1
|
Aonso-Diego G, Krotter A, García-Pérez Á. Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis. Addiction 2024; 119:438-463. [PMID: 37967848 DOI: 10.1111/add.16390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/27/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND AND AIMS The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups. METHOD We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults). RESULTS The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2 = 99.80], 43.4% (95% CI = 36.1-50.6; I2 = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2 = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2 = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2 = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035). CONCLUSIONS The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.
Collapse
Affiliation(s)
| | - Andrea Krotter
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Ángel García-Pérez
- Department of Psychology, Sociology and Philosophy, University of León, León, Spain
| |
Collapse
|
2
|
Faris ME, Al Gharaibeh F, Islam MR, Abdelrahim D, Saif ER, Turki EA, Al-Kitbi MK, Abu-Qiyas S, Zeb F, Hasan H, Hashim MS, Osaili TM, Radwan H, Cheikh Ismail L, Naja F, Bettayeb FZ, Obaid RS. Caffeinated energy drink consumption among Emirati adolescents is associated with a cluster of poor physical and mental health, and unhealthy dietary and lifestyle behaviors: a cross-sectional study. Front Public Health 2023; 11:1259109. [PMID: 37908686 PMCID: PMC10613644 DOI: 10.3389/fpubh.2023.1259109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/28/2023] [Indexed: 11/02/2023] Open
Abstract
Background Consumption of caffeinated energy drinks (CED) has escalated during the last few years, especially among schoolchildren, with evident adverse health sequelae in this critical age group. Objective This study examined the prevalence of CED consumption and its associations with sleep, physical and mental health, and dietary and lifestyle habits among schoolchildren in the United Arab Emirates (UAE). Method A structured self-administered online questionnaire was developed and disseminated among schoolchildren aged 14-18 years, selected from schools of the seven emirates of the UAE. Results More than 4,500 (N= 4,648) responses received. A relatively low prevalence of CED consumption (20%) was found among schoolchildren in the UAE. However, those who reported CED consumption were more likely to report unhealthy dietary (skipping breakfast, frequent snacking, and eating fast foods, low fruit, and vegetable intake) and lifestyle behaviors (long screen time, poor sleep health), in addition to poor self-reported mental and physical health than non-users. CED consumption was significantly and variably associated with multiple sociodemographic factors such as students' nationality, parental companionship, sex, school type, education level (children's and parents'), daily allowance, academic performance, screen time, sleep quality parameters, self-reported physical and mental health, and parents' employment. Sources of knowledge about CED were social media (55%), friends/schoolmates (52%), and family members (52%). Students believed that CED constitute sugar (87%), caffeine (69%), artificial flavors (67%) sweeteners (54%), and stimulating components (43%). The majority (70%) of students reported that CED consumption increases the risks for heart disease, diabetes, high blood sugar (65%), addiction (64%), high blood pressure (59%), and obesity (57%). Conclusion These results offer important insights for health professionals, child health specialists, policymakers, and parents in the UAE regarding adolescents' attitudes, knowledge and behaviors toward CED consumption.
Collapse
Affiliation(s)
- MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Fakir Al Gharaibeh
- Research Institute of Humanities and Social Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - M. Rezaul Islam
- Research Institute of Humanities and Social Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Dana Abdelrahim
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Eman Rashid Saif
- Health Promotion Department, Supreme Council for Family Affairs, Sharjah, United Arab Emirates
| | - Eman Ali Turki
- Health Promotion Department, Supreme Council for Family Affairs, Sharjah, United Arab Emirates
| | - Mahra Khalfan Al-Kitbi
- Health Promotion Department, Supreme Council for Family Affairs, Sharjah, United Arab Emirates
| | - Salma Abu-Qiyas
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Falak Zeb
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Mona S. Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Tareq M. Osaili
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Fatima Zohra Bettayeb
- Research Institute of Humanities and Social Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Research (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
3
|
Use of Caffeine-Containing Energy Drinks by Japanese Middle School Students: A Cross-Sectional Study of Related Factors. Nutrients 2023; 15:nu15051275. [PMID: 36904274 PMCID: PMC10004827 DOI: 10.3390/nu15051275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Excessive consumption of caffeine negatively affects individuals' health. Therefore, we studied the use of energy drinks and the conditions associated with it among Japanese secondary school students. Participants were 236 students in grades 7-9 who completed anonymous questionnaires at home in July 2018. We measured the basic attributes and dietary, sleeping, and exercise habits. We used Chi-squared tests to compare differences between users and non-users of energy drinks. Logistic regression analyses were used to elucidate the complex association between the variables. The results showed that boys were more willing to consume energy drinks than girls. The reasons were 'feeling fatigued', 'needing to stay awake', 'for curiosity', and 'to quench one's thirst'. Among boys, the following were associated with the use of EDs. Buying their own snacks , not understanding nutritional labels on foods, high caffeinated beverage intake, late bed-times on weekdays, always waking up at about the same time, and weight. Health guidance is needed to prevent overconsumption and dependence on energy drinks. The cooperation of parents and teachers is needed to achieve these goals.
Collapse
|
4
|
Mafla AC, Herrera-López M, España-Fuelagan K, Ramírez-Solarte I, Gallardo Pino C, Schwendicke F. Psychometric Properties of the SOC-13 Scale in Colombian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413017. [PMID: 34948627 PMCID: PMC8700993 DOI: 10.3390/ijerph182413017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the psychometric properties of the Spanish version of the SOC-13 in Colombian adults. The SOC-13 questionnaire was administered to 489 individuals aged ≥18 years who were in lockdown from March to July 2020 in Nariño County, Colombia. Psychometric properties of the scale were examined using a cross-validation method via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, configural and metric invariance were tested. To determine the internal consistency of the questionnaire, McDonald’s omega (ω), Cronbach’s alpha (α), and composite reliability (CR) coefficients were estimated. The EFA determined that a three-factor structure best fit the data (comprehensibility, manageability, and meaningfulness) and CFA confirmed this three-factor model structure showing a good fit (χ2S-B = 188.530, χ2S-B/(62) = 3.615, p = 0.001; NNFI = 0.959; CFI = 0.968; RMSEA = 0.052 (90% CI [0.041–0.063]) and SRMR = 0.052).The invariance analysis indicated the same underlying theoretical structure between genders. Additionally, (ω), (α), and (CR) coefficients confirmed a high internal consistency of the instrument. The SOC-13 scale, reflecting comprehensibility, manageability, and meaningfulness, is a reliable and valid tool for assessing the sense of coherence in Colombian populations.
Collapse
Affiliation(s)
- Ana Cristina Mafla
- School of Dentistry, Universidad Cooperativa de Colombia, Pasto 520004, Colombia; (A.C.M.); (K.E.-F.); (I.R.-S.)
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | | | - Karen España-Fuelagan
- School of Dentistry, Universidad Cooperativa de Colombia, Pasto 520004, Colombia; (A.C.M.); (K.E.-F.); (I.R.-S.)
| | - Iván Ramírez-Solarte
- School of Dentistry, Universidad Cooperativa de Colombia, Pasto 520004, Colombia; (A.C.M.); (K.E.-F.); (I.R.-S.)
| | - Carmen Gallardo Pino
- Departamento de Especialidades Médicas y Salud Pública, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, 14197 Berlin, Germany
- Correspondence:
| |
Collapse
|
5
|
Effects of Caffeine and Caffeinated Beverages in Children, Adolescents and Young Adults: Short Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312389. [PMID: 34886115 PMCID: PMC8656548 DOI: 10.3390/ijerph182312389] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022]
Abstract
The prevalence of ED consumption has increased over the past 10–15 years. Studies describing the effects of caffeine and caffeinated beverages show confusing results, so it seems important to regularly summarize the available facts, and in more detail. By a thorough analysis of more than 156 scientific papers, the authors describe the molecular background of absorption, as well as the positive and negative effects of different dosages of caffeine, just like its effects in physical activity and performance. ED and EDwA consumption is a regular habit of not only adults, but nowadays even of children and adolescents. There are no safe dosages described of caffeine or ED consumption for children. There are no positive short- or long-term effects of these compounds/products concerning developing brain functions, psycho-motor functions, or social development. Instead, there are many unpleasant side effects, and symptoms of regular or higher-dose ED consumption, especially at younger ages. This mini review describes many details of these unpleasant side effects, their severity, and motivations for consuming these compounds/products. In a quantitative research in Hungary (10–26 years, mean age: 15.6 ± 3.8 y, 1459 subjects, randomly chosen population), a survey based on a questionnaire asking people about their ED consumption habits was conducted. According to the data, 81.8% of the participants consumed EDs at least once, and 63.3% tried several products of the kind. A positive correlation was found between age and consumption (p < 0.001). The results show that a high proportion of this group often consumed EDwA, in many cases leading to harmful side-effects of caffeine overdose. In a sample of Hungarian high school and college students (17–26 years), ED consumption matched the international data, and only 19.7% of respondents did not use EDs at all (had never tasted an ED in their life).
Collapse
|
6
|
Al-Yateem N, Fakhry R, Saifan AR, Saqan R, Alrimawi I. Assessing sense of coherence as an element of primary-focused health services in schools for children and adolescents with complex health care needs. J Nurs Manag 2021; 30:582-591. [PMID: 34799949 DOI: 10.1111/jonm.13517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/08/2021] [Accepted: 11/14/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools. BACKGROUND The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development. METHODS This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes. RESULTS A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems. CONCLUSION Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population. IMPLICATIONS FOR NURSING MANAGEMENT Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.
Collapse
Affiliation(s)
- Nabeel Al-Yateem
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Orange, New South Wales, Australia
| | - Randa Fakhry
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Roba Saqan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Intima Alrimawi
- School of Nursing and Health Professions, Trinity Washington University, Washington, District of Columbia, USA
| |
Collapse
|
7
|
Associations between sense of coherence, psychological distress, escape motivation of internet use, and internet addiction among Chinese college students: A structural equation model. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage. Nutrients 2021; 13:nu13082506. [PMID: 34444666 PMCID: PMC8401129 DOI: 10.3390/nu13082506] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 01/07/2023] Open
Abstract
The rise in energy drink (ED) intake in the general population and athletes has been achieved with smart and effective marketing strategies. There is a robust base of evidence showing that adolescents are the main consumers of EDs. The prevalence of ED usage in this group ranges from 52% to 68%, whilst in adults is estimated at 32%. The compositions of EDs vary widely. Caffeine content can range from 75 to 240 mg, whereas the average taurine quantity is 342.28 mg/100 mL. Unfortunately, exact amounts of the other ED elements are often not disclosed by manufacturers. Caffeine and taurine in doses 3–6 mg/kg and 1–6 g, respectively, appear to be the main ergogenic elements. However, additive or synergic properties between them seem to be implausible. Because of non-unified protocol design, presented studies show inconsistency between ED ingestion and improved physical performance. Potential side effects caused by abusive consumption or missed contraindications are the aspects that are the most often overlooked by consumers and not fully elucidated by ED producers. In this review, the authors aimed to present the latest scientific information on ED components and their possible impact on improving physical performance as well as to bring emphasis to the danger of inordinate consumption.
Collapse
|
9
|
Energy Drink Consumption among Adolescents Attending Schools in Lubumbashi, Democratic Republic of Congo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147617. [PMID: 34300068 PMCID: PMC8304143 DOI: 10.3390/ijerph18147617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The consumption of energy drinks (EDs) is increasing in the general population, but little is known about the consumption of EDs among pupils in Africa. This study was designed to assess the consumption of EDs among pupils between 10 and 17 years of age and to assess average caffeine concentrations contained in EDs sold in Lubumbashi. METHODS We conducted a cross-sectional survey in five schools using a standardised questionnaire taken face-to-face. Samples of locally purchased EDs were analysed by High Performance Liquid Chromatography with Ultra-Violet spectrometry (HPLC-UV). RESULTS Of 338 pupils (54% girls), 63% reported having consumed at least one ED in the last week and 34% drank at least one ED a day. The cheapest ED was the most widely consumed. Among pupils having consumed at least one ED in the last week, 79% reported consuming it for refreshment and 15% to get energy. For those who reported not consuming EDs, 40% reported that their parents or teachers forbade them to drink EDs. Some (14%) teenagers, mainly boys, mixed ED with alcohol. The concentrations of caffeine measured in twelve brands of EDs ranged from 7.6 to 29.4 mg/100 mL (median 23.3), giving caffeine contents of 37.5 to 160 mg (median 90 mg) per can or bottle. The estimated daily intake of caffeine through EDs was between 51.3 mg and 441.3 mg among those consuming EDs regularly. CONCLUSION Our study convincingly demonstrates that caffeine-containing EDs are not only consumed by youngsters living in affluent societies. We documented widespread regular consumption of EDs among (pre-)adolescent schoolchildren living in Lubumbashi, a large city of the Democratic Republic of Congo (DRC). In view of the global market expansion of caffeinated EDs, it is reasonable to suspect that similar surveys in other urban areas of sub-Saharan Africa would yield similar findings. Pricing and advertising regulations and education on EDs are necessary to limit the regular consumption of EDs among adolescents.
Collapse
|
10
|
ÇELAKIL M, TAKTAK A. Retrospective Analysis and Literature Review of Acute Tubulointerstitial Nephritis Cases Linked to Energy Drinks. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2021. [DOI: 10.17944/mkutfd.941866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
11
|
Predictors of Adolescent Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094508. [PMID: 33922778 PMCID: PMC8122983 DOI: 10.3390/ijerph18094508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
The present study expands the existing literature and supplements today’s knowledge on the relationship between personal, psychosocial and lifestyle factors and depressive symptoms among adolescents. The study aimed to investigate the variety of depressive symptoms predictors—personal resources, adverse school and family, health, lifestyle-related (sense of coherence, self-esteem, school involvement, negative acts at school, family stress and violence, psychosomatic health complaints, physical activity, smoking, alcohol) as well as gender, employing hierarchical linear regression analysis in a large representative sample of adolescents (N = 2212) in Kaunas, Lithuania. Four blocks of predictors were employed in hierarchical linear regression analysis. In the final model 64.9% of depressive symptoms were explained by all the predictors. Sense of coherence was the strongest predictor of depressive symptoms (standardized regression coefficient β = −605, p < 0.001 in the first model and β = −263, p < 0.001 in the final model after adjustment for all other independent variables) and accounted for 36.6% of variance. In conclusion, this study supports the notion that depressive symptoms among adolescents have multifactorial origins with many predictors showing significant effect seizes. Therefore, high sense of coherence and self-esteem, school involvement, higher levels of physical activity would be protective and influence lower levels of depressive symptoms among adolescents. Exposure to negative acts at school and negative experiences in the family, psychosomatic health complaints, smoking would increase the probability of depressive symptoms. Girls are more prone to depression as compared to boys.
Collapse
|