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Mental health problems in Kosovar adolescents: results from a national mental health survey

Psychische Gesundheitsprobleme bei Kosovarischen Jugendlichen: Ergebnisse aus einem nationalen Survey zur psychischen Gesundheit



Our purpose was to determine the effects of gender and age on Kosovar YSR scores and the prevalence of self-reported behavioral/emotional problems in Kosovar adolescents based on scores above a cutpoint.


Participants were 1351 adolescents recruited from secondary schools in seven regions of Kosova who completed the Youth Self-Report.


The oldest adolescents had the highest scores on many YSR scales. Although Kosova’s mean problems scores were not elevated relative to international norms, the percentage of adolescents scoring in the deviant range (borderline + clinical) was much higher than expected for almost all YSR problem scales, including Total Problems (31.2 %), Internalizing (40.8 %), and Externalizing (23.4 %). The 23 % prevalence of elevated scores on Stress Problems was triple the expected 7 % prevalence based on a 93rd percentile cutpoint.


Results revealed much higher prevalence of psychopathology than would be expected based on international norms, with 25–40 % of Kosovar adolescents scoring in the deviant range on YSR scales, Thus, our research indicates a need for expanding psychiatry services to meet the pressing mental health needs of Kosovar adolescents as well as the importance of considering mental health problems in their social context.



Der Zweck der vorliegenden Studie war, den Einfluss von Geschlecht und Alter auf die Scores des „Youth-Self-Report“ Fragebogens (YSR) bei Jugendlichen im Kosovo zu untersuchen und auf diese Weise die Prävalenz subjektiv berichteter psychischer Probleme zu erfassen.


1351 Jugendliche mittlerer und höherer Schulen in sieben Regionen des Kosovo wurden mittels des „Youth-Self-Report“ Fragebogens untersucht.


Die ältesten Jugendlichen zeigten in vielen YSR-Skalen die höchsten Werte. Obwohl die mittleren Problem-Scores im Kosovo nicht höher als die internationalen Normen waren, war der prozentuelle Anteil der Jugendlichen, die über den Cut-Off-Werten lagen, in nahezu allen Problembereichen höher als erwartet. Dies traf auch für die Gesamtprobleme (31,2 %), Internalisieren (40,8 %) und Externalisieren (23,4 %) zu. Die in der vorliegenden Studie gefundene Prävalenz von 23 % für erhöhte Stressprobleme ist das Dreifache der zu erwartenden Prävalenz von 7 % (basierend auf dem 93-Perzentil-Grenzwert).


Die Prävalenz psychopathologischer Auffälligkeiten war deutlich höher als aufgrund internationaler Daten zu erwarten gewesen wäre. Insgesamt zeigten 25–40 % des Jugendlichen im Kosovo Werte über dem Cut-Off in den YSR-Skalen. Die vorliegende Studie zeigt also den Bedarf an einer Ausweitung Kinder- und Jugend-psychiatrischer Dienste und Einrichtungen im Kosovo. Die Ergebnisse sind außerdem ein Hinweis, wie wichtig es ist, den sozialen Kontext psychischer Probleme zu berücksichtigen.

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  1. 1

    Achenbach TM. Integrative guide for the 1991 CBCL/4-18, YSR and TRF profiles. Burlington: Department of Psychiatry, University of Vermon; 1991.

    CAS  Article  PubMed  Google Scholar 

  2. 2

    Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont. Research Center for Children, Youth, and Families; 2001.

  3. 3

    Achenbach T M, Rescorla L, A. Multicultural understanding of child and adolescent psychopathology. Implication for mental health assessment. New York: The Guilford Press; 2007.

  4. 4

    Barkmann C, Schulte-Markwort M. Emotional and behavioral problems of children and adolescents in Germany–an epidemiological screening. Soc Psychiatry Psychiatr Epidemiol. 2005;40:357–66.

    Article  PubMed  Google Scholar 

  5. 5

    Belfer ML. Global child health. J Paediatr Child Health. 2013;49(9):E355 -6. doi: 10.1111/jpc.12226.

    Article  PubMed  Google Scholar 

  6. 6

    Boricevic MV, Aukst MB, Jukic V, Matko V,Grgic, V. Self-reported emotional and behavioral symptoms, parent-adolescent bonding and family functioning in clinically referred adolescent offspring of Croatian PTSD war veterans. Eur Child Adolesc Psychiatry. 2014;23:295–306.

    Article  Google Scholar 

  7. 7

    Clarke GN, Hornbrook M, Lynch F, Polen M, Gale J, Beardslee W, et al. A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Arch Gen Psychiatry. 2001;58:1127–34.

    CAS  Article  PubMed  Google Scholar 

  8. 8

    Cohen J. Statistical power analysis for the behavioral sciences 2. edn. Hillsdale:Erlbaum; 1988.

  9. 9

    Copeland WE, Keeler G, Angold A, Costello EJ. Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry. 2007;64:577–84.

    Article  PubMed  Google Scholar 

  10. 10

    Essex MJ, Kraemer HC, Armstrong JM, Boyce WT, Goldsmith HH, Klein MH, et al. Exploring risk factors for the emergence of children’s mental health problems. Arch Gen Psychiatry. 2006;63:1246–56.

    Article  PubMed  Google Scholar 

  11. 11

    Feldt LS. A test of the hypothesis that Cronbach’s alpha or Kuder-Richardson coefficient twenty is the same for two tests. Psychometrika. 1969;34:363–73.

    Article  Google Scholar 

  12. 12

    Helstela L, Sourander A. Self-reported competence and emotional and behavioral problems in a sample of Finnish adolescents. Nord J Psychiatry. 2001;55:381–5.

    CAS  Article  PubMed  Google Scholar 

  13. 13

    Kraja E, Konjufca J, Berbatovci A, Ahmeti A, Shahini M. Internalizing and externalizing problems in children of war veterans in Kosovo. Iliria Int Rev. 2015 (in press).

  14. 14

    Lopes CB, Vergara A, Agani F, Gotway CA. Mental health, social functioning, and attitudes of Kosovar Albanians following the war in Kosovo. JAMA. 2000;284:569–77.

    Article  Google Scholar 

  15. 15

    Lopes CB, Kaiser R, Gotway CA, Agani F. Mental health, social functioning, and feelings of hatred and revenge of Kosovar Albanians one year after the war in Kosovo. J Trauma Stress. 2003;16:351–60.

    Article  Google Scholar 

  16. 16

    Pejovic-Milovancevic M, Miletic V, Anagnostopoulos D, Raleva M, Stancheva V, Burgic-Radmanovic M, Barac-Otasevic Z, Ispanovic V. Management in child and adolescent psychiatry: how does it look in the Balkans? Psychiatriki. 2014;25(1):48–54.

    CAS  PubMed  Google Scholar 

  17. 17

    Philipp J, Zeiler M, Waldherr K, Nitsch M, Dur W, Karwautz A, et al. The Mental Health in Austrian Teenagers (MHAT)-Study: preliminary results from a pilot study. Neuropsychiatr. 2014;28:198–207.

    Article  PubMed  Google Scholar 

  18. 18

    Rescorla L, Achenbach TM, Ivanova MY, Dumenci L, Almqvist F, Bilenberg N, et al. Epidemiological comparisons of problems and positive qualities reported by adolescents in 24 countries. J Consult Clin Psychol. 2007;75:351–8.

    Article  PubMed  Google Scholar 

  19. 19

    Rescorla L, Ginzburg S, Achenbach TM, Ivanova MY, Almquist F, Verhulst, FC, et al. Cross informant agreement between parent-reported and adolescent self-reported problems in 25 societies. J Clin Child Adolesc Psychol. 2013;42(2):262–273. doi:10.1080/15374416.2012.717870. (Published online: 25 Sep 2012).

    Article  PubMed  Google Scholar 

  20. 20

    Rudan V, Begovac I, Szirovocza L, Filipović O, Skočic M. The Child Behavior Checklist, Teacher Report Form, and Youth Self Report problem scales in a normative sample of Croatian children and adolescents aged 7–18. Coll Anthropol. 2005;29(1):17–26.

    Google Scholar 

  21. 21

    Schick M, Morina N, Klaghofer R, Schnyder U, Muller J. Trauma, mental health, and intergenerational associations in Kosovar families 11 years after the war. Eur J Psychotraumatol. 2013 Aug 13;4. doi: 10.3402/ejpt.v4i0.21060. eCollection 2013.

  22. 22

    Schubert EW, Henriksson KM, McNeil TF. A prospective study of offspring of women with psychosis: visual dysfunction in early childhood predicts schizophrenia-spectrum disorders in adulthood. Acta Psychiatr Scand. 2005;112:385–93.

    CAS  Article  PubMed  Google Scholar 

  23. 23

    Selimbasic Z, Sinanovic O, Avdibegovic E. Psychosocial problems among children of parents with posttraumatic stress disorder. Med Arch. 2012;66:304–8.

    Article  PubMed  Google Scholar 

  24. 24

    Shahini M, Rescorla LA, Ahmeti AP, Begovac I, Dobrean A, Markovic J, et al. Parent-reported behavioural and emotional problems in Albanian Kosovar children. Epidemiol Psychiatr Sci. 2015; 24(3):266-73. doi: 10.1017/S204579601400016X. Epub 2014 Apr 4.

    CAS  Article  PubMed  Google Scholar 

  25. 25

    Skre I, Onstad S, Edvardsen J, Torgersen S, Kringlen E. A family study of anxiety disorders: familial transmission and relationship to mood disorder and psychoactive substance use disorder. Acta Psychiatr Scand. 1994;90:366–74.

    CAS  Article  PubMed  Google Scholar 

  26. 26

    Wenzel T, Rushiti F, Aghani F, Diaconu G, Maxhuni B, Zitterl W. Suicidal ideation, post-traumatic stress and suicide statistics in Kosovo. An analysis five years after the war. Suicidal ideation in Kosovo. Torture. 2009;19:238–47.

    CAS  PubMed  Google Scholar 

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Conflict of Interest

M. Shahini, L. Rescorla, J. Wancata, and A. Adelina declare that there are no actual or potential conflicts of interest in relation to this article.

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Correspondence to Mimoza Shahini PhD.

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Shahini, M., Rescorla, L., Wancata, J. et al. Mental health problems in Kosovar adolescents: results from a national mental health survey. Neuropsychiatr 29, 125–132 (2015).

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  • Jugendliche
  • Psychische und Verhaltensprobleme
  • Prävalenz
  • Kosovo


  • Adolescence
  • Emotional and behavioral problems
  • Prevalence
  • Kosova