Abstract
Exposure to alcohol misuse is considered an adverse childhood experience impacting on neurodevelopmental and behavioural outcomes in adolescents including substance use, mental illness, problem behaviours, suicidality, and teenage pregnancy. Most research on this issue has focussed on higher income countries, whereas patterns of alcohol use and related factors may be different in low- and middle-income countries (LMICs). This systematic review therefore seeks to collate all published studies from 1990–2020 on the topic set in LMICs. 43 studies were included, totalling 70,609 participants from 18 LMICs. Outcomes assessed included: substance use; depression/anxiety; suicidal ideation; problem behaviour; emotional dysfunction; teenage pregnancy; and self-harm. Despite heterogeneity in the studies identified, this review documented some association between exposure to household alcohol misuse and adverse adolescent outcomes in LMICs, including mental health problems, problem behaviours, and suicidality. The mechanisms leading to these outcomes are likely varied, and further research in different socio-economic and cultural contexts, particularly in the form of longitudinal studies, is called for.
Highlights
Experiences in childhood and adolescence have been shown to have a significant impact on health in later life, primarily based on research from high income countries (HICs) [1, 2]
After filtering with the Cochrane low and middle income countries (LMICs) filter [27], 4437 results were screened by title and abstract. 602 papers were subsequently selected for full text review
This review confirms that, despite the heterogeneity of results, exposure to more than modest household alcohol use seems to be associated with some negative adolescent behavioural outcomes in many lower- and middle-income countries, just as in higher income countries
Summary
Experiences in childhood and adolescence have been shown to have a significant impact on health in later life, primarily based on research from high income countries (HICs) [1, 2]. Some of these consequences become apparent relatively quickly, others develop much later in adult life. The negative association between maternal alcohol exposure in utero and development is well known; exposure can cause foetal alcohol spectrum disorders which include developmental and later mental health problems [7, 8], but the impact of indirect alcohol exposure via caregivers and negative
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