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King D, Gronholm PC, Knapp M, Hoffmann MS, Bonin EM, Brimblecombe N, Kadel R, Maughan B, O'Shea N, Richards M, Hoomans T, Evans-Lacko S. Effects of mental health status during adolescence on primary care costs in adulthood across three British cohorts. Soc Psychiatry Psychiatr Epidemiol 2024; 59:917-928. [PMID: 37358606 PMCID: PMC11116205 DOI: 10.1007/s00127-023-02507-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/25/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE This study examines the association between mental health problems in adolescence and general practice (GP) costs during adulthood up to age 50 in the UK. METHODS We conducted secondary analyses of three British birth cohorts (individuals born in single weeks in 1946, 1958 and 1970). Data for the three cohorts were analysed separately. All respondents who participated in the cohort studies were included. Adolescent mental health status was assessed in each cohort using the Rutter scale (or, for one cohort, a forerunner of that scale) completed in interviews with parents and teachers when cohort members were aged around 16. Presence and severity of conduct and emotional problems were modelled as independent variables in two-part regression models in which the dependent variable was costs of GP services from data collection sweeps up to mid-adulthood. All analyses were adjusted for covariates (cognitive ability, mother's education, housing tenure, father's social class and childhood physical disability). RESULTS Adolescent conduct and emotional problems, particularly when coexisting, were associated with relatively high GP costs in adulthood up to age 50. Associations were generally stronger in females than males. CONCLUSION Associations between adolescent mental health problems and annual GP cost were evident decades later, to age 50, suggesting that there could be significant future savings to healthcare budgets if rates of adolescent conduct and emotional problems could be reduced. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Derek King
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
| | - Petra C Gronholm
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Mauricio S Hoffmann
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Department of Neuropsychiatry, Universidade Federal de Santa Maria, Avenida Roraima 1000, Building 26, Office 1446, Santa Maria, Brazil
- Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Porto Alegre, Brazil
| | - Eva-Maria Bonin
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Nicola Brimblecombe
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Rajendra Kadel
- Public Health Wales, Policy and International Health Directorate, WHO CC on Investment for Health and Wellbeing, Cardiff, UK
| | - Barbara Maughan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nick O'Shea
- Chief Economist, Centre for Mental Health, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Ties Hoomans
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
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Keyes KM, Platt JM. Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences. J Child Psychol Psychiatry 2024; 65:384-407. [PMID: 37458091 DOI: 10.1111/jcpp.13864] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/18/2023]
Abstract
Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jonathan M Platt
- College of Public Health, University of Iowa, Iowa City, IA, USA
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Jozefiak T, L Wallander J, Lydersen S. Change Over 11-13 Year Periods in Quality of Life, Emotional Problems and Negative Stressful Life Events Among 13-17 Year Old Students. Child Psychiatry Hum Dev 2023; 54:1415-1424. [PMID: 35338413 PMCID: PMC10435593 DOI: 10.1007/s10578-022-01325-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/03/2022]
Abstract
Studies investigating changes in the general population over time concerning adolescent self-reported Quality of life (QoL) are sparse. The aim of this study is to investigate stability and change over more than a decade in self-reported QoL, emotional problems, and negative stressful life-events among students. Three large cross-sectional samples (N = 1032, 4744 and 3826) of 13-17-year-old adolescents attending public school in the Norwegian County of Trøndelag provide data, one from 2017 to 2019 and two from 11 and 13 years earlier. We analyzed linear and binary linear regression adjusted for age. We found few indications of large changes in overall QoL. The exception was a 50% increase in reported emotional problems in both girls and boys. Girls also reported an increase of sexually uncomfortable/abusive acts from peers from 3.7 to 7.0%. The observed changes must be addressed through public health interventions targeting school as an important arena.
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Affiliation(s)
- Thomas Jozefiak
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Norwegian University of Science and Technology, MTFS, Pb 8905, 7491, Trondheim, Norway.
| | - Jan L Wallander
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, USA
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Differences in Emotional and Behavioral Problems of Students over Time: A 22-Year Cross-Sectional Cohort Study. Res Child Adolesc Psychopathol 2023; 51:557-569. [PMID: 36580170 PMCID: PMC9797879 DOI: 10.1007/s10802-022-01014-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
Levels of emotional and behavioral problems in children and adolescents demonstrate secular changes over time, warranting ongoing investigation. Prior studies examining secular trends in a range of such problems have been conducted in the U.S. and internationally. Research in this area generally has not fully considered the school setting. This study compared emotional and behavioral problems across two cohorts of students in the U.S. assessed over a 22-year time period as part of measurement development efforts for the Scales for Assessing Emotional Disturbance Rating Scale (SAED-RSRS; Epstein et al., 2020). Specifically, analyses drew from data collected via teacher report on matched cohorts of students for the 1998 (data collected from 1996 to 1997; n = 1,148) and 2020 (data collected from 2016 to 2018; n = 1,148) editions of the SAED-RS. After establishing measurement invariance across cohorts and testing for gender differences, structural equation modeling revealed statistically significant cohort mean differences on two of the five factors of the SAED-RS, suggesting increases over time in Inability to Learn (β = 0.09, p = .024) and Physical Symptoms and Fears (β = 0.14, p = .005) that were comparable for girls and boys. There were no statistically significant differences on the remaining factors: Relationship Problems, Inappropriate Behavior, and Unhappiness/Depression. Supplemental item-level tests revealed differences on 8 of the 39 SAED-RS items. Findings suggest increases in specific problem areas that could benefit from ongoing monitoring and targeted interventions to support contemporary students.
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Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older? BMC Psychiatry 2022; 22:779. [PMID: 36503425 PMCID: PMC9743552 DOI: 10.1186/s12888-022-04432-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
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Arulsamy K, Delaney L. The impact of automatic enrolment on the mental health gap in pension participation: Evidence from the UK. JOURNAL OF HEALTH ECONOMICS 2022; 86:102673. [PMID: 36323183 DOI: 10.1016/j.jhealeco.2022.102673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
A large body of evidence shows that individuals with poor mental health have lower income over the lifespan but a dearth of evidence exists on how poor mental health affects savings behaviour. In this paper, we provide novel evidence of a mental health gap in pension participation in the UK using nationally representative longitudinal data from Understanding Society (UKHLS). Beginning in 2012, the UK government introduced automatic enrolment enabling us to assess the impact of one of the largest pension policy reforms in the world on this mental health gap. We measure mental health using the General Health Questionnaire (GHQ-12) which is a commonly used tool for measuring psychological distress. Prior to automatic enrolment, we find that male private sector employees with poor mental health are 3.7 percentage points less likely to participate in a workplace pension scheme while female private sector employees with poor mental health are 2.9 percentage points less likely to participate after controlling for key observables including age, education, race, marital status, number of children, occupation type, industry type, presence of a physical health condition and cognitive ability. The implementation of automatic enrolment removes the mental health gap in pension participation, equalising the pension participation rates of individuals with and without poor mental health in the private sector.
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Affiliation(s)
- Karen Arulsamy
- School of Economics & Geary Institute for Public Policy, University College Dublin, Ireland.
| | - Liam Delaney
- Department for Psychological and Behavioural Science, London School of Economics, United Kingdom.
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Christian F, Kim Y. Association Between Place of Secondhand Smoke Exposure and Depression Among Nonsmoking Children and Adolescents: A Systematic Review. Asia Pac J Public Health 2022; 34:616-626. [PMID: 35596574 DOI: 10.1177/10105395221099418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Secondhand smoke (SHS) exposure patterns of children and adolescents are different from those of adults because children and adolescents spend a majority of their time in the home and school. It was aimed to conduct a systematic review of the published literature regarding the association between depression and the place of SHS exposure among children and adolescents. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, PubMed, ScienceDirect, and Cochrane Library databases were used for the literature review. The studies were screened and selected by two independent reviewers based on the inclusion criteria. All eight studies included in the systematic review measured SHS exposure in participants' own homes. Two studies measured SHS exposure at school and one study in cars. The majority of the studies showed a positive association between depression and SHS exposure in both private and public places among nonsmoking children and adolescents. Also, they concluded a dose-response relationship between SHS exposure and depression. Health practitioners would be encouraged to work with stakeholders to create smoke-free policies in both private and public places to avoid the adverse effects of SHS exposure.
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Affiliation(s)
| | - Yeonsoo Kim
- Central Michigan University, Mount Pleasant, MI, USA
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8
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Sun X, Wang ZJ, Li YY, Chan KQ, Miao XY, Zhao S, Wu YQ, Li Z, Wu BM. Trends of college students' mental health from 2005 to 2019 and its rural-urban disparities in China. J Affect Disord 2022; 302:160-169. [PMID: 35033592 DOI: 10.1016/j.jad.2022.01.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Xin Sun
- Department of Psychology, Ningbo University, China
| | - Zuo-Jun Wang
- Department of Psychology, Ningbo University, China.
| | - Yuan-Yuan Li
- Department of Psychology, Ningbo University, China
| | - Kai Qin Chan
- Department of Psychology, James Cook University, Singapore
| | - Xiao-Yan Miao
- Department of Psychology, Ningbo University, China; Faculty of Psychology, Beijing Normal University, China
| | - Shu Zhao
- Department of Psychology, Ningbo University, China
| | - Yu-Qing Wu
- Department of Psychology, Ningbo University, China
| | - Zhihua Li
- School of Education, Hunan University of Science and Technology, China
| | - Bei-Min Wu
- Department of Psychology, Ningbo University, China.
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9
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Lindell M, Grimby-Ekman A. Stress, non-restorative sleep, and physical inactivity as risk factors for chronic pain in young adults: A cohort study. PLoS One 2022; 17:e0262601. [PMID: 35061825 PMCID: PMC8782303 DOI: 10.1371/journal.pone.0262601] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/28/2021] [Indexed: 02/02/2023] Open
Abstract
Background Chronic pain is a common condition which causes patients much suffering and is very costly to society. Factors known to be associated with chronic pain include female gender, acute pain, depression, and anxiety. This study investigated whether stress, sleep disturbance, and physical inactivity were risk factors for developing chronic pain among young adults, and whether there were any interactions between these. Methods This retrospective longitudinal study was based on an existing database from a cohort study on IT use and health, called Health 24 Years. A questionnaire was sent to students aged 19–24 in Sweden for five consecutive years, containing questions on pain, stress, sleep, physical activity, technology use, health, and more. In logistic regressions, stress, sleep, and physical activity at baseline were potential predictors of chronic pain one and four years later. In addition, a new variable including all possible interactions between potential predictors was created to test for effect modification between risk factors. Results At the one-year follow-up, stress, non-restorative sleep, and physical inactivity showed odds ratios of 1.6 (95% CI: 1.0–2.4), 1.5 (95% CI: 1.0–2.3), and 1.8 (95% CI: 1.1–3.0) respectively after adjusting for confounders, the reference being non-stressed, having restorative sleep and being active. At the four-year follow-up, stress showed an adjusted odds ratio of 1.9 (95% CI: 1.3–2.9), while non-restorative sleep and physical inactivity were statistically insignificant. At the one-year follow-up, the interaction between risk factors were significant. The most clear example of this effect modification was to be inactive and not have -restorative sleep, compared to individuals who were active and had restorative sleep, showing an adjusted odds ratio of 6.9 (95% CI: 2.5–19.2) for developing chronic pain one year after baseline. This in comparison of odds ratios for only inactive respectively only non-restorative sleep being 1.7 (95% CI: 0.6–5.3) respectively 1.6 (95% CI: 0.7–3.5). Conclusions Stress, non-restorative sleep, and physical inactivity were risk factors for developing chronic pain one year after baseline, and stress were also a risk factor four years after baseline. These findings suggest that non-restorative sleep and inactivity are risk factors in the short term while stress is a risk factor in both the short and the long term. In addition to the independent effects of non-restorative sleep and inactivity, their combination seems to further increase the odds of chronic pain.
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Affiliation(s)
- Maja Lindell
- Chronic Pain, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Anna Grimby-Ekman
- Chronic Pain, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- * E-mail:
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Knapstad M, Sivertsen B, Knudsen AK, Smith ORF, Aarø LE, Lønning KJ, Skogen JC. Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychol Med 2021; 51:470-478. [PMID: 31779729 PMCID: PMC7958482 DOI: 10.1017/s0033291719003350] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 12/05/2022]
Abstract
BACKGROUND An increase in reported psychological distress, particularly among adolescent girls, is observed across a range of countries. Whether a similar trend exists among students in higher education remains unknown. The aim of the current study was to describe trends in self-reported psychological distress among Norwegian college and university students from 2010 to 2018. METHODS We employed data from the Students' Health and Wellbeing Study (SHoT), a nationwide survey for higher education in Norway including full-time students aged 18-34. Numbers of participants (participation rates) were n = 6065 (23%) in 2010, n = 13 663 (29%) in 2014 and n = 49 321 (31%) in 2018. Psychological distress was measured using the Hopkins Symptom Checklist-25 (HSCL-25). RESULTS Overall, a statistically significant increase in self-reported psychological distress was observed over time across gender and age-groups. HSCL-25 scores were markedly higher for women than for men at all time-points. Effect-size of the mean change was also stronger for women (time-by-gender interaction: χ2 = 70.02, df = 2, p < 0.001): in women, mean HSCL-25 score increased from 1.62 in 2010 to 1.82 in 2018, yielding a mean change effect-size of 0.40. The corresponding change in men was from 1.42 in 2010 to 1.53 in 2018, giving an effect-size of 0.26. CONCLUSIONS Both the level and increase in self-reported psychological distress among Norwegian students in higher education are potentially worrying. Several mechanisms may contribute to the observed trend, including changes in response style and actual increase in distress. The relative low response rates in SHoT warrant caution when interpreting and generalising the findings.
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Affiliation(s)
- Marit Knapstad
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann Kristin Knudsen
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Kari Jussie Lønning
- The Norwegian Medical Association, Oslo, Norway
- The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol and Drug Research Western Norway (KoRFor), Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Zhong X, Jin X, Yan L, Yang L, Long H, Wang J, Wang H, Liu Y, Pu J, Xie P, Ji P. Reliability and Validity of General Health Questionnaire-12 in Chinese Dental Healthcare Workers During the COVID-19 Pandemic. Front Psychiatry 2021; 12:792838. [PMID: 35115967 PMCID: PMC8805792 DOI: 10.3389/fpsyt.2021.792838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/02/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The General Health Questionnaire-12 (GHQ-12) is a widely used instrument to assess mental health status. However, little is known about its applicability in Chinese healthcare workers. This study aimed to evaluate the reliability and validity of the GHQ-12 in Chinese dental healthcare workers. METHODS Dental healthcare workers participated in the first occupational survey in China conducted by the Chongqing Stomatological Association from February 2021 to March 2021 by filling out GHQ-12. The reliability and validity of GHQ-12 were then tested. RESULTS A total of 3,020 valid electronic questionnaires were acquired. The positive detection rate of self-reported mental health status was 23.80% (719/3,020). The Cronbach's α coefficient of the GHQ-12 was 0.892, and the Cronbach's α coefficient was 0.877-0.888 after the deletion of individual items, and the split-half reliability was 0.843. The correlation coefficient between the item-total score ranged from 0.465 to 0.762 (P<0.05). The exploratory factor analysis found 2 common factors with a factor load of 0.564-0.818. The confirmatory factor analysis showed that the factor load on the specified items was 0.480-0.790. CONCLUSIONS The two-factor model of GHQ-12 featured good reliability and validity, which could be used to assess the mental health status of Chinese dental healthcare workers.
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Affiliation(s)
- Xiaogang Zhong
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Xin Jin
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Li Yan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Lu Yang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Huiqing Long
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Wang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Haiyang Wang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Stomatological Association, Chongqing, China
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Mrug S, Jones LC, Elliott MN, Tortolero SR, Peskin MF, Schuster MA. Soft Drink Consumption and Mental Health in Adolescents: A Longitudinal Examination. J Adolesc Health 2021; 68:155-160. [PMID: 32636141 DOI: 10.1016/j.jadohealth.2020.05.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/28/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Previous studies showed associations between soft drink consumption and mental health problems in adolescents, but the direction of these effects is unknown. This study examines the hypotheses that soft drink consumption predicts aggression and depressive symptoms over time and that these mental health problems predict soft drink consumption. METHODS Interviews were conducted with 5,147 children and their caregivers from three sites at child ages 11, 13, and 16. At each time point, youth reported on their frequency of consuming soft drinks, aggressive behavior, and depressive symptoms. An autoregressive cross-lagged path model tested reciprocal relationships between soft drink consumption, aggressive behavior, and depressive symptoms over time. RESULTS More frequent consumption of soft drinks was associated with more aggressive behavior at each time point and depressive symptoms at ages 11 and 13 (r = .04 to .18, p ≤ .002). After adjusting for covariates and stability of each behavior over time, soft drink consumption at ages 11 and 13 predicted more aggressive behavior at the next time point (β = .08 and .06, p < .001). Aggressive behavior at age 13 also predicted more soft drink consumption at age 16 (β = .06, p = .002). Soft drink consumption at age 13 predicted fewer depressive symptoms (β = -.04, p = .007), but depressive symptoms did not predict soft drink consumption. CONCLUSIONS More frequent consumption of soft drinks may contribute to aggressive behavior in adolescents over time; there is some support for reciprocal relationships. There is no evidence for soft drink consumption contributing to adolescents' depression. Future research should examine longitudinal effects over shorter intervals.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - LaRita C Jones
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Susan R Tortolero
- Texas Prevention Research Center, University of Texas Health Science Center, Houston, Texas
| | - Melissa F Peskin
- Texas Prevention Research Center, University of Texas Health Science Center, Houston, Texas
| | - Mark A Schuster
- Office of the Dean, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Aanesen SM, Notøy RRG, Berg H. The Re-shaping of Bodies: A Discourse Analysis of Feminine Athleticism. Front Psychol 2020; 11:1751. [PMID: 32793072 PMCID: PMC7394218 DOI: 10.3389/fpsyg.2020.01751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
Slender and skinny body ideals have been associated with psychological disorders such as eating disorders. However, the tendency to promote a “healthier” and more athletic female body ideal has received minimal critical attention. This study aims at exploring the underlying conditions for such an athletic ideal through asking: How is the female athletic body constructed in the pseudonymous contemporary women’s fitness magazine, “Xrzise”? We investigated the object of inquiry through a modified version of Parker’s Foucauldian discourse analysis. We analyzed the interviews of four athletic role models in “Xrzise” and identified four discourses: “Neo-liberal discourse,” “Health expertise discourse,” “Discourse of surveillance and control” and “Discourse of emancipation.” The “Neoliberal discourse” constructs the female athletic body as something that the individual woman should strive for by appropriately managing her own resources, abilities and skills. The “Health expertise discourse” constructs the female athletic body through a homeostatic logic where the individual is responsible and healthcare experts have the mandate to intervene in order to maintain good health. The “Discourse of surveillance and control” constructs the female athletic body as an internalized panoptic stance, disciplining women to accept hegemonic beauty ideals. The “Discourse of emancipation” accentuates that the female athletic body is alleviated from a culturally rigid body image and instead improved physical performance and functionality are considered good ends. The results and discussion indicate that the female athletic body is a result of a complex nexus of different discourses associated with the powers of economy, sex differences, institutions, and ideological forces. We have advocated that magazines like “Xrzise” can have covert disciplinary effects hidden by seemingly well-intentioned motives, which can contribute to women’s objectification of their bodies.
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Affiliation(s)
- Sofia M Aanesen
- Centre for the Study of the Sciences and the Humanities, University of Bergen, Bergen, Norway
| | - Runa R G Notøy
- Centre for the Study of the Sciences and the Humanities, University of Bergen, Bergen, Norway
| | - Henrik Berg
- Centre for the Study of the Sciences and the Humanities, University of Bergen, Bergen, Norway
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Mojtabai R, Olfson M. National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry 2020; 77:703-714. [PMID: 32211824 PMCID: PMC7097842 DOI: 10.1001/jamapsychiatry.2020.0279] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/17/2020] [Indexed: 12/13/2022]
Abstract
Importance The prevalence of adolescent depression and other internalizing mental health problems has increased in recent years, whereas the prevalence of externalizing behaviors has decreased. The association of these changes with the use of mental health services has not been previously examined. Objective To examine national trends in the care of different mental health problems and in different treatment settings among adolescents. Design, Setting, and Participants Data for this survey study were drawn from the National Survey on Drug Use and Health, an annual cross-sectional survey of the US general population. This study focused on adolescent participants aged 12 to 17 years interviewed from January 1, 2005, to December 31, 2018. Data were reported as weighted percentages and adjusted odds ratios (aORs) and analyzed from July 20 to December 1, 2019. Main Outcomes and Measures Time trends in 12-month prevalence of any mental health treatment or counseling in a wide range of settings were examined overall and for different sociodemographic groups, types of mental health problems (internalizing, externalizing, relationship, and school related), and treatment settings (inpatient mental health, outpatient mental health, general medical, and school counseling). Trends in the number of visits and nights in inpatient settings were also examined. Results A total of 47 090 of the 230 070 adolescents across survey years (19.7%) received mental health care. Of these, 57.5% were female; 31.3%, aged 12 to 13 years; 35.8%, aged 14 to 15 years; and 32.9%, aged 16 to 17 years. The overall prevalence of mental health care did not change appreciably over time. However, mental health care increased among girls (from 22.8% in 2005-2006 to 25.4% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.19; P = .001), non-Hispanic white adolescents (from 20.4% in 2005-2006 to 22.7% in 2017-2018; aOR, 1.08; 95% CI, 1.03-1.14; P = .004), and those with private insurance (from 19.4% in 2005-2006 to 21.2% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.18; P = .002). Internalizing problems, including suicidal ideation and depressive symptoms, accounted for an increasing proportion of care (from 48.3% in 2005-2006 to 57.8% in 2017-2018; aOR, 1.52; 95% CI, 1.39-1.66; P < .001), whereas externalizing problems (from 31.9% in 2005-2006 to 23.7% in 2017-2018; aOR, 0.67; 95% CI, 0.62-0.73; P < .001) and relationship problems (from 30.4% in 2005-2006 to 26.9% in 2017-2018; aOR, 0.75; 95% CI, 0.69-0.82; P < .001) accounted for decreasing proportions. During this period, use of outpatient mental health services increased from 58.1% in 2005-2006 to 67.3% in 2017-2018 (aOR, 1.47; 95% CI, 1.35-1.59; P < .001), although use of school counseling decreased from 49.1% in 2005-2006 to 45.4% in 2017-2018 (aOR, 0.86; 95% CI, 0.79-0.93; P < .001). Outpatient mental health visits (eg, private mental health clinicians, from 7.2 in 2005-2006 to 9.0 in 2017-2018; incidence rate ratio, 1.30; 95% CI, 1.23-1.37; P < .001) and overnight stays in inpatient mental health settings (from 4.0 nights in 2005-2006 to 5.4 nights in 2017-2018; incidence rate ratio, 1.18; 95% CI, 1.02-1.37; P = .03) increased. Conclusions and Relevance This study's findings suggest that the growing number of adolescents who receive care for internalizing mental health problems and the increasing share who receive care in specialty outpatient settings are placing new demands on specialty adolescent mental health treatment resources.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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15
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Forslund T, Kosidou K, Wicks S, Dalman C. Trends in psychiatric diagnoses, medications and psychological therapies in a large Swedish region: a population-based study. BMC Psychiatry 2020; 20:328. [PMID: 32576173 PMCID: PMC7313191 DOI: 10.1186/s12888-020-02749-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/19/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Health services utilization for mental health disorders is reported to increase sharply in many countries. The aim of this study was to report trends in all aspects of mental health care utilization in a total population sample. METHODS Repeated cross-sectional register study of the Stockholm Region (VAL) including both primary and secondary care. Trends in the proportion of adults in the total population of Stockholm Region with a recorded ICD-10 psychiatric diagnosis or psychological therapy during 2007-2017 as well as claims of psychiatric medication from 2011 were calculated. RESULTS The proportion of adults utilizing any mental health care increased from 13.2% in 2011 to 16.1% in 2017. In 2017, 49.3% were treated in primary care, 32.2% in secondary care and 18.5% were jointly managed. The increase was most pronounced in younger adults. Women were more likely to receive mental health care than men in all ages. Medication decreased from 71.0 to 67.7%, while psychological therapy increased from 33.1 to 37.6%. The use of psychiatric medication increased with age while psychological therapy decreased. All time trends were statistically significant (p < .0001). CONCLUSION Care for mental health disorders has been increasing mainly in primary care and was delivered to one in seven adult individuals in 2017. Interventions are needed to address the growing burden of mental health disorders while avoiding overtreatment.
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Affiliation(s)
- T. Forslund
- grid.4714.60000 0004 1937 0626Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden ,Public Healthcare Services Committee, Department of Healthcare Development, Box 6909, 102 39 Stockholm, Stockholm Region Sweden
| | - K. Kosidou
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden ,Centre for Epidemiology and Community Medicine, Stockholm, Stockholm Region Sweden
| | - S. Wicks
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden ,Centre for Epidemiology and Community Medicine, Stockholm, Stockholm Region Sweden
| | - C. Dalman
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden ,Centre for Epidemiology and Community Medicine, Stockholm, Stockholm Region Sweden
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Silva SA, Silva SU, Ronca DB, Gonçalves VSS, Dutra ES, Carvalho KMB. Common mental disorders prevalence in adolescents: A systematic review and meta-analyses. PLoS One 2020; 15:e0232007. [PMID: 32324835 PMCID: PMC7179924 DOI: 10.1371/journal.pone.0232007] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
An increasing number of original studies suggest the relevance of assessing mental health; however, there has been a lack of knowledge about the magnitude of Common Mental Disorders (CMD) in adolescents worldwide. This study aimed to estimate the prevalence of CMD in adolescents, from the General Health Questionnaire (GHQ-12). Only studies composed by adolescents (10 to 19 years old) that evaluated the CMD prevalence according to the GHQ-12 were considered. The studies were searched in Medline, Embase, Scopus, Web of Science, Lilacs, Adolec, Google Scholar, PsycINFO and Proquest. In addition, the reference lists of relevant reports were screened to identify potentially eligible articles. Studies were selected by independent reviewers, who also extracted data and assessed risk of bias. Meta-analyses were performed to summarize the prevalence of CMD and estimate heterogeneity across studies. A total of 43 studies were included. Among studies that adopted the cut-off point of 3, the prevalence of CMD was 31.0% (CI 95% 28.0-34.0; I2 = 97.5%) and was more prevalent among girls. In studies that used the cut-off point of 4, the prevalence of CMD was 25.0% (CI 95% 19.0-32.0; I2 = 99.8%). Global prevalence of CMD in adolescents was 25.0% and 31.0%, using the GHQ cut-off point of 4 and 3, respectively. These results point to the need to include mental health as an important component of health in adolescence and to the need to include CMD screening as a first step in the prevention and control of mental disorders.
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Affiliation(s)
- Sara Araújo Silva
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | - Simoni Urbano Silva
- Graduate Program in Collective Health, University of Brasilia, Federal District, Brasilia, Brazil
| | - Débora Barbosa Ronca
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | - Kênia Mara Baiocchi Carvalho
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
- Graduate Program in Collective Health, University of Brasilia, Federal District, Brasilia, Brazil
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Griffith GJ, Jones K. Understanding the population structure of the GHQ-12: Methodological considerations in dimensionally complex measurement outcomes. Soc Sci Med 2019; 243:112638. [PMID: 31665657 DOI: 10.1016/j.socscimed.2019.112638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/22/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mental health and its complexity, measurement and social determinants are increasingly important avenues of research for social scientists. Quantitative social science commonly investigates mental health as captured by population screening metrics. One of the most common of these metrics is the 12-Item General Health Questionnaire (GHQ-12). Despite itscanonical use as an outcome of interest in social science, the traditional use of the summed scores of summed questionnaires carries empirical and substantive assumptions which are often not fully considered or justified in the research. We outline the implications of these assumptions and the restrictions imposed by traditional modelling techniques and advocate for a more nuanced approach to population mental health modelling and inference. DATA & METHODS We use novel Exploratory Structural Equation Modelling (ESEM) on a large, representative UK sample taken from the first wave of the Understanding Society Survey, totalling 40,452 respondents. We use this to exemplify the potential of traditional, restrictive assumptions to bias conclusions and policy recommendations. RESULTS ESEM analysis identifies a 4-factor structure for the GHQ-12, including a newly proposed "Emotional Coping" dimension. This structure is then tested against leading proposed factor structures from the literature and is demonstrated to perform better across all metrics, under both Maximum Likelihood and Bayesian estimation. Moreover, the proposed factors are more substantively dissimilar than those retrieved from previous literature. CONCLUSIONS The results highlight the inferential limitations of using simple summed scores as population health outcomes. We advocate for the use of the highlighted methods, which in combination with population studies offer quantitative social scientists the opportunity to explore predictors and patterns of underlying processes of population mental health outcomes, explicitly addressing the complexity and measurement error inherent to mental health analysis.
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Affiliation(s)
- Gareth J Griffith
- School of Geographical Sciences, University Road, University of Bristol, BS8 1SS, United Kingdom.
| | - Kelvyn Jones
- School of Geographical Sciences, University Road, University of Bristol, BS8 1SS, United Kingdom
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18
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Waters L, Loton DJ, Grace D, Jacques-Hamilton R, Zyphur MJ. Observing Change Over Time in Strength-Based Parenting and Subjective Wellbeing for Pre-teens and Teens. Front Psychol 2019; 10:2273. [PMID: 31649593 PMCID: PMC6795758 DOI: 10.3389/fpsyg.2019.02273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 09/23/2019] [Indexed: 01/22/2023] Open
Abstract
The focus of this study was on adolescent mental health. More specifically, the relationship between strength-based parenting (SBP) and subjective wellbeing (SWB) during adolescence was examined at three time points over 14 months (N = 202, M age = 12.97, SD age = 0.91, 48% female). SBP was positively related to life satisfaction and positive affect at each of the three time points, and was negatively related to negative affect. SBP and SWB both declined significantly over time. When examining the causal relationships between SBP and SWB, two different statistical models were applied: latent growth-curve models (LGM) and random-intercept cross-lagged panel models (RI-CLPM). The LGM revealed a strong positive relationship between changes in SBP and SWB. Specifically, this model showed that SBP at one time point predicted adolescent SWB at future time points. However, when the more stringent statistical test was completed through RI-CLPMs, no cross-lagged paths reached significance. Thus, while parenting is a significant predictor of wellbeing for pre-teens and teens in real time, it is not predictive of wellbeing at future time points. Parents, thus, cannot assume that their current levels of SBP are 'banked' by their children to support future wellbeing. Instead, SBP needs to be an ongoing, contemporary parenting practice. Furthermore, the fact that perceptions of SBP decline in this age bracket suggest that SBP interventions may be helpful in supporting adolescent mental health.
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Affiliation(s)
- Lea Waters
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Daniel J. Loton
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Dawson Grace
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Michael J. Zyphur
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
- Department of Management and Marketing, The University of Melbourne, Melbourne, VIC, Australia
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19
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Sellers R, Warne N, Pickles A, Maughan B, Thapar A, Collishaw S. Cross-cohort change in adolescent outcomes for children with mental health problems. J Child Psychol Psychiatry 2019; 60:813-821. [PMID: 30989670 PMCID: PMC6617990 DOI: 10.1111/jcpp.13029] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Child mental health problems are common. Previous studies have examined secular changes in their prevalence but have not assessed whether later outcomes have changed. We therefore aimed to test whether outcomes of child mental health problems have changed over a 40-year period. METHODS Three cohorts were utilized: The National Child Development Study (NCDS: N = 14,544, aged 7 in 1965), the Avon Longitudinal Study of Parents and Children (ALSPAC: N = 8,188, aged 7 in 1998), and the Millennium Cohort Study (MCS: N = 13,192, aged 7 in 2008). Mental health problems at age 7 were identified using the parent-reported Rutter-A scale (NCDS) and Strengths and Difficulties Questionnaire (ALSPAC and MCS). Associated outcomes were compared across cohorts: age 11 social functioning, age 16 exam attainment and age 16 mental health. RESULTS Child mental health problems were common in each cohort (boys: 7.0%-9.7%; girls: 5.4%-8.4%). Child mental health problems became more strongly associated with social functioning problems (boys: NCDS OR = 1.95 (1.50, 2.53), MCS OR = 3.77 (2.89, 4.92); interaction p < .001; girls: NCDS OR = 1.69 (1.22, 2.33), MCS OR = 3.99 (3.04, 5.25), interaction p < .001), lower academic attainment for boys (NCDS OR = 0.49 (0.31, 0.78), ALSPAC OR = 0.30 (0.22, 0.41), interaction p = .009), and age 16 mental health problems (boys: NCDS d' = 0.55 (0.38, 0.72), ALSPAC d' = 0.95 (0.73, 1.16); interaction p = .004; girls: NCDS d' = 0.50 (0.34, 0.65), ALSPAC d' = 0.99 (0.78, 1.20); interaction p < .001). CONCLUSIONS Child mental health problems have become more strongly associated with negative social, educational and mental health outcomes in recent generations.
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Affiliation(s)
- Ruth Sellers
- Rudd Centre for Adoption Research and PracticeSchool of PsychologyUniversity of SussexBrightonUK
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and Genomics, School of MedicineCardiff UniversityCardiffUK
| | - Naomi Warne
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and Genomics, School of MedicineCardiff UniversityCardiffUK
| | - Andrew Pickles
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondon, UK
| | - Barbara Maughan
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and Genomics, School of MedicineCardiff UniversityCardiffUK
| | - Stephan Collishaw
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and Genomics, School of MedicineCardiff UniversityCardiffUK
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20
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Winzer R, Sorjonen K, Lindberg L. What Predicts Stable Mental Health in the 18⁻29 Age Group Compared to Older Age Groups? Results from the Stockholm Public Health Cohort 2002⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2859. [PMID: 30558161 PMCID: PMC6313492 DOI: 10.3390/ijerph15122859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/07/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022]
Abstract
Mental health has decreased in young people since the 1990s, and mental health promotion is an urgent matter. A first step is to identify which social determinants could be of importance for intervention. We used the Stockholm Public Health Cohort, a longitudinal population-based health survey, completed by 31,000 inhabitants in the Stockholm County. We focused on the 18⁻29 age group, n = 3373 (60% females, 40% males) and aimed at assessing which social determinants predict stable mental health, measured as scoring <3 points on the General Health Questionnaire 12 at all time points: 2002, 2007, 2010, and 2014. Forty-six percent of males and 36% of females reported stable mental health. Among the 17 predictors on sociodemographics, socioeconomics, social capital, health behavior, and victimization, six predicted stable mental health in the following order: occupation and especially employment, emotional support, male gender, being born in Sweden, absence of financial strain, and consumption of fruit and berries. In the 30⁻84 age group, 66% males and 55% females reported stable mental health. Nine determinants in the following rank predicted stable mental health: absence of financial strain, occupation and especially being self-employed, emotional support, male gender, physical activity, instrumental support, interpersonal trust, community trust, and absence of hazardous alcohol consumption. Interaction analysis showed significant difference between the younger and older group regarding physical activity and absence of financial strain with importance being higher for the older group. Our findings indicate that the determinants of health differ across the life-course with fewer predictors related to social capital and health behavior in the younger group compared to the older. We conclude that health-promoting interventions should be lifespan-sensitive.
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Affiliation(s)
- Regina Winzer
- Department of Public Health Sciences, Karolinska Institutet, 17165 Stockholm, Sweden.
- Department of Living Conditions and Lifestyles, Public Health Agency of Sweden, 17182 Solna, Sweden.
| | - Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, 17165 Stockholm, Sweden.
| | - Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet, 17165 Stockholm, Sweden.
- Center for Epidemiology and Community Medicine, Stockholm County Council, 10431 Stockholm, Sweden.
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Mishina K, Tiiri E, Lempinen L, Sillanmäki L, Kronström K, Sourander A. Time trends of Finnish adolescents' mental health and use of alcohol and cigarettes from 1998 to 2014. Eur Child Adolesc Psychiatry 2018; 27:1633-1643. [PMID: 29704065 DOI: 10.1007/s00787-018-1158-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/18/2018] [Indexed: 11/26/2022]
Abstract
This study reports time-trend changes in self-reported mental health problems, smoking, and alcohol habits among Finnish adolescents over a 16-year period using three cross-sectional studies with similar designs, methodologies, and geographical recruitment areas. There were 4508 participants with a mean age of 14.4 years (range 13-18) in 1998 (n = 1449), 2008 (n = 1560), and 2014 (n = 1499). The information they provided on their mental health was measured with the Strengths and Difficulties Questionnaire and they were also asked questions about their alcohol and smoking habits. The findings showed that from 1998 to 2014 females reported less hyperactivity and conduct problems and males reported fewer peer problems and better prosocial skills. The only mental health problem that showed a significant increase was emotional symptoms among females. Smoking and alcohol use consistently decreased in males and females during the 16-year period. Our findings suggest that overall adolescent's self-reported mental health problems were either stable or falling, indicating increased well-being. The decreased smoking indicates that anti-smoking campaigns have been successfully changing teenagers' attitudes towards smoking. The important finding is that self-reported emotional symptoms had increased in females. This may indicate an increase or earlier onset of affective disorders.
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Affiliation(s)
- Kaisa Mishina
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Elina Tiiri
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Lotta Lempinen
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Lauri Sillanmäki
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Kim Kronström
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland.
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
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Anniko MK, Boersma K, Tillfors M. Sources of stress and worry in the development of stress-related mental health problems: A longitudinal investigation from early- to mid-adolescence. ANXIETY STRESS AND COPING 2018; 32:155-167. [PMID: 30465445 DOI: 10.1080/10615806.2018.1549657] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Stress and stress-related mental health complaints are common and increasing among adolescents, especially girls. Identifying typical sources of stress as well as central intervention targets is an important effort in the development of effective prevention and treatment protocols. This study investigated worry as potential mediator in the development of mental health problems in response to common stressors in adolescence. We also examined to what sources adolescents ascribe their stress over the years from the 7th through the 9th grade. DESIGN Prospective cohort study. METHODS Self-reported subjective stressor load, worry, anxiety and depressive symptoms were assessed in a sample of Swedish 7th graders (N = 1137; 46% girls, mean age 13.2) with follow-up assessments one and two years later. RESULTS School was the most common source of stress across all time-points, with girls reporting considerable more stress than boys. Worry mediated the relationship between overall stressor load and depressive symptoms and anxiety over time and was not moderated by gender. CONCLUSIONS Worry may be an important target in stress prevention and efforts to prevent stress-related problems would benefit from focusing on early adolescence as especially school stress is already relatively common in grade 7.
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Affiliation(s)
- M K Anniko
- a School of Law, Psychology and Social Work , Örebro University , Örebro , Sweden
| | - K Boersma
- a School of Law, Psychology and Social Work , Örebro University , Örebro , Sweden
| | - M Tillfors
- b Faculty of Arts and Social Sciences, Department of Social and Psychological Studies: Psychology , Karlstad University , Karlstad , Sweden
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Gutman LM, Joshi H, Parsonage M, Schoon I. Trends in parent- and teacher-rated mental health problems among 10- and 11-year-olds in Great Britain: 1999-2012. Child Adolesc Ment Health 2018; 23:26-33. [PMID: 32677368 DOI: 10.1111/camh.12179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous evidence indicates that mental health problems are becoming more common for adolescents. Less is known about whether these trends have continued and there has been no study to date which has specifically focused on early adolescents over a sufficiently long period. This study examines changes in parent- and teacher-reported mental health problems among 10- and 11-year-olds in 1999, 2004 and 2012 in Great Britain. METHOD Parent and teacher ratings of the Strengths and Difficulties Questionnaire were used to compare the prevalence of conduct problems, hyperactivity/inattention, emotional problems, peer problems and total difficulties among 10- and 11-year-olds in three nationally representative British samples assessed in 1999 (n = 1904), 2004 (n = 1348) and 2012 (n = 11,397). RESULTS Teacher reports showed improving trends for boys' and girls' mental health from 1999 to 2012, particularly for externalizing behaviours (i.e. conduct problems and hyperactivity/inattention). Parent reports, on the other hand, identified only one area of sustained improvement between 1999 and 2012, namely hyperactivity/inattention among boys. Although parent reports of girls' mental health indicate improving trends from 1999 to 2004, they also suggest worsening mental health from 2004. CONCLUSIONS These findings suggest that perceptions of emotional and behavioural problems vary by the gender of the adolescent, the context in which they are observed or by whom they are reported.
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Affiliation(s)
| | - Heather Joshi
- UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL, UK
| | | | - Ingrid Schoon
- UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL, UK
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van Vuuren CL, Uitenbroek DG, van der Wal MF, Chinapaw MJM. Sociodemographic differences in 10-year time trends of emotional and behavioural problems among adolescents attending secondary schools in Amsterdam, The Netherlands. Eur Child Adolesc Psychiatry 2018; 27:1621-1631. [PMID: 29700615 PMCID: PMC6245132 DOI: 10.1007/s00787-018-1157-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 04/11/2018] [Indexed: 01/08/2023]
Abstract
Societal change in western societies may impact emotional and behavioural problems of adolescents. Firm epidemiological evidence of changes in emotional and behavioural problems during the last decade is lacking. Insight into secular changes in emotional and behavioural problems among adolescents from various sociodemographic groups is crucial for adequate and targeted policy making. Therefore, the purpose of this study was to examine 10-year time trends in emotional and behavioural problems among adolescents, and potential differences in time trends between sociodemographic groups. Analyses were based on annually repeated cross-sectional data including 56,159 multi-ethnic students (13-14 years old) in the second year of various levels of secondary education in Amsterdam, The Netherlands, using the internationally validated Strengths and Difficulties Questionnaire. In general, emotional and behavioural problems increased over a 10-year time period (i.e., relative increase of total difficulties by 19%). This increase was mainly due to an increase in hyperactivity/inattention problems, while peer-relationship problems decreased. Time trends differed somewhat by sex: total difficulties and emotional problems increased in girls but remained fairly stable in boys. In Amsterdam, emotional and behavioural problems in adolescents seemingly increased over time, especially hyperactivity/inattention problems. Further research is needed to clarify the underlying causes. We cannot totally exclude potential confounders underlying our findings. Our findings can inform policies to target health programs at sociodemographic groups at increased risk.
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Affiliation(s)
- Cornelia Leontine van Vuuren
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. .,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Daan G. Uitenbroek
- 0000 0000 9418 9094grid.413928.5Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands
| | - Marcel F. van der Wal
- 0000 0000 9418 9094grid.413928.5Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands
| | - Mai J. M. Chinapaw
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Kosidou K, Lundin A, Lewis G, Fredlund P, Dal H, Dalman C. Trends in levels of self-reported psychological distress among individuals who seek psychiatric services over eight years: a comparison between age groups in three population surveys in Stockholm County. BMC Psychiatry 2017; 17:345. [PMID: 29020938 PMCID: PMC5637348 DOI: 10.1186/s12888-017-1499-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/02/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Psychiatric service use has increased in Sweden and in other developed countries, particularly among young people. Possible explanations include lower threshold for help-seeking among young people, but evidence is scarce. METHODS We analysed the 2002, 2006 and 2010 Stockholm public health surveys for changes in the mean level of psychological distress among adult users of psychiatric in- and outpatient services in four age groups: 18-24, 25-44, 45-64 and ≥65 years. Psychological distress was measured via the 12-item General Health Questionnaire (GHQ-12), using the Likert scoring method 0-1-2-3. In- and out-patient psychiatric service use within 6 months from the surveys was obtained from registers. RESULTS The mean level of distress among young adults 18-24 years who utilize psychiatric services decreased between 2002 (mean GHQ-12 score, 95% confidence interval 20.5, 18.1-23.0) and 2010 (16.2, 14.6-17.7), while it remained fairly stable in older age groups. Results were similar in sex-stratified analyses, although the decrease was statistically significant only among young women 18-24 years. At the end of the follow-up, the level of distress among patients was similar for all age-groups. CONCLUSIONS There were no differences between age groups in the level of distress when seeking care at the end of the follow-up period, supporting that there is no age-specific over- or under-consumption of psychiatric care in later years. However, the lowered threshold for help-seeking among young adults over time might have contributed to increases in psychiatric service use in the young age group. Public health policy and service delivery planning should consider the needs of the widening group of young users of psychiatric services.
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Affiliation(s)
- Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Solnavägen 1 E, -113 65, Stockholm, SE, Sweden. .,Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1 E, -113 65s, Stockholm, SE, Sweden.
| | - Andreas Lundin
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1 E, -113 65s Stockholm, SE Sweden
| | - Glyn Lewis
- 0000000121901201grid.83440.3bDivision of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7NF UK
| | - Peeter Fredlund
- 0000 0001 2326 2191grid.425979.4Centre for Epidemiology and Community Medicine, Stockholm County Council, Solnavägen 1 E, -113 65 Stockholm, SE Sweden
| | - Henrik Dal
- 0000 0001 2326 2191grid.425979.4Centre for Epidemiology and Community Medicine, Stockholm County Council, Solnavägen 1 E, -113 65 Stockholm, SE Sweden
| | - Christina Dalman
- 0000 0001 2326 2191grid.425979.4Centre for Epidemiology and Community Medicine, Stockholm County Council, Solnavägen 1 E, -113 65 Stockholm, SE Sweden ,0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1 E, -113 65s Stockholm, SE Sweden
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Thorisdottir IE, Asgeirsdottir BB, Sigurvinsdottir R, Allegrante JP, Sigfusdottir ID. The increase in symptoms of anxiety and depressed mood among Icelandic adolescents: time trend between 2006 and 2016. Eur J Public Health 2017; 27:856-861. [DOI: 10.1093/eurpub/ckx111] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cosma A, Belić J, Blecha O, Fenski F, Lo MY, Murár F, Petrovic D, Stella MT. 'Talkin' 'Bout My Generation': Using a Mixed-Methods Approach to Explore Changes in Adolescent Well-Being across Several European Countries. Front Psychol 2017; 8:758. [PMID: 28572776 PMCID: PMC5436655 DOI: 10.3389/fpsyg.2017.00758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 04/25/2017] [Indexed: 11/13/2022] Open
Abstract
The promotion of positive mental health is a becoming priority worldwide. Despite all the efforts invested in preventive and curative work, it is estimated that one in four persons will experience a mental health condition at some point in their lives. Even more worrying is the fact that up to a half of all mental health problems have their onset before the age of 14. Recent statistics (national and international surveys, meta-analyses, international reports) point out to the fact that child and adolescent mental health problems are on the rise. The present study will try to corroborate these results and further explore their meaning, by employing a sequential mixed methods research design (quantitative-qualitative). The quantitative part will analyze time trends using Health Behaviors in School-aged Children data (four survey cycles: 2002, 2006, 2010, 2014) on mental well-being from four European countries (the Czechia, Germany, Italy, and United Kingdom). The qualitative part will rely on focus groups to explore the perspectives of 13- and 15-year-old boys and girls on gender differences and on the changes in adolescent mental well-being over time, as well as measures through which these issues could be addressed. Thematic analysis will be employed to analyze qualitative data. The results of this study could make a major contribution to our understanding of the current trends in adolescent mental well-being, as well as the ways in which existing data could be linked to international and national health policies.
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Affiliation(s)
- Alina Cosma
- Child and Adolescent Health Research Unit, School of Medicine, University of St AndrewsSt Andrews, United Kingdom
| | - Jelisaveta Belić
- Department of Psychology, Faculty of Social and Behavioural Sciences, Leiden UniversityLeiden, Netherlands
| | - Ondřej Blecha
- Department of Psychology, Faculty of Arts, Masaryk UniversityBrno, Czechia
| | - Friederike Fenski
- Department of Psychology, Faculty of Education and Psychology, Free University of BerlinBerlin, Germany
| | - Man Y Lo
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College LondonLondon, United Kingdom
| | - Filip Murár
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College LondonLondon, United Kingdom
| | - Darija Petrovic
- Department of Psychology, Faculty of Philosophy, University of Novi SadNovi Sad, Serbia
| | - Maria T Stella
- Department of Psychology and Cognitive Science, University of TrentoTrento, Italy
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Nitkowski D, Lohbeck A, Petermann U, Petermann F. Hat die Angstausprägung bei Kindern und Jugendlichen in Deutschland von 1974 bis 2016 zugenommen? KINDHEIT UND ENTWICKLUNG 2017. [DOI: 10.1026/0942-5403/a000222] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Säkulare Trends bezeichnen Zu- oder Abnahmen von psychischer Symptomatik über die Zeit. Für den deutschsprachigen Raum liegen kaum Befunde darüber vor, ob sich Verhaltensauffälligkeiten bei Kindern und Jugendlichen in der Schwere über Geburtskohorten hinweg verändern. In der vorliegenden Studie wurden Selbsteinschätzungen von Kindern und Jugendlichen im Angstfragebogen für Schüler (AFS; Wieczerkowski et al., 1974 , 2016 ) aus den Jahren 1974 und 2016 analysiert, um herauszustellen, ob sich die Ausprägungen auf den Skalen „Prüfungsangst“, „Manifeste Angst“, „Schulunlust“ und „Soziale Erwünschtheit“ unterscheiden. Als Datengrundlage dienten die Normstichprobe von 1974 (N = 2374, 9 – 17 Jahre) und von 2016 (N = 2267, 9 – 17 Jahre). Die Analyse der Skalenmittelwerte wies eine leichte Abnahme der Werte auf der Skala „Prüfungsangst“ und eine geringe bis mittelstarke Zunahme auf den Skalen „Schulunlust“ und „Soziale Erwünschtheit“ nach. Über den Zeitraum von 42 Jahren lassen sich keine oder nur leichte Veränderungen in den Angstwerten finden.
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Affiliation(s)
- Dennis Nitkowski
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Annette Lohbeck
- Institut für Pädagogik, Lehr- und Lernforschung der Carl von Ossietzky-Universität Oldenburg
| | - Ulrike Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Wiens K, Williams JVA, Lavorato DH, Duffy A, Pringsheim TM, Sajobi TT, Patten SB. Is the prevalence of major depression increasing in the Canadian adolescent population? Assessing trends from 2000 to 2014. J Affect Disord 2017; 210:22-26. [PMID: 28012349 DOI: 10.1016/j.jad.2016.11.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 10/24/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Major depressive disorder is a relatively common diagnosis with onset across the lifespan. There is a recent belief that major depressive episodes (MDE) are increasing in adolescence; however, it is not clear if this is truly an increase in prevalence or reflective of other causes such as change in diagnostic patterns. This study aimed to determine whether evidence supports an epidemic of MDE in Canadian adolescents. METHODS Past year MDE prevalence estimates were derived from a series of nationally representative surveys. Random effects meta-regression and graphical analyses were used to evaluate trends. A post hoc analysis compared trends in MDE prevalence to trends in self-reported mood disorder diagnosis (made by a health professional). The sample was split into 9 birth cohorts to examine whether MDE prevalence increased in more recent cohorts. RESULTS Prevalence of MDE did not significantly change between 2000 and 2014 (β=0.001; p=0.532), and there was no modification of trends by sex or age. However, prevalence of self-reported mood disorder diagnosis by a health professional increased from 2003 to 2014 (β=0.001; p=0.024). There was no indication that MDE prevalence differed by birth cohort. LIMITATIONS Limitations include reduced precision in subgroup analyses, lack of clinical judgement in the structured diagnostic interview, and inability to differentiate mild, moderate and severe episodes of depression. CONCLUSION These findings do not support an epidemic of MDE in adolescents, however as more individuals report diagnoses by a health professional, future policy may need to incorporate an increase in need of mental health services.
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Affiliation(s)
- Kathryn Wiens
- Department of Community Health Sciences, University of Calgary, Canada.
| | | | - Dina H Lavorato
- Department of Community Health Sciences, University of Calgary, Canada
| | - Anne Duffy
- Department of Psychiatry, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Canada
| | - Tamara M Pringsheim
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Canada
| | - Tolulope T Sajobi
- Department of Community Health Sciences, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada
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Ross A, Kelly Y, Sacker A. Time trends in mental well-being: the polarisation of young people's psychological distress. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1147-1158. [PMID: 28698927 PMCID: PMC5581824 DOI: 10.1007/s00127-017-1419-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Previous research on time trends of young people's mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period. METHODS GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16-24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene's homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean. RESULTS There was a small but significant increase in mean GHQ-12 among young women (b 0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (p < 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men. CONCLUSIONS The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008.
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Affiliation(s)
- Andy Ross
- Research Department of Epidemiology and Public Health, ESRC International Centre for Lifecourse Studies in Society and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Yvonne Kelly
- Research Department of Epidemiology and Public Health, ESRC International Centre for Lifecourse Studies in Society and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Amanda Sacker
- Research Department of Epidemiology and Public Health, ESRC International Centre for Lifecourse Studies in Society and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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Ivert AK, Mulinari S, van Leeuwen W, Wagner P, Merlo J. Appropriate assessment of ethnic differences in adolescent use of psychotropic medication: multilevel analysis of discriminatory accuracy. ETHNICITY & HEALTH 2016; 21:578-595. [PMID: 26884047 DOI: 10.1080/13557858.2016.1143090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE In the present study, we used a multilevel approach to investigate the role of maternal country of birth (MCOB) in predicting adolescent use of psychotropic medication in Sweden. DESIGN Using the Swedish Medical Birth Register we identified all 428,314 adolescents born between 1987 and 1990 and who were residing in Sweden in the year they turned 18. We applied multilevel logistic regression analysis with adolescents (level 1) nested within MCOBs (level 2). Measures of association (odds ratio) and measures of variance (intra-class correlation (ICC)) were calculated, as well as the discriminatory accuracy by calculating the area under the Receiver Operator Characteristic (AU-ROC) curve. RESULTS In comparison with adolescents with Swedish-born mothers, adolescents with mothers born in upper-middle, lower-middle and low-income countries were less likely to use psychotropic medication. However, the variance between MCOBs was small (ICC = 2.5 in the final model) relative to the variation within MCOBs. This was confirmed by an AU-ROC value of 0.598. CONCLUSIONS Even though we found associations between MCOB and adolescent use of psychotropic medication, the small ICC and AU-ROC indicate that MCOB appears to be an inaccurate context for discriminating adolescent use of psychotropic medication in Sweden.
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Affiliation(s)
- Anna-Karin Ivert
- a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden
- b Faculty of Health and Society , Malmö University , Malmö , Sweden
| | - Shai Mulinari
- a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden
- c Department of Sociology , Lund University , Lund , Sweden
| | - Willemijn van Leeuwen
- a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden
- d Medisch Centrum Leeuwarden , Leeuwarden , Netherlands
| | - Philippe Wagner
- a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden
- e Centre for Clinical Research Västmanland , Uppsala University , Sweden
| | - Juan Merlo
- a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden
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Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics 2016; 138:peds.2016-1878. [PMID: 27940701 PMCID: PMC5127071 DOI: 10.1542/peds.2016-1878] [Citation(s) in RCA: 766] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014. METHODS Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services. RESULTS The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents. CONCLUSIONS The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group.
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Affiliation(s)
- Ramin Mojtabai
- Departments of Mental Health, Bloomberg School of Public Health, and .,Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Mark Olfson
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University;,New York State Psychiatric Institute, New York, New York; and
| | - Beth Han
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
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Liang Y, Wang L, Yin X. The factor structure of the 12-item general health questionnaire (GHQ-12) in young Chinese civil servants. Health Qual Life Outcomes 2016; 14:136. [PMID: 27669741 PMCID: PMC5037881 DOI: 10.1186/s12955-016-0539-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background The 12-item General Health Questionnaire (GHQ-12) is a commonly used screening instrument for measuring mental disorders. However, few studies have measured the mental health of Chinese professionals or explored the factor structure of the GHQ-12 through investigations of young Chinese civil servants. Method This study analyses the factor structure of the GHQ-12 on young Chinese civil servants. Respondents include 1051 participants from six cities in eastern China. Exploratory Factor Analysis (EFA) is used to identify the potential factor structure of the GHQ-12. Confirmatory Factor Analysis (CFA) models of previous studies are referred to for model fitting. Results The results indicate the GHQ-12 has very good reliability and validity. All ten CFA models are well fitted with the actual data. Conclusion All the ten models are feasible and fit the data equally well. The Chinese version of the GHQ-12 is suitable for professional groups and can serve as a screening tool to detect anxiety and psychiatric disorders.
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Affiliation(s)
- Ying Liang
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, Jiangsu Province, People's Republic of China.
| | - Lei Wang
- College of Sciences, Northeastern University, Shenyang, People's Republic of China
| | - Xican Yin
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, Jiangsu Province, People's Republic of China
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van Geelen SM, Hagquist C. Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life? A 23-year study among 20,000 15-16year olds in Sweden. J Psychosom Res 2016; 87:50-6. [PMID: 27411752 DOI: 10.1016/j.jpsychores.2016.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/26/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment. Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously. METHODS A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16years old in eight cohorts in one geographically defined population (Värmland, Sweden). RESULTS The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment. Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form. CONCLUSION The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study.
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Affiliation(s)
- Stefan M van Geelen
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden; Division of Pediatrics, University Medical Center Utrecht, The Netherlands.
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Sweden
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Motor Problems as a Risk Factor for Poorer Mental Health in Children and Adolescents: What Do We Know and Should We Be Screening for Psychological Difficulties in Those with Poor Motor Skills? CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0091-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dahlqvist HZ, Landstedt E, Young R, Gådin KG. Dimensions of Peer Sexual Harassment Victimization and Depressive Symptoms in Adolescence: A Longitudinal Cross-Lagged Study in a Swedish Sample. J Youth Adolesc 2016; 45:858-73. [PMID: 26910524 PMCID: PMC4826406 DOI: 10.1007/s10964-016-0446-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/16/2016] [Indexed: 11/26/2022]
Abstract
Sexual harassment is commonly considered unwanted sexual attention and a form of gender-based violence that can take physical, verbal and visual forms and it is assumed to cause later depression in adolescents. There is a dearth of research explicitly testing this assumption and the directional pathway remains unclear. The purpose of this study was to use a feminist theoretical framework to test competing models in respect of the direction of the relationships between dimensions of peer sexual harassment victimization and dimensions of depressive symptoms from ages 14 to 16 in adolescents. The study also aimed to investigate gender differences in these pathways. Cross-lagged models were conducted using a three-wave (2010, 2011 and 2012) longitudinal study of 2330 students (51 % females) from Sweden, adjusted for social background. Girls subjected to sexual harassment in grade seven continued to experience sexual harassment the following 2 years. There was weaker evidence of repeated experience of sexual harassment among boys. Depressive symptoms were stable over time in both genders. Sexual name-calling was the dimension that had the strongest associations to all dimensions of depressive symptoms irrespective of gender. In girls, name-calling was associated with later somatic symptoms and negative affect, while anhedonia (reduced ability to experience pleasure) preceded later name-calling. Physical sexual harassment had a reciprocal relationship to somatic symptoms in girls. In boys, name-calling was preceded by all dimensions of depressive symptoms. It is an urgent matter to prevent sexual harassment victimization, as it is most likely to both cause depressive symptoms or a reciprocal cycle of victimization and depression symptoms in girls as well as boys.
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Affiliation(s)
| | - Evelina Landstedt
- Department of Health Sciences, Mid Sweden University, 851 70, Sundsvall, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Robert Young
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
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Ten-year trends in adolescents' self-reported emotional and behavioral problems in the Netherlands. Eur Child Adolesc Psychiatry 2015; 24:1119-28. [PMID: 25534927 DOI: 10.1007/s00787-014-0664-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
Changes in social, cultural, economic, and governmental systems over time may affect adolescents' development. The present study examined 10-year trends in self-reported emotional and behavioral problems among 11- to 16-year-old adolescents in the Netherlands. In addition, gender (girls versus boys), ethnic (Dutch versus non western) and educational (vocational versus academic) differences in these trends were examined. By means of the Strengths and Difficulties Questionnaire, trends in emotional and behavioral problems were studied in adolescents belonging to one of five independent population representative samples (2003: n = 6,904; 2005: n = 5,183; 2007: n = 6,228; 2009: n = 5,559; 2013: n = 5,478). Structural equation models indicated rather stable levels of emotional and behavioral problems over time. Whereas some small changes were found between different time points, these changes did not represent consistent changes in problem levels. Similarly, gender, ethnic and educational differences in self-reported problems on each time point were highly comparable, indicating stable mental health inequalities between groups of adolescents over time. Future internationally comparative studies using multiple measurement moments are needed to monitor whether these persistent mental health inequalities hold over extended periods of time and in different countries.
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Collishaw S. Annual research review: Secular trends in child and adolescent mental health. J Child Psychol Psychiatry 2015; 56:370-93. [PMID: 25496340 DOI: 10.1111/jcpp.12372] [Citation(s) in RCA: 392] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Child and adolescent mental health problems are common, associated with wide-ranging functional impairments, and show substantial continuities into adult life. It is therefore important to understand the extent to which the prevalence of mental health problems has changed over time, and to identify reasons behind any trends in mental health. SCOPE AND METHODOLOGY This review evaluates evidence on whether the population prevalence of child and adolescent mental health problems has changed. The primary focus of the review is on epidemiological cross-cohort comparisons identified by a systematic search of the literature (using the Web of Knowledge database). FINDINGS Clinical diagnosis and treatment of child and adolescent psychiatric disorders increased over recent decades. Epidemiological comparisons of unselected population cohorts using equivalent assessments of mental health have found little evidence of an increased rate of ADHD, but cross-cohort comparisons of rates of ASD are lacking at this time. Findings do suggest substantial secular change in emotional problems and antisocial behaviour in high-income countries, including periods of increase and decrease in symptom prevalence. Evidence from low- and middle-income countries is very limited. Possible explanations for trends in child and adolescent mental health are discussed. The review also addresses how cross-cohort comparisons can provide valuable complementary information on the aetiology of mental illness.
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Affiliation(s)
- Stephan Collishaw
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Rahmati Najarkolaei F, Raiisi F, Rahnama P, Gholami Fesharaki M, Zamani O, Jafari MR, Montazeri A. Factor structure of the Iranian version of 12-item general health questionnaire. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 16:e11794. [PMID: 25593708 PMCID: PMC4270680 DOI: 10.5812/ircmj.11794] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 12/08/2013] [Accepted: 01/21/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The 12-Item General Health (GHQ-12) questionnaire is one of the most commonly used instruments in screening studies on mental health. OBJECTIVES The current study aimed to examine the factor structure of the GHQ-12 questionnaire among the students in Iran. MATERIALS AND METHODS It was a cross-sectional study in which 428 university students were recruited and completed the GHQ-12. Reliability of the GHQ-12 was evaluated using the Cronbach's alpha and the split-half method by applying the Spearman-Brown coefficient. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was conducted to assess how well the EFA extracted model fitted the observed data. RESULTS The mean age of the participants was 22.83 years (SD = 3.09). Most of them were female (56.1%) and 81% were unemployed. The Cronbach's alpha coefficient for the Iranian version of GHQ-12 was 0.85. Using the split-half method, the alpha for the social dysfunction was found to be 0.77; it was 0.76 for the psychological distress. The principal component analysis revealed a two-factor structure for the questionnaire including social dysfunction and psychological distress that explained 48% of the observed variances. The confirmatory factor analysis was showed fit for the data. CONCLUSIONS The current study findings confirm that the Iranian version of GHQ-12 has a good factor structure and is a reliable and valid instrument to measure psychological distress and social dysfunction.
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Affiliation(s)
| | - Fatemeh Raiisi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Parvin Rahnama
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, IR Iran
- Corresponding Author: Parvin Rahnama, Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, IR Iran. Tel: +98-9121756442, E-mail:
| | | | - Omid Zamani
- Regional Knowledge Hub for HIV/AIDS Surveillance, Kerman University of Medical Sciences, Kerman, IR Iran
| | | | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, Academic Center for Education Culture & Research (ACECR), Tehran, IR Iran
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Sellers R, Maughan B, Pickles A, Thapar A, Collishaw S. Trends in parent- and teacher-rated emotional, conduct and ADHD problems and their impact in prepubertal children in Great Britain: 1999-2008. J Child Psychol Psychiatry 2015; 56:49-57. [PMID: 24953088 DOI: 10.1111/jcpp.12273] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence from Western countries indicates marked increases in diagnosis and treatment of childhood psychiatric disorders in recent years. These could reflect changes in prevalence of mental health problems, changes in their impact or increased clinical recognition and help-seeking. Epidemiological cross-cohort comparisons are required to test possible changes in prevalence, but are lacking for pre-adolescent children in Great Britain. METHODS Parent and teacher Strength and Difficulties Questionnaire (SDQ) ratings were used to compare rates of emotional, conduct and hyperactivity problems in 7-year-old children across three nationally representative British samples assessed in 1999 (n = 1033), 2004 (n = 648) and 2008 (n = 13,857). The SDQ impact supplement was used to assess associated distress, social, and educational impairment. Stratified analyses examined trends by gender and socio-economic group. RESULTS There was a decline in mean problem scores and a fall in the percentages scoring in the 'abnormal' range for all symptom types across the period of study. This decline was observed for all demographic groups, for parent and teacher reports, and was more marked for boys than girls. Both parent- and teacher-rated impact scores differed across the three cohorts for boys. Teacher-rated impact scores differed across cohorts for girls. CONCLUSIONS The first decade of the 21st Century saw a reduction in perceived levels of emotional and behaviour problems in pre-adolescent children in Great Britain. The threshold at which mental health problems have an impact on children's distress and classroom learning has changed over time. Continued monitoring of child mental health remains a priority.
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Affiliation(s)
- Ruth Sellers
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Låftman SB, Modin B, Östberg V, Hoven H, Plenty S. Effort-reward imbalance in the school setting: associations with somatic pain and self-rated health. Scand J Public Health 2014; 43:123-9. [PMID: 25504584 DOI: 10.1177/1403494814561818] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS According to the workplace theory of effort-reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort-reward imbalance model to the school setting. It aims to analyse the associations that effort-reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents. METHODS Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14-16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort-reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted. RESULTS The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort-reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health. CONCLUSIONS Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students.
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Affiliation(s)
- Sara Brolin Låftman
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| | - Bitte Modin
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| | - Viveca Östberg
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| | - Hanno Hoven
- Centre for Health and Society, Institute for Medical Sociology, University of Duesseldorf, Germany
| | - Stephanie Plenty
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
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Maras P, Moon A, Gupta T, Gridley N. The role of materialism on social, emotional and behavioural difficulties for British adolescents. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2014. [DOI: 10.1080/13632752.2014.989055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bor W, Dean AJ, Najman J, Hayatbakhsh R. Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Aust N Z J Psychiatry 2014; 48:606-16. [PMID: 24829198 DOI: 10.1177/0004867414533834] [Citation(s) in RCA: 401] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Up to one in five children experience mental health problems. Social and cultural factors may influence emergence of mental health problems. The 21st century has led to changes in many of these factors, but it is unclear whether rates of internalizing and externalizing problems have also changed in recent cohorts of young people. METHODS A comprehensive literature search was undertaken to locate cohort or population studies that examined changes in mental health of children over time, where participants were aged 18 years and under, and the time frame for change was at least 10 years, with data for at least one time point in the 21st century being statistically compared to at least one time point in the 20th century. Studies were reviewed for quality and outcome. RESULTS Nineteen studies met criteria for review. These included studies of toddlers, children, and adolescents. Seventeen studies examined internalizing problems, and 11 studies examined externalizing problems. For both children and toddlers, recent cohorts did not exhibit worsening of mental health symptoms. In adolescents, the burden of externalizing problems appear to be stable. However, the majority of studies report an increase in internalizing problems in adolescent girls. The findings for internalizing problems in boys were mixed. CONCLUSIONS These findings suggest that recent cohorts of adolescent girls are experiencing increases in internalizing symptoms compared to previous cohorts. Approaches for prevention and early intervention should be explored.
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Affiliation(s)
- William Bor
- Mater Research, Mater Children's Hospital, South Brisbane, QLD, Australia School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Angela J Dean
- Mater Research, Mater Children's Hospital, South Brisbane, QLD, Australia School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Jacob Najman
- Queensland Alcohol and Drug Research and Education Centre (QADREC), The University of Queensland, Herston, QLD, Australia
| | - Reza Hayatbakhsh
- Queensland Alcohol and Drug Research and Education Centre (QADREC), The University of Queensland, Herston, QLD, Australia
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Relationship between salivary cortisol and depression in adolescent survivors of a major natural disaster. J Physiol Sci 2014; 64:261-7. [PMID: 24744089 PMCID: PMC4070489 DOI: 10.1007/s12576-014-0315-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 03/30/2014] [Indexed: 10/30/2022]
Abstract
The purpose of this study was to determine the utility of salivary cortisol levels for screening mental states such as depression in adolescents following a natural disaster. We examined the relationship of salivary cortisol levels in adolescent survivors of the 2011 Tohoku Earthquake with the depression subscale of the 28-item General Health Questionnaire (GHQ). Subjects were 63 adolescent survivors (age = 14.29 years ± 0.51) who were administered the GHQ and provided saliva samples thrice daily (morning, afternoon and evening) over the course of 3 days. Based on the GHQ-depression subscores, subjects were divided into low and high depression groups. About 22 % of the subjects were classified into the high symptom group. When data collected over 3 days were used, a significant difference was observed between the two groups in the salivary cortisol levels at the evening time point as well the ratio of the morning/evening levels (p < 0.05). Analyzed by means of receiver-operating characteristic curves, the morning/evening ratios showed a good power in discriminating between subjects with and without depressive symptoms. Our study suggests that repeated measurement of salivary cortisol levels over 3 days has utility in screening for depressive states in adolescents following a natural disaster.
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Ivert AK, Torstensson Levander M, Merlo J. Adolescents' utilisation of psychiatric care, neighbourhoods and neighbourhood socioeconomic deprivation: a multilevel analysis. PLoS One 2013; 8:e81127. [PMID: 24260548 PMCID: PMC3829940 DOI: 10.1371/journal.pone.0081127] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 10/09/2013] [Indexed: 11/28/2022] Open
Abstract
Mental health problems among adolescents have become a major public health issue, and it is therefore important to increase knowledge on the contextual determinants of adolescent mental health. One such determinant is the socioeconomic structure of the neighbourhood. The present study has two central objectives, (i) to examine if neighbourhood socioeconomic deprivation is associated to individual variations in utilisation of psychiatric care in a Swedish context, and (ii) to investigate if neighbourhood boundaries are a valid construct for identifying contexts that influence individual variations in psychiatric care utilization. Data were obtained from the Longitudinal Multilevel Analysis in Scania (LOMAS) database. The study population consists of all boys and girls aged 13–18 years (N=18,417), who were living in the city of Malmö, Sweden, in 2005. Multilevel logistic regression analysis was applied to estimate the probability of psychiatric care utilisation. The results from the study indicate that the neighbourhood of residence had little influence on psychiatric care utilisation. Although we initially found a variation between neighbourhoods, this general contextual effect was very small (i.e. 1.6 %). The initial conclusive association between the neighbourhood level of disadvantage and psychiatric care utilisation (specific contextual effect) disappeared following adjustment for individual and family level variables. Our results suggest the neighbourhoods in Malmö (at least measured in terms of SAMS-areas), do not provide accurate information for discriminating adolescents utilisation of psychiatric care. The SAMS-areas appears to be an inappropriate construct of the social environment that influences adolescent utilisation of psychiatric care. Therefore, public health interventions should be directed to the whole city rather than to specific neighbourhoods. However, since geographical, social or cultural contexts may be important for our understanding of adolescent mental health further research is needed to identify such contexts.
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Affiliation(s)
- Anna-Karin Ivert
- Faculty of Health and Society, Malmö University, Malmö, Sweden
- * E-mail:
| | | | - Juan Merlo
- Unit of Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden
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How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents? Soc Psychiatry Psychiatr Epidemiol 2013; 48:693-9. [PMID: 23001409 DOI: 10.1007/s00127-012-0589-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 09/08/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate how parental country of birth and individual gender affect utilisation of psychiatric care in adolescents. METHODS On the basis of data from the Longitudinal Multilevel Analysis in Scania database, the article employs logistic regression to analyse the utilisation of psychiatric care among adolescents aged 13-18 (n = 92203) who were living in the southern Swedish county of Scania in 2005. RESULTS Adolescents whose parents were born in middle- or low-income countries presented lower levels of psychiatric outpatient care utilisation than those with native parents. Initially, no associations were found between the utilisation of psychiatric inpatient care and parental country of birth. Following adjustment for socio-demographic variables, it was found that adolescents with parents born in low-income countries were less likely to utilise psychiatric inpatient care. Girls presented higher levels of psychiatric care utilisation, but controls for possible interactions revealed that this was true primarily for girls with parents born in Sweden or other high-income countries. CONCLUSIONS The different utilisation patterns found among adolescents with different backgrounds should be taken into consideration when planning and designing psychiatric care for adolescents, and when allocating resources. Our results may indicate lower levels of mental health problems among adolescents with parents born in middle- or low-income countries implying that protective factors compensate other stressors implicated in mental health problems. On the other hand, our findings may indicate an unmet health-care need as a result of problems accessing care.
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Shevlin M, Murphy S, Mallett J, Stringer M, Murphy J. Adolescent loneliness and psychiatric morbidity in Northern Ireland. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2013; 52:230-4. [PMID: 24215150 DOI: 10.1111/bjc.12018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/12/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Previous research has identified an association between loneliness and psychiatric morbidity, but many of the studies have been based on small convenience samples and have not always used standardized measures. AIMS AND METHODS This study aimed to assess the association between standardized measures of loneliness and psychiatric morbidity using data from a large sample of adolescents from Northern Ireland (Young Life and Times Survey, 2011). A total of 1,434 participants completed the survey. RESULTS The prevalence of loneliness and psychiatric morbidity was 15.6% and 28.4% respectively. A multivariate binary logistic regression was used to identify the significant correlates of psychiatric morbidity. Demographic and loneliness variables were entered as covariates and female gender and perceptions of familial poverty were significantly associated with GHQ caseness. Loneliness increased the likelihood of GHQ caseness by more than five times. CONCLUSIONS Adolescent loneliness is significantly associated with psychiatric morbidity for Northern Irish adolescents. School-based screening and interventions to reduce loneliness may reduce the prevalence of loneliness.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, University of Ulster at Magee, Northern Ireland
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Padrón A, Galán I, Rodríguez-Artalejo F. Second-hand smoke exposure and psychological distress in adolescents. A population-based study. Tob Control 2012; 23:302-7. [PMID: 23002180 DOI: 10.1136/tobaccocontrol-2012-050548] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the association between duration and place of second-hand smoke (SHS) exposure and psychological distress in adolescents. METHODS A cross-sectional study conducted in 2008 and 2009 in a representative sample of 4th-year students of secondary education (mean age 15.7 years) in the region of Madrid, Spain. The 2215 students who were not smokers were selected for the analysis. Duration of SHS exposure within and outside the home was obtained by self-report. Psychological distress was defined as a score ≥ 3 points in the General Health Questionnaire (GHQ-12). The analyses were made using logistic regression adjusted for demographic variables, lifestyles and family characteristics. RESULTS Among non-smoking adolescents, 27.8% (95% CI 25.5 to 30.0) were exposed to SHS in the home, and 33.6% (95% CI 31.3 to 36.0) outside the home. Compared with those with no SHS exposure in the home, the multivariate OR for psychological distress was 1.23 (95% CI 0.92 to 1.64) in individuals with SHS exposure <1 h/day, 2.07 (95% CI 1.30 to 3.28) for exposure 1-3 h/day, and 2.24 (95% CI 1.45 to 3.47) for exposure >3 h/day (p for linear trend <0.001). No association was observed between SHS exposure outside the home and psychological distress. CONCLUSIONS In non-smoking adolescents, duration of exposure to SHS in the home had a positive dose-response relationship with the frequency of psychological distress. However SHS exposure outside the home did not show an association with mental health.
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Affiliation(s)
- Alicia Padrón
- Public Health Centre, Area 10, Madrid Regional Health Authority, Getafe, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Challenging claims that mental illness has been increasing and mental well-being declining. Soc Sci Med 2012; 75:581-8. [DOI: 10.1016/j.socscimed.2012.02.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 02/20/2012] [Accepted: 02/25/2012] [Indexed: 11/18/2022]
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Kidger J, Heron J, Lewis G, Evans J, Gunnell D. Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England. BMC Psychiatry 2012; 12:69. [PMID: 22737989 PMCID: PMC3439325 DOI: 10.1186/1471-244x-12-69] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 06/12/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored. METHOD Cross-sectional analysis of self-reported questionnaire data collected from members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England. Respondents (n = 4810) were aged 16-17 years old and have been followed up since birth. RESULTS Altogether 905 (18.8%) respondents had ever self-harmed. The prevalence of lifetime self-harm was higher in females (25.6%) than males (9.1%). The most commonly used method was self-cutting: this was used alone or in combination in 73.5% of episodes, compared to 10.0% who took overdoses alone or in combination with other methods. Of those who reported self-harm, 25.3% wanted to die during the most recent episode. Concurrent depression was associated with a greatly increased risk of self-harm (OR 5.43). Only 12.4% of participants sought medical help following their most recent episode of self-harm, although this figure was higher (30.1%) where self-harm was carried out with desire to die. Of the whole sample, 15.8% had ever thought of killing themselves, and 4.3% had ever made plans to kill themselves. Compared to those who had never self-harmed, those who had self-harmed but not wanted to die during the most recent episode were at increased risk of ever having had suicidal thoughts (37.6% compared to 7.8% χ2 =102.3, p < 0.001) and ever making suicidal plans (8.7% compared to 0.7%, χ2 =166.9, p < 0.001). As the frequency of self-harm increased, so did the risk of suicidal thoughts and plans. CONCLUSIONS Self-harm and suicidal thoughts are common among 16/17 year olds. Although the majority of self-harm behaviour is not accompanied by a desire to die, all self-harm regardless of motivation is associated with increased risk of suicidal thoughts and plans, particularly when it is carried out repeatedly.
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Affiliation(s)
- Judi Kidger
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - Glyn Lewis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - Jonathan Evans
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
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