Aim: The aim was to develop a factor model of the clustering of poor mental-health symptoms and health-compromising behaviours (HCBs) in adolescent males. Methods: The study was based on two cross-sectional school-based Swedish surveys in 2011 (response rate 80%, N=2823) and 2014 (response rate 85%, N=2358), both of which comprised questionnaires from males aged 15–16 and 17–18 years. A factor model was developed by exploratory factor analysis on the 2011 survey and validated by confirmatory factor analysis on the 2014 survey. Results: Four aspects of poor mental health and HCBs emerged in the exploratory factor analysis: (a) deviancy as a tendency to substance use and delinquency, (b) unsafety as an inclination towards feelings of unsafety in different environments, (c) gloominess as a tendency towards pessimism and feeling unwell and (d) pain as an inclination to experience physical pain. The model was validated with good model fit. Age did not affect the model structure, but older adolescent males were more influenced by deviancy and gloominess and less by unsafety compared to their younger peers. Conclusions: Separating symptoms of poor mental health and HCBs into four areas – deviancy, unsafety, gloominess and pain – brings new perspectives to the understanding of adolescent males’ health. To the best of our knowledge, our factor model is the first to include unsafety and pain in this context. Whenever a comprehensive approach to the health of adolescent males is needed in the clinic or in the field of public health, this factor model may provide guidance.

Objective To investigate to what degree adolescent males (1) value confidentiality, (2) experience confidentiality and are comfortable asking sensitive questions when visiting a general practitioner (GP), and (3) whether self-reported symptoms of poor mental health and health-compromising behaviours (HCB) affect these states of matters. Design Cross-sectional. Setting School-based census on life, health and primary care in Region Sörmland, Sweden. Subjects 2,358 males aged 15–17 years (response rate 84%). Main outcome measures The impact of poor mental health and HCBs on adolescent males’ valuing and experiencing private time with the GP, having professional secrecy explained, and being comfortable asking about the body, love and sex, analysed with structural equation modelling. Results Almost all respondents valued confidentiality regardless of their mental health or whether they engaged in HCBs: 86% valued spending private time with the GP, and 83% valued receiving a secrecy explanation. Among those who had visited a GP in the past year ( n = 1,200), 74% had experienced private time and 42% a secrecy explanation. Three-quarters were at least partly comfortable asking sensitive questions. Adolescent males with HCBs were more likely to experience a secrecy explanation (approximative odds ratio [appOR] 1.26; p = 0.005) and to be comfortable asking about sex than their peers (appOR 1.22; p = 0.007). Respondents reporting experienced confidentiality were more comfortable asking sensitive questions (appOR 1.25–1.54; p ≤ 0.010). Conclusion Confidentiality matters regardless of poor mental health or HCBs and makes adolescent males more comfortable asking sensitive questions. We suggest that GPs consistently offer private time and explain professional secrecy. Key Points Confidentiality for adolescent males has been scantily studied in relation to mental health and health-compromising behaviours. In this study, most adolescent males valued confidentiality, regardless of their mental health and health-compromising behaviours. Health-compromising behaviours impacted only slightly, and mental health not at all, on experiences of confidentiality in primary care. When provided private time and an explanation of professional secrecy, adolescent males were more comfortable asking the GP sensitive questions.