Mental Health Problems and Substance Use among Iraqi Adolescents: Retrospective Study from the Global School-Based Health Survey

Mental health problems and addiction are interconnected public health concerns among adolescents. The objective was to examine the estimated prevalence and identify shared predictors of mental health and addiction problems among Iraqi adolescents using data from the Global School-Based Student Health Survey (GSHS). Data from 1611 students aged 11–16 years were analyzed. Binary outcomes were derived from Global School-Based Student Health Survey items; Chi-square tests and logistic regression examined associations with demographics and psychosocial factors. Overall, 10.3% reported mental health problems and 2.1% exhibited substance use problems . Beyond prevalence, the risk of substance addiction was substantially higher among students with mental health problems; female students had higher odds of mental health problems, while male students had a higher odd of substance addiction. Bullying and the lack of close friendships were strongly associated with substance addictions, and smoking and drug use were strong predictors of mental health distress. Older age and higher grade were associated with increased mental health problems. Emotional distress and risky behaviors co-occur and cluster around social adversities (bullying, weak peer ties) in Iraqi schools. This study provides the first national analysis of Iraq’s Global School-Based Student Health Survey data to jointly examine mental health and substance use problems and their shared social predictors, establishing a baseline for trend comparisons. The findings support early integrated, school-based approaches that are gender-responsive, incorporate bullying prevention and peer support structures, and link to cessation and referral pathways in school and primary care systems. These data offer concrete goals for Ministries of Health/Education when updating school health programs and child protection policies.

Cite this article as: Ahmed, D. R., Blbas, H. T. A., & Ahmed, J. O. (2025). Mental health problems and substance use among Iraqi adolescents: retrospective study from the global school-based health survey. Addicta: The Turkish Journal on Addictions, Published online November 7, 2025. doi:10.5152/ADDICTA.2025.25543.