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Eriksson C, Stattin H. Mental health profiles of 15-year-old adolescents in the Nordic Countries from 2002 to 2022: person-oriented analyses. BMC Public Health 2024; 24:2358. [PMID: 39215310 PMCID: PMC11363628 DOI: 10.1186/s12889-024-19822-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
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.
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Affiliation(s)
- Charli Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, SE-17177, Stockholm, Sweden.
| | - Håkan Stattin
- Department of Psychology, Uppsala University, Box 1225, 75142, Uppsala, Sweden
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Låftman SB, Östberg V. Psychosomatic complaints are indicative of stress in young individuals: findings from a Swedish national cohort study. Scand J Public Health 2024:14034948241255179. [PMID: 39086218 DOI: 10.1177/14034948241255179] [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: 08/02/2024]
Abstract
AIMS Psychosomatic complaints are common in youth and are often assumed to indicate stress. Although several studies have confirmed that a cross-sectional association exists, few have empirically investigated whether or not perceived stress influences psychosomatic complaints. The objective of the present study was to build upon previous research by exploring whether changes in perceived stress over time are associated with corresponding changes in psychosomatic complaints. This analytical approach takes unmeasured time-invariant confounding into account, thereby offering more robust evidence for a causal association between the variables under study. METHODS Data was derived from the Swedish national cohort study Futura01, with information from 2,708 participants aged 17-18 in 2019 and 20-21 in 2022. Perceived stress was measured by Cohen's Perceived Stress Scale. Psychosomatic complaints were measured by questions on the frequency of stomach aches, headaches and difficulties falling asleep, which were added to an index. Information on gender, parental education, and parental country of birth was derived from registries. Linear regression analyses were conducted and the first difference (FD) approach was used. RESULTS Perceived stress and psychosomatic complaints exhibited cross-sectional associations at both time points. The FD analyses showed that increases in perceived stress were associated with increases in psychosomatic complaints, and this was the case irrespective of sociodemographic characteristics. CONCLUSIONS This study provides further empirical support for the assumption that psychosomatic complaints can be partially attributed to stress. Societal efforts aimed at reducing stressors and strengthening coping resources and strategies among young people may help mitigate perceived stress and, consequently, the likelihood of developing psychosomatic complaints.
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Affiliation(s)
- Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Sweden
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Anthony R, Moore G, Page N, Ollerhead C, Parker J, Murphy S, Rice F, Armitage JM, Collishaw S. Trends in adolescent emotional problems in Wales between 2013 and 2019: the contribution of peer relationships. J Child Psychol Psychiatry 2024; 65:887-898. [PMID: 38083987 DOI: 10.1111/jcpp.13924] [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: 09/27/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Epidemiological evidence shows a substantial increase in adolescent emotional problems in many countries, but reasons for this increase remain poorly understood. We tested change in emotional problems in a national sample of young people in Wales in 2013, 2017 and 2019 using identical symptom screens, and examined whether trends were accounted for by changes in youth friendship quality and bullying. METHODS The present study of 230,735 11-16-year olds draws on repeat cross-sectional data obtained on three occasions (2013, 2017 and 2019) in national school-based surveys in Wales (conducted by the School Health Research Network). Emotional problems were assessed with a brief validated symptom screen (the SCL-4). RESULTS There was a significant increase in emotional problem scores between 2013 and 2019 (b[95% CI] = 1.573 [1.380, 1.765]). This increase was observed for all ages and was more pronounced for girls than boys (interaction b [95% CI] = 0.229 [0.004, 0.462]) and for young people from less affluent families (interaction b [95% CI] = -0.564[-0.809, -0.319]). Of the total sample, 14.2% and 5.7% reported frequent face-to-face and cyberbullying respectively. There were modest decreases in friendship quality and increases in rates of bullying between 2013 and 2019, but accounting for these changes did not attenuate estimates of the population-level increase in emotional problems. CONCLUSIONS This study provides evidence of a substantial increase in emotional problems among young people in Wales, particularly for young people from less affluent backgrounds. Changes in bullying or friendship quality did not explain this increase.
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Affiliation(s)
- Rebecca Anthony
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Graham Moore
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Nicholas Page
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | | | - Jack Parker
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
| | - Simon Murphy
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Frances Rice
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff University, Cardiff, UK
| | - Jessica M Armitage
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff University, Cardiff, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff University, Cardiff, UK
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Buli BG, Larm P, Nilsson K, Giannotta F. Trends in adolescent mental health problems 2004-2020: Do sex and socioeconomic status play any role? Scand J Public Health 2024; 52:565-572. [PMID: 37139789 PMCID: PMC11292962 DOI: 10.1177/14034948231165552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 05/05/2023]
Abstract
AIMS This study aims to investigate trends in four types of adolescent mental health problems; that is, psychosomatic symptoms, depressive symptoms, suicidal ideations, and suicide attempts 2004-2020. A second aim is to investigate the moderating roles of socioeconomic status and sex in these trends. METHODS The analysis is based on repeated cross-sectional data 2004-2020 among grade 9 students in secondary schools in a Swedish county. In total, data from 19,873 students were included in the analysis. We fitted linear and logistic regression equations and used survey-years' coefficients to estimate the trends. We also estimated the moderating effects of socioeconomic status and sex using interactions between survey year and socioeconomic status and sex, respectively. RESULTS The trends in all mental health problems declined over time. Through its interaction with survey year, socioeconomic status moderated the trends; psychosomatic symptoms (B = -0.115, P<0.001), depressive symptoms (B = -0.084, P<0.001) and suicidal ideations (odds ratio 0.953, confidence interval 0.924-0.983) significantly declined over time among those with high socioeconomic status. However, socioeconomic status did not have an association with the trend in suicide attempts. Interaction between sex and year of survey was associated with significant decreasing trends in depressive symptoms and suicidal ideations only among girls. CONCLUSIONS Adolescent mental health problems have decreased over time, but only for adolescents with high socioeconomic status, or only in depressive symptoms and suicidal ideations for girls. The results shed light on the growing inequalities in health outcomes across levels of socioeconomic status.
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Affiliation(s)
- Benti Geleta Buli
- Department of Public Health Sciences, Mälardalen University, Västerås, Sweden
| | - Peter Larm
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Kent Nilsson
- Department of Public Health Sciences, Mälardalen University, Västerås, Sweden
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Fabrizia Giannotta
- Department of Public Health Sciences, Mälardalen University, Västerås, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Ahlborg MG, Morgan A, Svedberg P, Nygren JM, Eriksson M, Westberg KH. SoCap YMH - youth mental health, social capital and help-seeking: a study protocol. Front Public Health 2024; 12:1406649. [PMID: 38919916 PMCID: PMC11196961 DOI: 10.3389/fpubh.2024.1406649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Background The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours. Aim This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden. Methods A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized. Conclusion The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures.
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Affiliation(s)
| | - Antony Morgan
- Department of Public Health, Glasgow Caledonian University in London, London, United Kingdom
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens M. Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Malin Eriksson
- Department of Social Work, Umeå University, Umeå, Sweden
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Peprah P, Oduro MS, Atta-Osei G, Addo IY, Morgan AK, Gyasi RM. Problematic social media use mediates the effect of cyberbullying victimisation on psychosomatic complaints in adolescents. Sci Rep 2024; 14:9773. [PMID: 38684725 PMCID: PMC11058249 DOI: 10.1038/s41598-024-59509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/11/2024] [Indexed: 05/02/2024] Open
Abstract
Adolescent psychosomatic complaints remain a public health issue globally. Studies suggest that cyberbullying victimisation, particularly on social media, could heighten the risk of psychosomatic complaints. However, the mechanisms underlying the associations between cyberbullying victimisation and psychosomatic complaints remain unclear. This cross-cultural study examines the mediating effect of problematic social media use (PSMU) on the association between cyberbullying victimisation and psychosomatic complaints among adolescents in high income countries. We analysed data on adolescents aged 11-16.5 years (weighted N = 142,298) in 35 countries participating in the 2018 Health Behaviour in School-aged Children (HBSC) study. Path analysis using bootstrapping technique tested the hypothesised mediating role of PSMU. Results from the sequential binary mixed effects logit models showed that adolescents who were victims of cyberbullying were 2.39 times significantly more likely to report psychosomatic complaints than those who never experienced cyberbullying (AOR = 2.39; 95%CI = 2.29, 2.49). PSMU partially mediated the association between cyberbullying victimisation and psychosomatic complaints accounting for 12% ( β = 0.01162, 95%CI = 0.0110, 0.0120) of the total effect. Additional analysis revealed a moderation effect of PSMU on the association between cyberbullying victimisation and psychosomatic complaints. Our findings suggest that while cyberbullying victimisation substantially influences psychosomatic complaints, the association is partially explained by PSMU. Policy and public health interventions for cyberbullying-related psychosomatic complaints in adolescents should target safe social media use.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Michael Safo Oduro
- Pfizer Research and Development, PSSM Data Sciences, Pfizer, Inc., Connecticut, USA
| | - Godfred Atta-Osei
- Centre for Disability and Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
| | - Anthony Kwame Morgan
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
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Mojtabai R. Problematic social media use and psychological symptoms in adolescents. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02657-7. [PMID: 38584201 DOI: 10.1007/s00127-024-02657-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE This study examined time trends in significant child and adolescent psychological symptoms and explored the association of frequent and problematic social media use with these symptoms. METHODS Time trends in psychological symptoms were assessed using data from five waves of the international survey of Health Behavior in School-aged Children (HBSC), conducted between 2001 and 2018 (N = 1,036,869). The associations of frequent and problematic social media use with significant psychological symptoms were assessed by hierarchical multinomial logistic regression using data from 2001-2002 and the 2017-2018 survey waves. The direction of effect between social media use variables and psychological symptoms was explored using Linear Non-Gaussian Acyclic Models (LiNGAM). RESULTS Prevalence of more severe psychological symptoms increased from 6.7% in 2001-2002 to 10.4% in the 2017-2018 survey waves. The increase was especially large among 15-year old and older girls: from 10.9 to 19.1%. The higher prevalence of more severe psychological symptoms in 2017-2018 compared with 2001-2002 was eliminated after adjusting the model for problematic social media use. LiNGAM analysis supported the direction of effect going from social media use and problematic social media use to psychological symptoms. CONCLUSIONS The findings suggest that frequent and problematic use of social media contribute to the increasing trend of psychological symptoms in adolescents in recent years.
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Affiliation(s)
- Ramin Mojtabai
- Department of Psychiatry and Behavioral Sciences, Tulane University, 1440 Canal Street, Suite 1000, New Orleans, LA, 70112, USA.
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Almaradheef R, Alhalal E. Outcomes of adverse childhood experience during late adolescence: Evidence from college and community samples. Res Nurs Health 2024; 47:182-194. [PMID: 38217469 DOI: 10.1002/nur.22368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/31/2023] [Accepted: 12/23/2023] [Indexed: 01/15/2024]
Abstract
Scant studies have investigated adverse childhood experience (ACE) outcomes and mastery during adolescence in different cultural contexts. This cross-sectional study examines the impact of ACEs on subjective well-being, health complaints, and healthcare utilization during late adolescence, including the mediating role of the sense of mastery in the Saudi context. Adolescents (N = 396) aged 17-21 years were recruited via convenience sampling from colleges and local communities from two regions in Saudi Arabia. Data were collected using a paper-pencil anonymous survey and analyzed using path analysis. Of the sample, 85.5% experienced at least one ACE. ACEs had a direct effect on subjective well-being (p = 0.034), health complaints (p < 0.001), healthcare utilization (p < 0.001), and sense of mastery (p < 0.001). Sense of mastery had an effect on subjective well-being (p < 0.001) and health complaints (p < 0.001), but not on healthcare utilization (p = 0.436). Sense of mastery partially mediated the relationship between ACEs and subjective well-being (p = 0.034) and health complaints (p < 0.001), but not healthcare utilization (p = 0.438). ACEs have detrimental effects on adolescent health. Attention should be paid to primary prevention and early detection to avoid further harm, and interventions that address the role of the sense of mastery should be developed for adolescents.
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Affiliation(s)
| | - Eman Alhalal
- Community and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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Buli BG, Lehtinen-Jacks S, Larm P, Nilsson KW, Hellström-Olsson C, Giannotta F. Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors. BMC Public Health 2024; 24:878. [PMID: 38515098 PMCID: PMC10958834 DOI: 10.1186/s12889-024-18327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
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.
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Affiliation(s)
- Benti Geleta Buli
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden.
| | - Susanna Lehtinen-Jacks
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
| | - Peter Larm
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Kent W Nilsson
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Fabrizia Giannotta
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Turin, Turin, Italy
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Corell M, Friberg P, Petzold M, Löfstedt P. Socioeconomic inequalities in adolescent mental health in the Nordic countries in the 2000s - A study using cross-sectional data from the Health Behaviour in School-aged Children study. Arch Public Health 2024; 82:20. [PMID: 38326845 PMCID: PMC10848422 DOI: 10.1186/s13690-024-01240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Adolescents in Sweden experience more mental health problems and lower mental well-being than adolescents in other Nordic countries. According to the literature, one possible explanation may be differences in income inequality. The at-risk-of-poverty rate varies significantly across the Nordic countries, and the highest rate is found in Sweden. The aims of the study were to examine socioeconomic inequalities in subjective health complaints and life satisfaction among adolescents in the Nordic countries during 2002 - 2018 and to explore whether subjective health complaints and life satisfaction were related to income inequality in terms of the at-risk-of-poverty rate at the country level. METHODS Data regarding 15-year-olds from the Health Behaviour in School-aged Children study from five survey rounds (2002 - 2018) were used (n = 41,148). The HBSC Symptoms Checklist and Cantril's ladder were used as measures of subjective health complaints and life satisfaction, respectively. The Family Affluence Scale, the Perceived Family Wealth item and the at-risk-of-poverty rate in each country were used as measures of individual-level socioeconomic conditions and country-level income inequality. Statistical methods involved ANOVA, multiple linear regressions and multilevel regression analyses. RESULTS Absolute and relative socioeconomic inequalities in both subjective health complaints and life satisfaction were found in all countries. Sweden showed average socioeconomic inequalities, Iceland the largest and Denmark the smallest. Country-level income inequality in terms of the at-risk-of-poverty rate was associated with a higher prevalence of subjective health complaints and lower levels of life satisfaction in all countries. CONCLUSION Socioeconomic inequalities in adolescent mental health and well-being persisted in Nordic countries in the 2000s. Increasing income inequality may have contributed to higher levels of SHC and lower LS in Sweden compared to the other Nordic countries. Policies improving families' socioeconomic conditions and reducing income inequality at the country level are needed to improve and reduce inequalities in mental health and well-being among adolescents.
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Affiliation(s)
- Maria Corell
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, 405 30, Göteborg, Box 428, Sweden.
- Public Health Agency of Sweden, 171 82, Solna, Sweden.
| | - Peter Friberg
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, 405 30, Göteborg, Box 428, Sweden
| | - Max Petzold
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, 405 30, Göteborg, Box 428, Sweden
| | - Petra Löfstedt
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, 405 30, Göteborg, Box 428, Sweden
- Public Health Agency of Sweden, 171 82, Solna, Sweden
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Grigorian K, Östberg V, Raninen J, Åhlén J, Brolin Låftman S. Prospective associations between psychosomatic complaints in adolescence and depression and anxiety symptoms in young adulthood: A Swedish national cohort study. SSM Popul Health 2023; 24:101509. [PMID: 37720821 PMCID: PMC10500464 DOI: 10.1016/j.ssmph.2023.101509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023] Open
Abstract
Background Psychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood. Methods A Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779). Results The frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls. Conclusions Psychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.
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Affiliation(s)
- Karina Grigorian
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Johan Åhlén
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Sweden
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Nilsen SA, Stormark KM, Heradstveit O, Breivik K. Trends in physical health complaints among adolescents from 2014 - 2019: Considering screen time, social media use, and physical activity. SSM Popul Health 2023; 22:101394. [PMID: 37114241 PMCID: PMC10126924 DOI: 10.1016/j.ssmph.2023.101394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
The rising rates of physical and mental health complaints among adolescents observed in many countries have coincided with an increased time spent on screen-based devices, including social media use. We sought to document recent trends in physical health complaints (PHC) and whether co-occurring trends in screen time, social media use, and physical activity may account for these trends. To achieve these aims, we used data from the nationwide Ungdata surveys conducted annually at the municipality level in Norway, comprising 419,934 adolescents aged 13-18 from six survey years (2014-2019). Six items assessed PHC, including neck and shoulder pain, headache, and abdominal pain, during the past month. To account for the nesting structure of Ungdata, and to exploit the variation within and between municipalities, we used multilevel analyses with adolescents nested in municipality-years (n = 669), nested in municipalities (n = 345). We found a small to moderate linear increase in number of PHC among boys and girls from 2014 to 2019. Screen time and social media use moderately attenuated the trend for girls, and to a lesser extent for boys. Screen time and social media use were further positively associated with PHC across the between and within-municipality levels, and social media use was more strongly associated with PHC for girls than boys across all levels of analysis. A similar pattern emerged when considering each symptom individually. The results suggest that the prevalence of PHC rose in tandem with a group-level shift towards higher screen time and social media use. Moreover, the results indicate that higher screen time and social media use may have led to changes in the youth culture with potential consequences for adolescents' well-being.
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Affiliation(s)
- Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Corresponding author. Norwegian Research Centre, Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 22, Nygårdstangen, 5838, Bergen, Norway.
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Postbox 22, Nygårdstangen, 5838, Bergen, Norway
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Inchley JC, Willis M, Mabelis J, Brown J, Currie DB. Inequalities in health complaints: 20-year trends among adolescents in Scotland, 1998-2018. Front Psychol 2023; 14:1095117. [PMID: 37020907 PMCID: PMC10067662 DOI: 10.3389/fpsyg.2023.1095117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 03/22/2023] Open
Abstract
This study examined trends in inequalities in health complaints among early adolescents in Scotland from 1998 to 2018. We analysed data from the Health Behaviour in School-aged Children (HBSC) survey conducted in Scotland in 1998, 2002, 2006, 2010, 2014 and 2018. A self-report questionnaire was administered in schools to a nationally representative sample of 11-, 13-, and 15-year-olds (n = 29,250). Health complaints were measured using a scale comprising four psychological symptoms (feeling low, feeling nervous, irritability and sleep difficulties) and four somatic symptoms (headache, backache, stomachache and dizziness). Socio-economic status was measured using the Family Affluence Scale. Between 1998 and 2018, there were significant increases in the proportion of girls and boys reporting feeling low, feeling nervous, sleep difficulties and backache. Prevalence of the eight individual health complaints was higher among girls and adolescents from lower affluence families. Socio-economic inequalities increased over time, such that declines in mental health were greatest among low affluence adolescents. The data show worsening trends in health complaints among Scottish adolescents between 1998 and 2018, particularly for girls and adolescents from low affluence families. Increasing inequalities in mental health highlight the need to address the underlying social and structural determinants of adolescent mental health.
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Affiliation(s)
- Joanna C. Inchley
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Judith Mabelis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Judith Brown
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Dorothy B. Currie
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
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Eriksson C, Stattin H. Secular trends in mental health profiles among 15-year-olds in Sweden between 2002 and 2018. Front Public Health 2023; 11:1015509. [PMID: 36875365 PMCID: PMC9978413 DOI: 10.3389/fpubh.2023.1015509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/13/2023] [Indexed: 02/18/2023] Open
Abstract
Background Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contrast to the long-term increase in mental health problems seen in many countries, this Swedish study did not find an increase among young persons, both boys and girls, with the poorest mental health, the Poor mental health profile. Rather, the most substantial increase over the survey years, predominantly between 2010 and 2018, was found among the 15-year-olds with High psychosomatic symptoms only.
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Affiliation(s)
- Charli Eriksson
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet (KI), Stockholm, Sweden
| | - Håkan Stattin
- Department of Psychology, Faculty of Social Sciences, Uppsala University, Uppsala, Sweden
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