Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria

Abstract

Background This study determined the association between mental health and risky oral health and sexual health behaviours. Methods A household cross-sectional survey was conducted in Ile-Ife, Nigeria between December 2019 and January 2020. Data were collected from 10 to 19-year-old on the sociodemographic profile (age, sex at birth and socioeconomic status); mental health problems (psychological distress, depressive symptoms and suicidal ideation); and mental (smoking habit, consumption of alcohol, use of psychoactive substances), sexual (history of vaginal or anal sexual intercourse; transactional sex, multiple sex partners, use of condom at last sexual intercourse) and oral (frequency of daily tooth brushing, daily frequency of consumption of refined carbohydrate in-between-meals, frequency of use of dental floss, history of dental service utilization in the last 12 months and dental anxiety) health risk factors. Binary logistic regression analysis was conducted to determine the association between risky oral (neglecting to brush twice daily and frequent consumption of refined carbohydrates in-between-meals), and sexual (neglecting to use condoms during the last sex act and having multiple sex partners) health behaviours as outcome variables, and mental health status as the explanatory variables. An ordinal logistic regression model was also developed where the outcome variable was the number of risky health behaviours. The models were adjusted for the socio-demographic variables and history of dental service utilisation in the last 12 months of the survey. Results High psychological distress was significantly associated with lower odds of frequent consumption of refined carbohydrates in-between-meals (AOR = 0.32; 95%CI 0.23, 0.47), and having multiple sex partners (AOR = 0.10; 95%CI 0.02, 0.57); but higher odds of having a higher number of risky behaviours (AOR = 3.04; 95%CI 2.13, 4.33). Having depressive symptoms was significantly associated with higher odds of neglecting to use condom at the last sexual intercourse (AOR = 7.20; 95%CI 1.94, 26.76) and having multiple partners (AOR = 95.43; 95%CI 24.55, 370.90). Suicidal ideation was significantly associated with lower odds of neglecting to use condom at the last sexual intercourse (AOR = 0.00; 95%CI 0.00, 0.00) and having multiple sex partners (AOR = 0.00; 95%CI 0.00, 0.00). Conclusion The associations between psychological distress and oral and sexual health risk behaviours in adolescents seem complex and need to be studied further.

Examining the relationship between risky sexual behavior and suicidal thoughts among unmarried adolescents in India

“…Based on the previous literature, five risky sexual behaviors were selected for this study. (1) More than one sexual partner 32 : the question on the number of sexual partners was: “In all, how many boyfriends have you had in the last 3 years?” and was recoded as “one or no” and “more than one”. (2) The early sexual debut: it was created using the question on age at first sex among unmarried adolescents; that is, adolescents who experienced their first sexual intercourse before 18 years of age were coded as 1 representing early sexual debut and 0 otherwise 32 .…”

“…(3) Sexually active: it was recoded as “yes” and “no”. (4) Contraceptive use: it was recoded as “yes” and “no” 32 . (5) Watching pornography: it was recoded as “yes” and “no”.…”

“…Risky sexual behaviour among adolescents includes early sexual debut, unprotected sexual activity, inconsistent use of condoms, high-risk partners (e.g. injection drug users, survival sex [sex in exchange for money, drugs, food, or shelter]), or sex with more than one partners or with partner who has other partners or more than one partner at a time 31 , 32 . Risky sexual behaviour is also an important aspect related to sexuality which increases the susceptibility of an individual to his/her problems related to sexuality and reproductive health, unwanted and unplanned pregnancy, abortion, and psychological distress 33 – 35 .…”

The association between adolescent mental health and oral health behavior: The Luxembourg Health Behavior in School-Aged Children study

“…However, contrasting results have been reported. Loneliness, suicidal ideation, sadness, and anxiety were not related to regular toothbrushing among African and Asian adolescents (14)(15)(16)(17).…”

“…The World Health Organization (WHO) recommends toothbrushing twice daily with fluoride-containing toothpaste (2, 12). Poor mental health, including anxiety, no close friends, loneliness, depression, symptoms of post-traumatic stress disorder, suicidal ideation and suicide attempt, has been related to irregular toothbrushing among adolescents (13)(14)(15)(16)(17)(18). However, contrasting results have been reported.…”