Socioeconomic and lifestyle factors associated with mental health problems among Mongolian elementary school children

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

BACKGROUND

Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.

METHODS

The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.

RESULTS

There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).

CONCLUSIONS

The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.

Postpartum Depression in Young Mothers in Urban and Rural Indonesia

OBJECTIVES

Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions.

METHODS

This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression.

RESULTS

The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88).

CONCLUSIONS

In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers' mental health. The healthcare system needs to involve families to support young mothers' mental health from pregnancy until the postpartum period.

The Mediating Role of the Muscle Quality Index in the Relation of Screen Time and Abdominal Obesity with Health-Related Quality of Life in Chilean Schoolchildren

Screen time (ST) and abdominal obesity have a negative effect on health-related quality of life (HRQoL). However, there is little information regarding the mediating role of the muscle quality index (MQI) in these relationships. The aim of the present study was to investigate the association between HRQoL, physical status (i.e., anthropometrics and fitness), lifestyle (i.e., ST and physical activity), and the MQI, and then to determine the potential mediating role of the MQI in the relation of ST and abdominal obesity with HRQoL in Chilean schoolchildren. The cross-sectional study included 750 schoolchildren (girls, n = 332 and boys, n = 418) aged between 10 and 14 years (11.73 ± 1.08 y). MQI, lifestyle, fitness parameters, waist-to-height ratio (WtHR) and HRQoL were measured. HRQoL presented a significant correlation with WtHR (r: -0.19), VO2_max (r: 0.20), physical activity after school (r: 0.26), ST (r: -0.26) and MQI (r: 0.15). According to MQI, the high-MQI group reported higher HRQoL than the low-MQI group (low MQI: 36.10 ± 3.63 vs. high MQI: 37.43 ± 4.00, p < 0.001). In the mediation model, ST and abdominal obesity were negatively linked to HRQoL; the indirect effect confirmed that MQI is a partial mediator in the relation between ST and HRQoL (indirect effect = -0.04; SE = 0.02; 95% CI: -0.09, -0.01) and in the relation between abdominal obesity and HRQoL (indirect effect = -1.81; SE = 0.83; 95% CI: -3.41, -0.40). In conclusion, MQI is related to better HRQoL in schoolchildren, and the negative relation of ST and abdominal obesity with HRQoL is mediated by MQI.

Quality of life of mothers of children and adolescents with mental health problems in Mongolia: associations with the severity of children's mental health problems and family structure

BACKGROUND

In low- and middle-income countries (LMICs), most parents of children with mental health problems receive limited support from social and health services while caring for their children. However, research on the quality of life (QOL) of these parents in LMICs is limited. This study aimed to investigate the association between maternal QOL and children's mental health problems, and other related factors in Mongolia.

METHODS

A cross-sectional analysis of children aged 4-17 years who lived in Ulaanbaatar and visited the National Mental Health Centre in Mongolia and their mothers was conducted. The mothers' QOL was assessed using the WHOQOL-BREF, and the severity of children's mental health problems was assessed using the Strengths and Difficulties Questionnaire (SDQ). Multivariate linear regression analyses were performed using the mothers' WHOQOL domain scores as dependent variables and the children's SDQ scores and demographic and socioeconomic factors as explanatory variables.

RESULTS

A total of 242 child-mother dyads were included in this study, and 231 dyads were included in the multivariate regression analyses. Children's SDQ internalising scores were negatively associated with all four maternal QOL domain scores, while their externalising scores were negatively associated with maternal physical and psychological domain scores. Non-cohabitation of fathers was negatively associated with physical, social, and environmental domain scores, and non-cohabitation of grandparents was associated with psychological and environmental domain scores.

CONCLUSIONS

In Mongolia, maternal QOL is influenced by the severity of children's mental health problems and family member support. These findings highlight the importance of developing systems to support all families.