Child and Adolescent Mental Disorders in Bangladesh: Prevalence, Associated Factors, and Treatment Gap from a Nationwide Household Survey

Background: Mental disorders among children and adolescents represent a major public health concern, yet population-based evidence from low- and middle-income countries remains limited. This study aimed to estimate the prevalence, associated factors, and treatment gap of mental disorders among children and adolescents aged 7–17 years in Bangladesh using nationally representative data. Methods: A nationwide household survey was conducted in 2019, where a total of 2246 children were assessed through a two-stage process. In the first stage, caregivers completed the World Health Organization’s Reporting Questionnaire for Children (RQC) to identify potential psychiatric cases. In the second stage, children who screened positive underwent clinical evaluation by a psychiatrist, with diagnoses made using the DSM-5 criteria. Multivariable logistic regression analyses were performed to identify associations between mental disorders and various child, parental, and household characteristics, adjusting for all sociodemographic variables simultaneously. Results: The overall weighted prevalence of mental disorders was 12.6% (95% confidence interval [CI]: 10.9–14.5). Neurodevelopmental disorders were the most prevalent (5.2%), followed by anxiety disorders (4.5%) and disruptive, impulse-control, and conduct disorders (1.6%). After multivariable adjustment, a family history of mental illness remained significantly associated with neurodevelopmental disorders (aOR = 3.02, P = .012). Disruptive, impulse-control, and conduct disorders were substantially more common among early adolescents (aOR = 1.93, P = .003) and middle adolescents (aOR = 4.93, P = .042) compared to children aged 7–9 years. No sociodemographic factors demonstrated a statistically significant association with depressive and anxiety disorders. The treatment gap was substantial, as only 5.5% of affected children and adolescents had received any form of care. Conclusions: National mental health strategies in Bangladesh should prioritize early detection and intervention for neurodevelopmental and anxiety disorders among children and adolescents, emphasizing integration of mental health services into primary care and school-based programs to address the high burden.