MHM Magazine

6 | MENTAL HEALTH MATTERS | 2023 | Issue 2 MHM Introduction Teenage pregnancy and attention deficit hyperactivity disorder (ADHD) are two major challenges afflicting young South Africans, resulting in serious consequences for society and those affected. This article explores the causes and consequences of teenage pregnancy and ADHD in South Africa and the efforts being made to address these challenges. The World Health Organization’s annual figures indicate that 21 million girls, aged 15-19, become pregnant in low and middle-income countries, and 12 million give birth each year. Adolescent girls younger than 15 produce 777,000 births. Sub-Saharan Africa (the high fertility countries) shows consistently high rates of teenage pregnancy. SA has one of the highest rates globally with 30% of girls falling pregnant before the age of 18, thus posing serious health consequences for both mother and child. One study found increases of 48% in SA teenage pregnancy in younger adolescents (aged 10-14 years) and an increase of 17% for those aged 15–19 years. ADHD is a global neurodevelopmental disorder where a continuous pattern of inattentiveness and/hyperactivity-impulsiveness occurs, and interferes with the development, or daily functioning of the person. ADHD has three categories or types: mainly hyperactive and impulsive, mainly inattentive, and a combined type. ADHD is also linked to poor social, academic, occupational and health related functioning. The global figure for the prevalence of ADHD in children and adolescents is estimated at 5.3%. In SA the prevalence of ADHD among children across all ethnic groups in the Limpopo province is 5%. The Adolescent phase and ADHD Adolescence is a challenging phase. Adolescents with ADHD face extra challenges, as puberty worsens their ADHD symptoms. This combination hinders adolescents’ executive functions - therefore, risky impulsivity could be activated. Furthermore, adolescents face: transitional milestones like exploring and engaging in sexual activity, forming peer relations, experimenting with cigarettes, substances, drugs, and learning to drive a car. Therefore, many families, experience the adolescent phase, as a challenging period. The Centre for Disease Control (CDC) in 2022 found that approximately half of those with ADHD had a behaviour or conduct disorder, predisposing them to risk taking. Approximately 3 in 10 children aged 3-17 with ADHD also suffered with anxiety. Disturbingly, many cases go undiagnosed and untreated. Thus, if ADHD is not properly diagnosed and treated, it can have long- term negative effects on the individual’s mental health and well-being. Consequently, SA teenage pregnancy and ADHD are two major, interlinked, health concerns. As previously mentioned, SA has one of the highest rates of teenage pregnancy globally, i.e., 73 per 1,000 women aged 15–19. The prevalence of pregnancy increased with age, with rates for 19-year-old pregnant women at nearly 7%. Link between ADHD, risk behaviour and teenage pregnancy ADHD is associated with sexual risk-taking behaviour. Childhood ADHD is linked to earlier sexual activity, more sexual partners, more sexual encounters outside of a stable, monogamous relationship, higher levels of sexually transmitted diseases, more pregnancies or partner pregnancies, and teenage parenthood. Globally, adolescents with ADHD have increased risk of early pregnancy compared to non-ADHD adolescents. The long-term use of ADHDmedication was linked to a lower risk of early pregnancy. For individuals with ADHD, both genders engage in risky, sexual behaviours, with substantially more risk for females. ADHD sufferers are more disorganised in daily activities, hence more prone to inconsistent contraception and condom use. Miché Moodley Psychometrist The Goldilocks and the Bear Foundation, Cape Town ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) AND TEENAGE PREGNANCY IN SOUTH AFRICA