Mental health and nutritional issues: a dual burden among adolescent school going girls of urban and rural Jodhpur

Varsha Joshi, Naveen Kikkeri Hanumantha Setty, Nitin Kumar Joshi, Yogesh Kumar Jain, Pankaj Bhardwaj, Kuldeep Singh


Background: Adolescents constitute 21% of the total population in India. Untreated mental disorders affect a person’s potential to live a fulfilling life and raises the possibility of conduct disorders. Moreover, malnutrition leads to growth retardation and sexual maturation in later life. Thus, this study was undertaken to understand the role of family size, socio-economic status, marital status on mental and nutritional health of adolescent girls in urban and rural Jodhpur.

Methods: A descriptive cross-sectional study in three schools each from rural and urban Jodhpur was conducted to include adolescent girls aged 10-19 years. Semi-structured questionnaire was administered to collect demographic and socio-economic data along with DASS-21 and SMFQ for mental health assessment and BMI, waist-hip ratio collected for nutritional health.

Results: Depression score ≥10 was observed in 34.3% girls (significantly associated with monthly attendance), anxiety score ≥10 observed in 64.8% (associated with socio-economic class and monthly attendance) and stress score ≥10 observed in 26.2% (associated with monthly attendance). Th e17.4% were thin while 4.7% overweight, significantly associated with location, age group and socio-economic class. The 5% were at increased metabolic risk, associated with non-participation in extra-curricular activities.

Conclusions: The study indicated high prevalence of depression, anxiety and stress, nutritional imbalance and risk of metabolic disorders at an early age, that were significantly associated with the low monthly attendance indicating negative impact of such factors on regular education and academic growth. The findings highlight a greater emphasis needed on mental health and nutritional components during the active growth years of adolescent females.


Adolescent, Female, Cross-sectional study, Mental health, Nutritional status, Malnutrition

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WHO South-East Asia. World Health Organization. Available at: Accessed on 4 September 2021.

World Health Organization‎. Health for the world's adolescents: a second chance in the second decade: summary. World Health Organization. 2014. Available at: Accessed on 4 September 2021.

WHO South-East Asia. World Health Organization. 2021. Available at: Accessed on 4 September 2021.

RBSK Strategy Handbook. 1st ed. Ministry of Health and Family Welfare; 2014. Available at: Accessed on 4 September 2021.

Jain YK, Joshi NK, Bhardwaj P, Singh K, Suthar P, Joshi V. Developing a health-promoting school using knowledge to action framework. J Edu Health Promot. 2021;10:306.

Jain YK, Joshi NK, Bhardwaj P, Suthar P. Health-promoting school in India: Approaches and challenges. J Family Med Prim Care. 2019;8:3114-9.

Child and adolescent mental and brain health. Available at: Accessed on 4 September 2021.

UNICEF DATA - Child Statistics. UNICEF DATA. Available at: Accessed on 4 September 2021.

Adolescent mental health. 2020. Available at: Accessed on 4 September 2021.

Mukolo A, Heflinger CA, Wallston KA. The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry. 2010;49(2):92-103.

National Mental Health Survey. 2016. Available at: Accessed on 4 September 2021.

Murthy RS. National Mental Health Survey of India 2015-2016. Indian J Psychiatry. 2017;59(1):21-6.

Malnutrition. 2020. Available at: Accessed on 4 September 2021.

UNICEF in India. Available at: Accessed on 4 September 2021.

Bhattarai S, Bhusal CK. Prevalence and associated factors of malnutrition among school going adolescents of Dang district, Nepal. AIMS Public Health. 2019;6(3):291-306.

Sivagurunathan C, Umadevi R, Rama R, Gopalakrishnan S. Adolescent Health: Present Status and Its Related Programmes in India. Are We in the Right Direction? J Clin Diagn Res JCDR. 2015;9(3):LE01-6.

Adolescent Demographics-UNICEF DATA. UNICEF DATA. 2019. Available at: Accessed on 4 September 2021.

Jha KK, Singh SK, Nirala SK, Kumar C, Kumar P, Aggrawal N. Prevalence of Depression among School-going Adolescents in an Urban Area of Bihar, India. Indian J Psychol Med. 2017;39(3):287-92.

Trivedi D, Dhakappa N, Ghildiyal P, Deekonda S, Subramaniam S, Iyer JS et al. Depression among adolescent students in South India: How serious is the issue? Indian J Psychiatry. 2016;58(3):349-50.

Madasu S, Malhotra S, Kant S, Sagar R, Mishra AK, Misra P et al. anxiety disorders among adolescents in a rural area of northern India using Screen for Child Anxiety-Related Emotional Disorders tool: A Community-based Study. Indian J Community Med. 2019;44:317-21.

Farooq SA, Muneeb A, Ajmal W. Quality of Life Perceptions in School-Going Adolescents with Social Anxiety. J Child Dev Disord. 2017;3:2.

Wahab S, Rahman FNA, Hasan WMHW, Zamani IZ, Arbaiei NC, Khor SL et al. Stressors in secondary boarding school students: Association with stress, anxiety and depressive symptoms. Asia-Pac Psychiatry. 2019;5(S1):82-9.

Watode BK, Kishore J, Kohli C. Prevalence of Stress among School Adolescents in Delhi. 2015;2:4-9.

Deshmukh PR, Gupta SS, Bharambe MS, Dongre AR, Maliye C, Kaur S et al. Nutritional status of adolescents in rural Wardha. Indian J Pediatr. 2006;73(2):139-41.

Choudhary S, Mishra CP, Shukla KP. Nutritional status of adolescent girls in rural area of varanasi. 2005;34:9.

Shahabuddin AK, Talukder K, Talukder MK, Hassan M, Seal A, Rahman Q et al. Adolescent nutrition in a rural community in Bangladesh. Indian J Pediatr. 2000;67(2):93-8.