Risk Factors of Mental Health Disorders among Immigrant and Non-Immigrant Adolescent Visiting Healthcare Centers: A Population-based Cross-Sectional Study

Background Adolescence is a high-risk period for mental disorders, but prevalence and risk factors among Iranian and immigrant youth remain unclear. Objective This study aims to compare mental disorder prevalence and associated factors between Iranian and immigrant adolescents in Mashhad, Iran, to inform services. Methods This population-based cross-sectional study was conducted from March 2021 to December 2023 among adolescents aged 5–18 years visiting healthcare centers in Mashhad, Iran. The study population included all Iranian and immigrant adolescents who completed mental health evaluations documented in the Sina Electronic Health Record system (SinaEHR®). Logistic regression analysis was performed to identify factors associated with mental disorders, adjusting for sociodemographic variables. Candidate predictor variables with p<0.25 in bivariate analyses were included in the final multivariate model. Results Of 1,034,962 adolescents, 499,165 (48.2%) were female and 535,797 (51.8%) were male. The prevalence of mental disorders was 12.6% among Iranian adolescents and 14.4% among immigrants. Common conditions were anxiety, depression, hyperactivity, epilepsy, intellectual disability, and multi-symptom disorders. Significant risk factors included older age, female, underweight status, comorbidities, welfare service use, not living with both parents, abuse, family adversity, and secondhand smoke exposure (all p<0.05). Fruit consumption, physical activity, frequent meals, less gaming, and insurance coverage were protective (all p<0.05). For immigrants, residence cards offered additional protection (p=0.02). No significant differences in overall mental health status between groups. Conclusion Mental disorders affected a notable portion of both Iranian and immigrant adolescents, with key risk and protective factors identified. Despite slight variations, overall mental health status was comparable across groups, reflecting global patterns.