A new systematic review of 172 studies including data of more than 12 million adolescents in 166 countries reveals that, although transnational mental health research of adolescents, including low and intermediate income countries, has widened, large lakes remain in global representation.
The systematic review, led by an international research team led by the Child of Psychiatry Research Center The University of Turku, Finland, noted that the inclusion of low and intermediate income countries (LMIC) in transnational research has increased considerably in the past 30 years, in particular since 2020. However, 52 countries have not been included in any of the 172 studies examined.
Most research is strongly based on cross -country school surveys with self -depressed questionnaires. The most commonly used international surveys were the study of health behavior in school -age children (19.8%), the Global School Student Health Survey (12.2%) and the international student evaluation program (8.1%).
The journal reveals that, although the problems of intimidation and internalization, such as anxiety and depression, are commonly studied, exteriorization behaviors as aggression are often neglected. While the prevalence of most mental and psychosocial health problems were comparable or mixed between PRFR and high -income countries, traditional intimidation has been reported more frequently in PRFR in the majority of studies examined.
Western standards pose methodological challenges for world mental health research
The main authors, the doctoral researcher Xiao Zhang and the postdoctoral researcher Yuko Mori, highlight a major methodological challenge revealed by the journal.
“Many commonly used tools have been initially developed on the basis of Western mental health constructions.
Professor Andre Surander, director of the research center for child psychiatry, agrees that our understanding of the mental health of adolescents is still based on the results of research in Western or high income.
Global trends, such as increased inequality, migration and climate change, emerging threats, such as war and pandemics, and extremely increased use of digital devices can have harmful effects on the well-being of adolescents in the world. Intercultural research on the mental health of adolescents, including various companies, minorities and risk groups, is very relevant and justified, especially since 90% of the world’s population of adolescents resides in low -income and intermediate income countries. “”
Professor Andre Surander, Director of the Child Psychiatry Research Center
Researchers highlight the importance of creating and validating their own culturally anchored instruments in LMIs, which could also enrich mental health research in high -income countries by offering more inclusive and applicable assessment frameworks. Future studies, they support, should use validated tools, use several sources of informants and rely on representative samples which include minority populations, such as adolescents from immigrants, people with disabilities and indigenous groups.
This systematic review was funded by the Invest flagship program of the Research Council of Finland and the European Research Council within the framework of the European Union research and innovation program.
The journal entitled “Transnational research on the mental health of adolescents: a systematic review comparing research in low, average and high income countries” was published in the journal BMJ Global Health the 25 July 2025.
