Psychosomatic problems in relation to alcohol use and physical exercise: a study between 1988 and 2011 among adolescents in Sweden

Mental health profiles of 15-year-old adolescents in the Nordic Countries from 2002 to 2022: person-oriented analyses

BACKGROUND

Studies of time trends in Nordic adolescents' mental health have often relied on analyses of adolescents' psychosomatic symptoms. In this study, we examine adolescents' self-reports on mental health in the context of the dual factor model, which encompasses both overt manifestations of mental health symptoms and subjective perception of one's health status.

METHOD

The objective of this study was to employ a person-oriented approach utilizing cluster analysis to discern time trends in mental health profiles of Nordic adolescents, using their psychosomatic complaints and their perception of their overall health as cluster variables. The resulting health profiles were then subjected to a comparative analysis with regard to different measures of psychological and social adjustment. The mental health profiles were based on data from the Health Behaviour in School-aged Children (HBSC) survey, which was conducted among almost 50000 15-year-olds in five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) between 2002 and 2022.

RESULTS

Mental health profiles exhibiting comparable content were observed in all Nordic countries, including profiles indicating adequate health, perceived good health, perceived poor health, high psychosomatic complaints, and dual health problems (defined as both high psychosomatic complaints and perceived poor health). These health profiles showed similar trends over time in the Nordic countries. Significant gender differences were observed. In 2002, adequate health was the dominant profile for both sexes. After 20 years, however, the high psychosomatic profile became the most common profile among girls. Among the three risk profiles, namely perceived poor health, high psychosomatic complaints and dual health problems, adolescents in the dual problems profile had the most psychological and social adjustment problems.

CONCLUSIONS

The comparatively lower incidence of adjustment problems among adolescents in the high psychosomatic profile relative to the dual mental health group challenges the prevailing view that there has been a sharp increase in mental health problems among Nordic adolescents. This view was largely based on the observed rise in psychosomatic symptoms. Indeed, there was a doubling in the proportion of adolescents in the high psychosomatic complaints profile between 2002 and 2022. This increase was considerably more pronounced than that observed for the dual health problems profile which exhibited most problems.

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.

Character strengths as protective factors against behavior problems in early adolescent

Character strengths could effectively prevent negative psychological outcomes in adults. However, there was little research conducted among early adolescents. The present study aimed to explore character strengths that were independently related to fewer behavior problems in early adolescents. In total, 521 early adolescents (mean age 10.92 ± 0.04, range 10-12 years) were recruited from primary schools in Sichuan, China. Character strengths were measured using the Values in Action Inventory of Strengths for Youth (VIA-Youth). Behavior problems were measured using the Conners Parent Symptom Questionnaire (PSQ). The results showed that behavior problems were negatively correlated with character strengths (r = -0.14 to -0.3, p < 0.05 Bonferroni corrected). Character strengths explained a significant proportion of additional variance (14-22%) in five types of behavior problems after controlling the effect of demographic factors (residence, left-behind experiences, maternal education level). Moreover, several specific character strengths showed an independent contribution (β = -0.34 to -0.14 for self-regulation, perseverance, zest, humility, and leadership; β = 0.21 to 0.34, for hope; all p < 0.05) to behavior problems. Our study revealed that character strengths were protective factors against behavior problems in early adolescents.

Self-perception of physical activity and fitness is related to lower psychosomatic health symptoms in adolescents with unhealthy lifestyles

The general aim of the present study was to examine how physical activity, participation in sports, and beliefs about personal physical activity and physical fitness are associated with adolescents' psychosomatic health complaints (PHC) in relation to their lifestyles.

METHODS

A total of 3284 11-19-year-old adolescents (average age 14.9 ± 2.0; 48.6% male) participated in the population-based cross-sectional study. Self-administered questionnaires addressed lifestyle, sports participation, physical activity, physical fitness perception, and PHC.

RESULTS

Female gender (OR = 1.92; 95% CI = 1.57-2.35), smoking (OR = 1.31; 95%PI = 1.01-1.68), alcohol consumption (OR = 1.60; 95%PI = 1.30-1.97), unhealthy foods (OR = 1.14; 95%PI = 1.04-1.26), hours of internet use (OR = 1.14; 95%PI = 1.07-1.21), and poor personal fitness perception (OR = 1.60; 95% CI = 1.27-2.02) were associated with PHC in adolescents. Lower physical activity and self-perceived insufficient physical activity, perception of physical fitness as being poor, and not participating in sports were associated with greater somatic and psychological complaints controlling for age, gender, and BMI. Participation in sports and physical activity did not change PHC in adolescents involved in unhealthy behaviour. However, a positive perception of one's own physical activity and physical fitness decreased PHC in adolescents who reported an unhealthy lifestyle.

CONCLUSIONS

Adolescents demonstrating poorer health-related behavioural profiles showed higher PHC. Physical activity and sports participation were related to lower PHC. Positive physical activity and physical fitness perception changed the associations between PHC and unhealthy lifestyle: adolescents perceiving themselves as sufficiently physically active and those evaluating their physical fitness as good showed lower PHC, despite the presence of unhealthy habits (high screen time, drinking alcohol, smoking, and consuming unhealthy foods). It is important to study cognitive factors when exploring the associations between adolescent lifestyles and PHC. These results are important for health promotion and education programmes aimed at improving healthy lifestyle and psychosocial well-being in adolescents.

The latent structure of major depressive symptoms and its relationship with somatic disorder symptoms among Filipino female domestic workers in China

Emerging research have investigated the factor structure of major depressive disorder (MDD) symptoms based on DSM-5 nomenclature. However, to date, results have been inconsistent on what symptom-structure best represent MDD. This study examines the best fitting MDD among four competing models in a sample of overseas Filipino domestic helpers (N = 232). The results show that a two-factor model (Model 2b; Krause et al., 2010) provided the best fit. The model consist of two factors: somatic and non-somatic/affective symptoms. Somatic component includes sleep difficulties, fatigue, appetite changes, concentration difficulties, and psychomotor agitation/retardation while non-somatic/affective component covers anhedonia, depressed mood, feelings of worthlessness, and thoughts of death. Further, the results reveal a pattern where PHQ-15 somatic symptom-items have a higher significant relationship with MDD's somatic symptoms than with the MDD's non-somatic/affective symptoms. These findings suggest that the items of model 2b are appropriately embedded in their respective factors. Differentiating MDD factors have important clinical implications, particularly in the diagnosis and treatment of depression among overseas Filipino domestic helpers.

Temporal trends in adolescents' self-reported psychosomatic health complaints from 1980-2016: A systematic review and meta-analysis

OBJECTIVE

There is increasing concern that mental health may be deteriorating in recent generations of adolescents. It is unclear whether this is the case for self-reported psychosomatic health complaints (PSHC).

METHOD

We conducted a systematic review and meta-analysis of published primary studies on PSHC in the general adolescent population over time. The primary databases were MEDLINE, Embase and PsycINFO, which were searched from inception to November 2016. Studies were included if they involved an observational design, presented self-reported data from participants aged 10-19 years and included data from at least two time points, five years apart. Inclusion and study quality were assessed by two independent reviewers.

RESULTS

Twenty-one studies were included; 18 reported trends on the prevalence of PSHC in a single country, while three studies reported on multiple countries. In total, over seven million adolescents from 36 countries in Europe, North America, Israel and New Zealand were represented, covering the period 1982-2013. In the descriptive analysis, 10 studies indicated a trend of increasing PSHC, eight showed a stable trend and three showed a decreasing trend at certain points in time. The results from the meta-analysis showed a mean odds ratio (OR) of 1.04 (K = 139, 95% CI 1.01-1.08) for PSHC from 1982 to 2013, thus indicating a minor increase in general. In the subgroup analysis, this minor increase was observed mainly between the 1980s and 2000s, while the trend appeared to be more stable between the 2000s and 2010s. Some differences were also found between multinational subregions. Findings from subgroup analysis, however, only supported a significant increasing trend in Northern Europe.

CONCLUSION

There may have been a minor increasing trend in adolescent self-rated PSHC between the 1980 and 2000s, but has become more stable since the 2010s, from a multinational perspective. Northern Europe was the only region to show a clearly significant minor increasing trend, without being the region with the highest total prevalence of PSHC at the present time. The discrepant trends regarding PSHC between regions and the reliance on self-reported data may reflect true changes in the occurrence of PSHC in the adolescent population. However, they may also reflect changes in how adolescents perceive and report health complaints.

OTHER

PROSPERO registration 2016: CRD42016048300.