, relationship, and family problems; problems with money, time, and the law; substance use; and eating disorders. The problem symptom checklist queried participants about anger, nervousness, depression, fear, loneliness, suicide, aggression, and self-esteem. The results indicated that these young males experienced significant mental health problems and symptoms, such as relationship problems, problems with time and money, and symptoms of anger, depression, and aggression. Further, scared/afraid feelings correlated with five of the eight problem areas. The authors recommend investigatin g ways to target young males who present at such clinics in order to address their mental health problems and symptoms, as well as studying how their environment affects their overall health.

A number of epidemiological studies have reported prevalence rates ranging from 12% to 20% for psychiatric disorders among children and adolescents. For example, Roberts, Attkisson, and Rosenblatt (1998), in an international meta-analysis of 52 studies, reported a mean prevalence rate of 15.8%. Kazdin's (1992) review of studies from a number of countries estimated that between 17% and 22% of youth under 18 years of age experience emotional and behavioral problems.

In several studies, depression has been singled out. For example, a review of epidemiological studies of childhood and adolescent depression by Birmaher et al. (1996) found that the prevalence rates of depression range between 0.4% and 2.5% in children and between 0.4% and 8.3% in adolescents. The lifetime prevalence rate of Major Depressive Disorder (MDD) in adolescents has been estimated to range from 15% to 20%. Lewinsohn and Clarke's (1999) review also suggested that between 2% and 5% of the general adolescent population experiences MDD at any given point in time.

Studies have found gender differences in the presentation of mental disorders. Females tend to have more episodic problems, such as depression, and milder manifestation, such as nonaggressive conduct disorders, while males tend to have more aggressive conduct disorders (Bardone, Moffitt, Caspi, Dickson, Stanton, & Silva, 1998). A two-stage cross-sectional analysis of a random sample of a rural population found that females mainly demonstrated neuroses and manic-depressive psychosis, while males had higher rates of personality disorders, alcoholism, and antisocial conduct (Vazquez-Barquero et al., 1992). A national study of 1,400 children ages 5-17 attending U.S. schools, which assessed behavioral pathology using the Adjustment Scales for Children and Adolescents, found that males dominated in the prevalence of psychological maladjustment (McDermott, 1996). Males accounted for roughly 60% of aggressive-provocative, oppositional, and avoidant maladjustment, 70% of hyperactive maladjustment, and 75% of impulser idden aggression. Conversely, no significant female prevalence was detected for any type of major disorder. The Dunedin Multidisciplinary Health and Development Study, with a sample from a New Zealand birth cohort of 890 youths who were followed from ages 3 to 18 years, also documented gender differences. Boys appeared more vulnerable, and those from socially disadvantaged backgrounds in early childhood had an elevated risk of disorder at age 18 (Feehan, McGee, Williams, & Nada-Raja, 1995).

Research has indicated that depression in adolescence is associated with an increased risk of suicidal behavior. For adolescent boys this risk may rise if the depression is accompanied by conduct disorder and alcohol or other substance abuse (Shaffer & Craft, 1999). …