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RÉSUMÉ
Introduction. L’adolescence est une période critique de vulnérabilité pour la santé mentale. En Afrique subsaharienne, et particulièrement au Cameroun, les données sur le bien-être psychosocial des adolescents scolarisés restent parcellaires, limitant la mise en place d’interventions de prévention ciblées. Cette étude visait à évaluer l’état psychosocial et à identifier ses déterminants chez les adolescents scolarisés dans une commune urbaine de Yaoundé. Méthodologie. Une étude transversale a été menée sur sept mois dans trois établissements secondaires publics de la commune de Yaoundé IV. Les adolescents âgés de 10 à 19 ans, ayant obtenu un assentiment et un consentement parental, ont été inclus. L’outil d’évaluation était l’entretien psychosocial HEADSSS. Les analyses univariée et multivariée ont identifié les facteurs associés à un risque psychosocial élevé. Résultats. Sur 281 adolescents inclus (âge moyen 15,6 ans ; 52,3% de sexe masculin), un quart (24%) présentait un risque psychosocial élevé. Les relations familiales étaient conflictuelles ou violentes pour 50,1% des participants. Un quart (24,9%) rapportait un antécédent de harcèlement scolaire et 41,3% une consommation de substances. Des pensées suicidaires étaient déclarées par 39,4% des adolescents. En analyse multivariée, les facteurs indépendamment associés à un risque psychosocial élevé étaient : un âge ≤ 15 ans (ORa=2,44 ; p=0,003), le sexe féminin (ORa=1,54 ; p=0,004), des relations familiales non harmonieuses (ORa=8,15 ; p<0,001), un antécédent de harcèlement scolaire (ORa=5,05 ; p<0,001), une consommation de substances (ORa=1,57 ; p=0,002), un antécédent de violence/abus sexuel (ORa=7,09 ; p<0,001) et des pensées suicidaires (ORa=19,80 ; p<0,001). Conclusion. Cette étude révèle une prévalence élevée de détresse psychosociale parmi les adolescents de Yaoundé, fortement liée au contexte familial et scolaire. Ces résultats appellent à l’intégration urgente de services de santé mentale scolaires et à des programmes de soutien familial pour atténuer ces facteurs de risque critiques.
ABSTRACT
Introduction. Adolescence is a critical period of vulnerability for mental health. In sub-Saharan Africa, and particularly in Cameroon, data on the psychosocial well-being of school-going adolescents remain scarce, hindering the development of targeted preventive interventions. This study aimed to assess the psychosocial state and identify its determinants among adolescents in an urban commune of Yaoundé. Methodology. A cross-sectional study was conducted over seven months in three public secondary schools in the Yaoundé IV district. Adolescents aged 10 to 19 years, who provided assent and had parental consent, were included. The assessment tool was the HEADSSS psychosocial interview. Univariate and multivariate analyses identified factors associated with high psychosocial risk. Results. Among 281 included adolescents (mean age 15.6 years; 52.3% male), one-quarter (24%) presented a high psychosocial risk. Family relationships were conflictual or violent for 50.1% of participants. A quarter (24.9%) reported a history of school bullying and 41.3% reported substance use. Suicidal ideation was reported by 39.4% of adolescents. In multivariate analysis, factors independently associated with high psychosocial risk were: age ≤ 15 years (aOR=2.44; p=0.003), female sex (aOR=1.54; p=0.004), non-harmonious family relationships (aOR=8.15; p<0.001), a history of school bullying (aOR=5.05; p<0.001), substance use (aOR=1.57; p=0.002), a history of violence/sexual abuse (aOR=7.09; p<0.001), and suicidal thoughts (aOR=19.80; p<0.001). Conclusion. This study reveals a high prevalence of psychosocial distress among adolescents in Yaoundé, strongly linked to family and school contexts. These findings call for the urgent integration of school-based mental health services and family support programs to mitigate these critical risk factors.
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References
- 1. Kasen, S., Berenson, K., Cohen, P., & Johnson, J. G. 2004. The Effects of School Climate on Changes in Aggressive and Other Behaviors Related to Bullying. In D. L. Espelage & S. M. Swearer (Eds.), Bullying in American schools: A social-ecological perspective on prevention and intervention (pp. 187–210). Lawrence Erlbaum Associates Publishers.
- 2. Sawyer AM, Borduin CM, Dopp AR. Long-term effects of prevention and treatment on youth antisocial behavior: A meta-analysis. Clin Psychol Rev. 2015 Dec ;42 :130-44. doi: 10.1016/j.cpr.2015.06.009. Epub 2015 Jun 29. PMID : 26197725.
- 3. The Global Action for Measurement of Adolescent health (GAMA). Geneva : World Health Organization; 2024 https://www.who.int/groups/the-global-action-for-measurement-of-adolescent-health, consulté le 2 février 2024.
- 4. État de la population mondiale 2023 - Huit milliards d’humains, un horizon infini de possibilités : Défendre les droits et la liberté de choix. New York : Fonds des Nations Unies pour la population ; 2023 (https://www.un-ilibrary.org/content/books/9789210027144)
- 5. Orpana H, Vachon J, Dykxhoorn J, McRae L, Jayaraman G. Monitoring positive mental health and its determinants in Canada : the development of the Positive Mental Health Surveillance Indicator Framework. Health Promot Chronic Dis Prev Can. 2016 Jan ;36(1) :1-10. doi: 10.24095/hpcdp.36.1.01. PMID : 26789022 ; PMCID : PMC4939463.
- 6. Schotanus-Dijkstra M, Ten Have M, Lamers SMA, de Graaf R, Bohlmeijer ET. The longitudinal relationship between flourishing mental health and incident mood, anxiety and substance use disorders. Eur J Public Health. 2017 Jun 1 ;27(3):563-568. doi: 10.1093/eurpub/ckw202. PMID : 27818372.
- 7. Diener, E., Tay, L., & Myers, D. G. 2011. The religion paradox: If religion makes people happy, why are so many dropping out? Journal of Personality and Social Psychology, 101(6), 1278–1290. https://doi.org/10.1037/a0024402
- 8. Shaffer-Hudkins, E., Suldo, S., Loker, T., & March, A. 2010. How adolescents' mental health predicts their physical health: Unique contributions of indicators of subjective well-being and psychopathology. Applied Research in Quality of Life, 5(3), 203-217. https://doi.org/10.1007/s11482-010-9105-7 APA PsycNET
- 9. Sanawai D. 2024. Accompagnement psychosocial et résilience des adolescents victimes de conflit intercommunautaire Arabe Choa Mousgoum à Logone Birni. ESI Preprints. https://doi.org/10.19044/esipreprint.8.2024.p413
- 10. Fazel M, Patel V, Thomas S, Tol W. Mental health interventions in schools in low-income and middle-income countries. Lancet Psychiatry. 2014 Oct;1(5):388-98. doi: 10.1016/S2215-0366(14)70357-8. Epub 2014 Oct 7. PMID: 26361001.
- 11. Organisation mondiale de la santé. Compétences de base en santé et développement de l’adolescent pour les prestataires de soins primaires et outil pour évaluer le volet « santé et développement de l’adolescent » dans la formation initiale des prestataires de soins de santé www.who.int/maternal_child_adolescent/documents/core_competencies/fr/, last accessed Feb 8th 2025.
- 12. Goldenring JM, Rosen DS. Getting into adolescent heads: an essential update. Contemp Pediatr 2004 ;21:64–9.
- 13. Klein D, Goldenring JM, Adelman WP. http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/content/tags/adolescent-medicine/heeadsss-30-psychosocial-interview-adolesce?page=full, last accessed Feb 8th 2025.
- 14. Goodman R, Gledhill J, Ford T. Child psychiatric disorder and relative age within school year: Cross sectional survey of large population sample. BMJ 2003 ;327 :472.
- 15. Crawford C, Dearden L, Greaves E. Does when you are born matter? The impact of month of birth on children’s cognitive and non-cognitive skills in England. London: Institute for Fiscal Studies; 2011.
- 16. Lien L, Tambs K, Oppedal B, et al. Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway. BMC Public Health 2005 ;5 :102e9.
- 17. Chen MH, Lan WH, Bai YM, et al. Influence of relative age on diagnosis and treatment of attention-deficit hyperactivity disorder in Taiwanese children. J Pediatrics. 2016 ; 172 : 162-167 e161
- 18. Olympia L K Campbell, David Bann, Praveetha Patalay,The gender gap in adolescent mental health: A cross-national investigation of 566,829 adolescents across 73 countries, SSM - Population Health, Volume 13, 2021,100742, ISSN 2352-8273, https://doi.org/10.1016/j.ssmph.2021.100742.
- 19. Berg, B., & Kelly, R. 1979. The measured self-esteem of children from broken, rejected, and accepted families. Journal of Divorce, 2,363-369
- 20. Emery, R. E. 1982. Interparental conflict and the children of discord and divorce, Psychological Bulletin, 92,310-330.
- 21. Grych, J. H., dr Fincham, F. D, 1990. Marital conflict and children's adjustment: A cognitive contextual framework. Psychological Bulletin, 108, 267-290.
- 22. Smetana, J. G. 1995. Parenting styles and conceptions of parental authority during adolescence. Child Development, 66(2), 299–316. https://doi.org/10.2307/1131579
- 23. https://www.who.int/europe/fr/news/item/27-03-2024-one-in-six-school-aged-children-experiences-cyberbullying--finds-new-who-europe-study
- 24. School Violence and Bullying - Global Status Report. Publié en 2017 par l’Organisation des Nations Unies pour l’éducation, la science et la culture ; ISBN 978-92-3-200107-8 REV
- 25. Meguieze C A, Ngole A N N, Nseme E G E, Koki N P O. Factors associated with psychoactive drugs initiation among adolescents in Yaoundé - Cameroon. Pediatr Oncall J. 2025;22. doi: 10.7199/ped.oncall.2025.20
- 26. Grant, B.F., F.S. Stinson, D.A. Dawson, P. Chou, M.C. Dufour, W. Compton, R.P. Pickering et K. Kaplan. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders, Archives of General Psychiatry, vol. 61, 2004, p. 807–816.
- 27. Clarke, V., Goddard, A., Wellings, K. et al. Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study. Soc Psychiatry Psychiatr Epidemiol 58, 1777–1793. 2023. https://doi.org/10.1007/s00127-021-02127-4
- 28. Christophe Léon, Emmanuelle Godeau, Stanislas Spilka, Ingrid Gillaizeau, François Beck. La santé mentale et le bien-être des collégiens et lycéens en France hexagonale : Résultats de l’Enquête nationale en collèges et en lycées chez les adolescents sur la santé et les substances. EnCLASS 2022, Santé publique France. 2024, pp.17. ⟨hal-04790436⟩
- 29. Côté, L., Pronovost, J. & Ross, C. 1990. Étude des tendances suicidaires chez des adolescents de niveau secondaire. Santé mentale au Québec, 15(1), 29–45. https://doi.org/10.7202/031540ar
- 30. C. Kayser, E. Jaunay, M. Giannitelli, E. Deniau, J. Brunelle, O. Bonnot, A. Consoli, J.-M. Guilé, D. Cohen. Facteurs de risque psychosociaux et troubles psychiatriques des jeunes pris en charge par l’aide sociale à l’enfance et ayant recours à des soins hospitaliers. Neuropsychiatrie de l'Enfance et de l'Adolescence, Volume 59, Issue 7, 2011, pages 393-403, ISSN 0222-9617, https://doi.org/10.1016/j.neurenf.2011.07.001.
References
1. Kasen, S., Berenson, K., Cohen, P., & Johnson, J. G. 2004. The Effects of School Climate on Changes in Aggressive and Other Behaviors Related to Bullying. In D. L. Espelage & S. M. Swearer (Eds.), Bullying in American schools: A social-ecological perspective on prevention and intervention (pp. 187–210). Lawrence Erlbaum Associates Publishers.
2. Sawyer AM, Borduin CM, Dopp AR. Long-term effects of prevention and treatment on youth antisocial behavior: A meta-analysis. Clin Psychol Rev. 2015 Dec ;42 :130-44. doi: 10.1016/j.cpr.2015.06.009. Epub 2015 Jun 29. PMID : 26197725.
3. The Global Action for Measurement of Adolescent health (GAMA). Geneva : World Health Organization; 2024 https://www.who.int/groups/the-global-action-for-measurement-of-adolescent-health, consulté le 2 février 2024.
4. État de la population mondiale 2023 - Huit milliards d’humains, un horizon infini de possibilités : Défendre les droits et la liberté de choix. New York : Fonds des Nations Unies pour la population ; 2023 (https://www.un-ilibrary.org/content/books/9789210027144)
5. Orpana H, Vachon J, Dykxhoorn J, McRae L, Jayaraman G. Monitoring positive mental health and its determinants in Canada : the development of the Positive Mental Health Surveillance Indicator Framework. Health Promot Chronic Dis Prev Can. 2016 Jan ;36(1) :1-10. doi: 10.24095/hpcdp.36.1.01. PMID : 26789022 ; PMCID : PMC4939463.
6. Schotanus-Dijkstra M, Ten Have M, Lamers SMA, de Graaf R, Bohlmeijer ET. The longitudinal relationship between flourishing mental health and incident mood, anxiety and substance use disorders. Eur J Public Health. 2017 Jun 1 ;27(3):563-568. doi: 10.1093/eurpub/ckw202. PMID : 27818372.
7. Diener, E., Tay, L., & Myers, D. G. 2011. The religion paradox: If religion makes people happy, why are so many dropping out? Journal of Personality and Social Psychology, 101(6), 1278–1290. https://doi.org/10.1037/a0024402
8. Shaffer-Hudkins, E., Suldo, S., Loker, T., & March, A. 2010. How adolescents' mental health predicts their physical health: Unique contributions of indicators of subjective well-being and psychopathology. Applied Research in Quality of Life, 5(3), 203-217. https://doi.org/10.1007/s11482-010-9105-7 APA PsycNET
9. Sanawai D. 2024. Accompagnement psychosocial et résilience des adolescents victimes de conflit intercommunautaire Arabe Choa Mousgoum à Logone Birni. ESI Preprints. https://doi.org/10.19044/esipreprint.8.2024.p413
10. Fazel M, Patel V, Thomas S, Tol W. Mental health interventions in schools in low-income and middle-income countries. Lancet Psychiatry. 2014 Oct;1(5):388-98. doi: 10.1016/S2215-0366(14)70357-8. Epub 2014 Oct 7. PMID: 26361001.
11. Organisation mondiale de la santé. Compétences de base en santé et développement de l’adolescent pour les prestataires de soins primaires et outil pour évaluer le volet « santé et développement de l’adolescent » dans la formation initiale des prestataires de soins de santé www.who.int/maternal_child_adolescent/documents/core_competencies/fr/, last accessed Feb 8th 2025.
12. Goldenring JM, Rosen DS. Getting into adolescent heads: an essential update. Contemp Pediatr 2004 ;21:64–9.
13. Klein D, Goldenring JM, Adelman WP. http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/content/tags/adolescent-medicine/heeadsss-30-psychosocial-interview-adolesce?page=full, last accessed Feb 8th 2025.
14. Goodman R, Gledhill J, Ford T. Child psychiatric disorder and relative age within school year: Cross sectional survey of large population sample. BMJ 2003 ;327 :472.
15. Crawford C, Dearden L, Greaves E. Does when you are born matter? The impact of month of birth on children’s cognitive and non-cognitive skills in England. London: Institute for Fiscal Studies; 2011.
16. Lien L, Tambs K, Oppedal B, et al. Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway. BMC Public Health 2005 ;5 :102e9.
17. Chen MH, Lan WH, Bai YM, et al. Influence of relative age on diagnosis and treatment of attention-deficit hyperactivity disorder in Taiwanese children. J Pediatrics. 2016 ; 172 : 162-167 e161
18. Olympia L K Campbell, David Bann, Praveetha Patalay,The gender gap in adolescent mental health: A cross-national investigation of 566,829 adolescents across 73 countries, SSM - Population Health, Volume 13, 2021,100742, ISSN 2352-8273, https://doi.org/10.1016/j.ssmph.2021.100742.
19. Berg, B., & Kelly, R. 1979. The measured self-esteem of children from broken, rejected, and accepted families. Journal of Divorce, 2,363-369
20. Emery, R. E. 1982. Interparental conflict and the children of discord and divorce, Psychological Bulletin, 92,310-330.
21. Grych, J. H., dr Fincham, F. D, 1990. Marital conflict and children's adjustment: A cognitive contextual framework. Psychological Bulletin, 108, 267-290.
22. Smetana, J. G. 1995. Parenting styles and conceptions of parental authority during adolescence. Child Development, 66(2), 299–316. https://doi.org/10.2307/1131579
24. School Violence and Bullying - Global Status Report. Publié en 2017 par l’Organisation des Nations Unies pour l’éducation, la science et la culture ; ISBN 978-92-3-200107-8 REV
25. Meguieze C A, Ngole A N N, Nseme E G E, Koki N P O. Factors associated with psychoactive drugs initiation among adolescents in Yaoundé - Cameroon. Pediatr Oncall J. 2025;22. doi: 10.7199/ped.oncall.2025.20
26. Grant, B.F., F.S. Stinson, D.A. Dawson, P. Chou, M.C. Dufour, W. Compton, R.P. Pickering et K. Kaplan. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders, Archives of General Psychiatry, vol. 61, 2004, p. 807–816.
27. Clarke, V., Goddard, A., Wellings, K. et al. Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study. Soc Psychiatry Psychiatr Epidemiol 58, 1777–1793. 2023. https://doi.org/10.1007/s00127-021-02127-4
28. Christophe Léon, Emmanuelle Godeau, Stanislas Spilka, Ingrid Gillaizeau, François Beck. La santé mentale et le bien-être des collégiens et lycéens en France hexagonale : Résultats de l’Enquête nationale en collèges et en lycées chez les adolescents sur la santé et les substances. EnCLASS 2022, Santé publique France. 2024, pp.17. ⟨hal-04790436⟩
29. Côté, L., Pronovost, J. & Ross, C. 1990. Étude des tendances suicidaires chez des adolescents de niveau secondaire. Santé mentale au Québec, 15(1), 29–45. https://doi.org/10.7202/031540ar
30. C. Kayser, E. Jaunay, M. Giannitelli, E. Deniau, J. Brunelle, O. Bonnot, A. Consoli, J.-M. Guilé, D. Cohen. Facteurs de risque psychosociaux et troubles psychiatriques des jeunes pris en charge par l’aide sociale à l’enfance et ayant recours à des soins hospitaliers. Neuropsychiatrie de l'Enfance et de l'Adolescence, Volume 59, Issue 7, 2011, pages 393-403, ISSN 0222-9617, https://doi.org/10.1016/j.neurenf.2011.07.001.