Mental health in adolescents: a first study on the prevalence and associated factors of self-injurious thoughts, behaviours, and psychosocial challenges in Paraguay.

Adolescent mental health remains an underexplored area in Paraguay despite its significant implications for public health. This study investigated the prevalence of self-injurious thoughts and behaviours as well as the associated psychosocial and demographic factors among Paraguayan adolescents. A cross-sectional study was conducted with 535 adolescents aged 12-18 years from Asunción and the Central Department, using validated instruments, including the PHQ-2 for depression, GAD-7 for anxiety, APCTSS for post-traumatic stress, and SDQ for emotional and behavioural issues. The findings revealed alarmingly high prevalence rates of anxiety (40.6%), depression (50.3%), and PTSD (64.5%), with females being disproportionately affected. Non-suicidal self-injury was reported by 30.5% of participants, with significantly higher rates among females. Factors such as bullying, loneliness, and food insecurity were strongly associated with self-harm and suicidal ideation. Logistic regression analysis identified female sex, depression, anxiety, and experiences of bullying as key predictors of self-injurious behaviours. These results highlight the urgent need for school-based mental health interventions, gender-sensitive policies, and trauma-informed care to mitigate the burden of adolescent mental-health disorders in Paraguay. Future studies should explore longitudinal trends and targeted prevention strategies to address this pressing public health concern.