Trends in adolescent mental health problems 2004–2020: Do sex and socioeconomic status play any role?

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.

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

“…Despite consistently higher PSS scores among the adolescents in the low FAS group, the increase over time was significant only among those in the high FAS group. This finding contrasts with prior research that reported more significant increasing trends in mental health problems, including PSS, among adolescents in the low SES group compared to those in the high SES group [51,52]. This difference could arise, among other things, from the fact that this study employed objectively measured economic indicator, FAS, whereas the referenced studies used subjective SES measures linked to individuals' self-perceived social standing.…”

Trends in mental health problems among Swedish adolescents: Do school-related factors play a role?

“…This highlights that the adolescents in the low SES group did not experience the same benefit from increased exposure to school-related factors over time as their counterparts in the high SES group did. In conclusion, this reinforces the role of SES in determining the long-term vulnerability disparities among these groups [25]. While the vulnerability hypothesis [21,28] may explain this difference, further studies are necessary to delve into why trends in mental health problems differed along the SES gradients despite similar trends in school-related factors within both groups.…”

“…Another limitation of the literature lies in a lack of evidence on the effects of SES on the association between school-related factors and trends in adolescent mental health problems. In a recent study, we found different trends in mental health problems for different SES groups, where the trends increased among adolescents with low SES and decreased among others [25]. This calls for a better understanding of whether school-related factors have changed differently for different SES groups and influenced the trends in adolescent mental health problems accordingly.…”

“…It was then completed in 1 hour during class hours under the supervision of teachers. Information on the data collection process in this project has been reported on in a previous study [25]. We analyzed data from a total of 19,873 students in Grade 9 (15-year-old) in all except special schools in the county between 2004 and 2020.…”