Trends and factors associated with mental health problems among children and adolescents in Malaysia

Figures & data

Table 1. Sociodemographic profiles of the respondents, NHMS 1996, NHMS 2006 and NHMS 2011.

	NHMS 1996	NHMS 2006	NHMS 2011
Variable	N (%)	N (%)	N (%)
Sex
Male	7370 (51.5)	7217 (51)	3278 (51.2)
Female	6929 (48.5)	6939 (49)	3130 (48.8)
Age group (years)
5–6	4189 (28.8)	2737 (19.3)	1069 (16.7)
7–9	2945 (20.2)	3980 (28.1)	1835 (28.6)
10–12	6435 (44.2)	4036 (28.5)	1800 (28.1)
13–15	980 (6.8)	3403 (24)	1704 (26.6)
Ethnicity
Malay	7725 (53.8)	8691 (61.4)	4077 (63.6)
Chinese	2601 (18.2)	2069 (14.6)	939 (14.7)
Indian	831 (5.8)	1006 (7.15)	431 (6.7)
Other Bumiputra	2692 (18.7)	1962 (13.9)	739 (11.5)
Other	509 (3.5)	428 (3.0)	222 (3.5)
Locality
Urban	7783 (51.1)	7702 (54.4)	3588 (56)
Rural	7440 (48.9)	6454 (45.6)	2820 (44)
Caregiver's highest education level
No formal education	83 (1.4)	493 (3.5)	168 (4.5)
Primary education	2452 (16.1)	2001 (14.1)	737 (19.9)
Secondary education	2512 (16.5)	3822 (27)	1880 (50.8)
Tertiary education	706 (12.3)	3403 (24.0)	836 (22.6)
Caregiver's marital status
Not married	89 (1.3)	167 (1.3)	67 (1.1)
Married	6032 (91.5)	11927 (92.3)	5348 (91.2)
Divorcee/widow/widower	470 (7.1)	823 (6.4)	450 (7.7)
Household income by quartile^a
Quartile 1	1459 (25.1)	3438 (24.3)	1602 (25)
Quartile 2	1490 (25.6)	3423 (24.2)	1609 (25.1)
Quartile 3	1552 (26.7)	3423 (24.2)	1599 (25)
Quartile 4	1308 (22.5)	3425 (24.2)	1598 (24.9)

^a Quartile: quartile 1 represents the lowest quarter; quartile 4, the highest.

Table 2. Prevalence of mental health disorders and rates of increase by sociodemographic profile, NHMS 1996, NHMS 2006 and NHMS 2011.

	NHMS 1996	Rate of increase (%)	NHMS 2006	Rate of increase (%)	NHMS 2011
	(95% CI)	1996 to 2006	% (95% CI)	2006 to 2011	% (95% CI)
Sex
Male	14.1 (12.1–15.9)	+53.2	21.6 (20.4–22.8)*	+0.9	21.8 (21.1–23.7)*
Female	12.1 (10.1–14.1)	+57.0	19.0 (17.9–20.2)	−4.7	18.1 (16.4–20.0)
Age group (years)
5–6	9.7 (7.5–11.9)	+87.6	18.2 (16.7–19.8)	+6.6	19.4 (16.3–23.0)
7–9	12.3 (9.7–14.9)	+54.5	19.0 (17.6–20.4)	−0.5	18.9 (16.4–21.7)
10–12	15.5 (13.4–17.5)	+33.5	20.7 (19.4–22.1)	−9.7	18.7 (16.6–21.1)
13–15	13.4 (9.0–17.9)	+43.3	19.2 (17.7–20.7)	+22.4	23.5 (20.6–26.6)
Ethnicity
Malay	11.9 (9.9–13.9)	+71.4	20.4 (19.3–21.6)	−10.3	18.3 (16.9–19.8)
Chinese	3.6 (0.6–6.6)	+366.7	16.8 (14.7–19.1)	−13.7	14.5 (11.9–17.6)
Indian	24.6 (18.1–31.2)	+8.5	26.7 (22.8–30.9)	+1.9	27.2 (22.1–32.9)
Other Bumiputra	23.6 (20.1–27.1)	−13.1	20.5 (18.0–23.2)	+36.6	28.0 (23.8–32.6)
Other	27.1 (18.3–36.0)	−26.2	20.0 (15.8–25.0)	+76.5	35.3 (25.8–46.1)
Locality
Urban	10.5 (8.4–12.7)	+87.6	19.7 (18.5–21.0)	−2.5	19.2 (17.6–20.9)
Rural	15.5 (13.3–17.7)*	+36.8	21.2 (19.9–22.7)	+2.4	21.7 (19.8–23.8)
Caregiver's highest education level
No formal education	15.4 (10.6–20.0)	−19.5	12.4 (9.6–15.9)	+170.2	33.5 (24.1–44.3)
Primary education	14.9 (14.0–15.7)	+24. 2	18.5 (16.7–20.3)	+57.8	29.2 (25.2–33.6)
Secondary education	13.4 (12.5–14.2)	+62.7	21.8 (20.4–23.2)	+31.2	28.6 (26.0–31.3)
Tertiary education	9.0 (7.7–10.1)	+55.6	14.0 (11.8–16.6)	+52.9	21.4 (18.2–24.9)
Caregiver's marital status
Not married	17.4 (12.5–22.2)	−47.1	9.2 (5.1–16.1)	+115.2	19.8 (9.8–36.0)
Married	13.7 (13.1–14.4)	+45.3	19.9 (18.9–20.9)	+2.0	20.3 (18.6–22.2)
Divorcee/widow/widower	15.5 (13.4–17.5)	+8.4	16.8 (14.0–20.0)	+16.1	19.5 (14.6–25.7)
Household income by quartile^a
Quartile 1	17.2 (16.0–18.4)	+10.5	19.0 (17.2–21.0)	+29.5	24.6 (21.1–28.5)
Quartile 2	14.1 (13.0–15.2)	+50.1	21.2 (19.5–23.1)	−1.4	20.9 (17.9–24.2)
Quartile 3	12.6 (11.4–13.7)	+67.5	21.1 (19.3–22.9)	−9.0	19.2 (16.4–22.2)
Quartile 4	11.3 (10.2–12.4)	+51.3	17.1 (15.6–18.7)	−7.6	15.8 (13.5–18.5)

CI = confidence interval; ^aquartile 1 represents the lowest quarter; quartile 4, the highest; *significant difference (p < 0.05).

Table 3. Factors associated with mental health problems among children, NHMS 2011.

	Crude OR	Wald test	Adjusted OR	p-value
	(95%CI)		(95%CI)
Locality
Urban	1			NS
Rural	1.13 (1.0–1.29)
Sex
Male	1	15.621	1.30 (1.14–1.48)	< .001
Female	1.29 (1.13–1.46)
Ethnicity
Malay	1
Chinese	0.77 (0.62–0.95)	4.555	0.79 (0.65–0.98)	.033
Indian	1.65 (1.30–2.09)	18.500	1.68 (1.33–2.13)	< .001
Other Bumiputra	1.70 (1.40–2.05)	21.703	1.58 (1.31–1.92)	< .001
Other	2.59 (1.92–3.49)	33.220	2.44 (1.80–3.30)	< .001
Household income by quartile^a
Quartile 1 ≤ 680.00	1.64 (1.36–1.96)	15.697	1.46 (1.21–1.76)	< .001
Quartile 2 680.01–1250.00	1.34 (1.11–1.61)	5.187	1.25 (1.03–1.51)	.023
Quartile 3 1250.01–2200.00	1.16 (0.95–1.39)	.922	1.10 (0.91–1.33)	NS
Quartile 4 2200.01+	1
Age group (years)
5–6	1
7–9	0.98 (0.8–1.2)
10–12	1.11 (0.91–1.34)			NS
13–15	1.35 (1.1–1.64)
Guardian's education level
No formal education	1.32 (0.89–1.96)			NS
Primary education	1.51 (1.18–1.91)
Secondary education	1.37 (1.12–1.67)
Tertiary education	1
Guardian's marital status
Not married	1			NS
Married	0.83 (0.45–1.51)
Divorcee/widow/widower	0.85 (0.44–1.63)

OR = odds ratio; NS = not significant; ^aquartile 1 represents the lowest quarter; quartile 4, the highest.