Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender – a cross-sectional school study in Northern Sweden

Abstract

BackgroundNegative trends in adolescent mental and subjective health are a challenge to public health work in Sweden and worldwide. Self-reported mental and subjective health complaints such as pain, sleeping problems, anxiety, and various stress-related problems seem to have increased over time among older adolescents, especially girls. The aim of this study has therefore been to investigate perceived stress, mental and subjective health complaints among older adolescents in Northern Sweden.MethodsData were derived from a cross-sectional school-based survey with a sample consisting of 16–18 year olds (n = 1027), boys and girls, in the first two years of upper secondary school, from different vocational and academic programmes in three public upper secondary schools in a university town in northern Sweden. Prevalence of perceived stress, subjective health complaints, general self-rated health, anxiety, and depression were measured using a questionnaire, including the Hospital Anxiety and Depression Scale (HADS).ResultsA large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference: two to three times as many girls as boys reported subjective health complaints, such as headache, tiredness and sleeping difficulties and musculoskeletal pain, as well as sadness and anxiety. High pressure and demands from school were experienced by 63.6% of girls and 38.5% of boys. Perceived stress in the form of pressure and demands correlated strongly with reported health complaints (r = 0.71) and anxiety (r = 0.71).ConclusionsThe results indicate that mental and subjective health complaints are prevalent during adolescence, especially in girls, and furthermore, that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in subjective adolescent health needs to be further explored.

Perceived Stress and Psychiatric Symptoms in Swedish Upper Secondary School Students

“…Strong associations have also been found for perceived stress, psychosomatic symptoms, and anxiety (Wiklund et al, 2012). There is also growing evidence of a significant relationship between psychosocial stress and psychopathology in children and adolescents from both cross-sectional (Compas, 1987;Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001) and longitudinal studies (Hammen & Goodman-Brown, 1990;Hilsman & Garber, 1995;Rudolph, Lambert, Clark, & Kurlakowsky, 2001;Schmeelk-Cone & Zimmerman, 2003).…”

“…One study used three scales (the internationally validated Hospital Anxiety and Depression (HAD) scale, a questionnaire measuring perceived stress and sleep and a questionnaire measuring subjective health complaints) on upper secondary school students aged 16-17 years from northern Sweden in [2007][2008]. The study showed a high prevalence of subjective health complaints and perceived stress, particularly among adolescent girls (Wiklund et al, 2012).…”

“…People aged 16-24 years, and particularly young women, show much steeper increases in these symptoms than other age groups (Petersen, 2007). Psychiatric symptoms have also been proposed to be more common among Swedish youths today compared with two decades ago (Bremberg, 2006;Petersen, 2007;Wiklund et al, 2012). A report from the Public Health Agency of Sweden from 2009/2010 showed that this increase might have levelled off, but they are still reported twice as often as in the mid-1980s (Folkhälsomyndigheten, 2010).…”

“…Such studies have previously been conducted among Swedish children and adolescents (Bremberg, 2006;Landstedt & Gådin, 2012;Nygren, Bergström, Janlert, & Nygren, 2012;Petersen, 2007;Wiklund, Malmgren-Olsson, Öhman, Bergström, & Fjellman Wiklund, 2012). Increases in anxiety, depressive symptoms, and somatization are observable among all age groups in society, except the oldest.…”

Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden

“…Obesity is related to poorer SRH, and a recent study from the SALLS study population showed increasing BMI in all cohorts over the same study period, especially in younger cohorts, with larger annual increases in BMI in females aged 24-39 years and in males aged 32-47 years (Caman et al 2013;Marques-Vidal et al 2012). Earlier studies have reported increases in mental health complaints, anxiety, and stress among adolescents, especially girls (Hagquist 2010;Wiklund et al 2012). …”