Discrepant Trends in Mental Health Complaints Among Younger and Older Adolescents in Sweden: An Analysis of WHO Data 1985–2005

doi:10.1016/j.jadohealth.2009.07.003

Journal of Adolescent Health

Volume 46, Issue 3, March 2010, Pages 258-264

https://doi.org/10.1016/j.jadohealth.2009.07.003 Get rights and content

Abstract

Purpose

To elucidate the time trends in self-reported mental health complaints (internalizing problems) among school children in Sweden during a time characterized by economic downturns and upturns, with a focus on possible differences across grades and genders.

Methods

The study uses nationwide and repeated cross-sectional data collected five times during 1985–2005 among students in Sweden in grades 5, 7, and 9. The number of participating students each year varied between 2,933 and 4,421. The attrition rates varied between 10% and 15% in the participating schools. Data were subjected to descriptive analysis and multinomial logistic regression using a composite measure of self-reported mental health complaints.

Results

The study results show significantly higher rates of mental health complaints in 2005/2006 compared with 1985/1986 among older adolescents, in particular girls, whereas the rates are almost unchanged among younger boys and girls. Only among girls in grade 9 has there been a successively (linear) increase of mental health complaints across years of investigations.

Conclusions

The increasing rates of mental health complaints among older adolescents, in particular girls, are a cause for concern and a challenge for public health work. By showing discrepant time trends among younger and older adolescents, the results of the study nuance the predominant and unambiguous notions about continuously deteriorating mental health among children and adolescents in Sweden. To address hypotheses concerning the causes of the discrepant time trends, suggestions are made for comparative cross-country analyses based on data from Sweden and other European countries.

Section snippets

Data collection

The study is based on repeated cross-sectional data collected during 1985/1986, 1993/1994, 1997/1998, 2001/2002, and 2005/2006 among students in Sweden in grades 5, 7, and 9 in the compulsory school system. The data collections were parts of the HBSC study. In 1989/1990, data collection also took place; however those data are not used in the present study because of a different response format on the mental health questions. Data were collected in schools using a questionnaire that was

Results

The Rasch analysis indicated a good capacity of the scale to differentiate the students with respect to mental health complaints, which was reflected by the person separation index (a Cronbach's alpha analogue) value of .723. The targeting was acceptable, although the items were a bit dislocated relative to the persons (mean, .784), reflecting a young general population with relatively good mental health as a whole. The analysis of the scale also showed that the item thresholds appeared in the

Discussion

The discrepant time trends among younger and older adolescents that are shown in this study challenge the predominant and unambiguous notion in the media about continuously deteriorating mental health among children and adolescents in Sweden. First, comparing the situation in 2005/2006 with that in 1985/1986, only among boys and girls in grade 9 and girls in grade 7 is there an unambiguous increase in mental health complaints. Among students in grade 5, there are no signs of such an increase in

Acknowledgments

This work was supported by the Royal Swedish Academy of Sciences. The Swedish National Institute of Public Health made the HBSC data available for the present paper. The Principal Investigator in Sweden for the HBSC study was Dr. Ulla Marklund.

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Original articleDiscrepant Trends in Mental Health Complaints Among Younger and Older Adolescents in Sweden: An Analysis of WHO Data 1985–2005

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Data collection

Results

Discussion

Acknowledgments

J Adolesc Health

J Adolesc

Int J Nurs Stud

Pers Individ Diff

Folkhälsorapport 2009

Major public health problems—mental ill-health

Scand J Public Health

The living conditions of young people in Sweden: On the crisis of the 1990s, social conditions and health

Living conditions and psychosomatic complaints in Swedish schoolchildren

Acta Paediatr

Psychiatric and psychosomatic symptoms are increasing problems among Swedish schoolchildren

Acta Paediatr

School stressors, psychological complaints and psychosomatic pain

Acta Pædiatr

Original article
Discrepant Trends in Mental Health Complaints Among Younger and Older Adolescents in Sweden: An Analysis of WHO Data 1985–2005