Trends in adolescent mental health problems: Differences by SES and gender

Abstract

Abstract Background Studies in Sweden and elsewhere have shown that mental health problems have increased among adolescents in recent decades. Unlike the previous studies, we extend the investigation to the trends of various mental health problems, namely: psychosomatic symptoms, suicide attempts, depressive symptoms, and suicide ideations in the last two decades, from 2004 to 2020. We also investigate the moderating role of gender and SES on these trends. Methods Data were collected through repeated bi-annual cross-sectional surveys between 2004 and 2020 among 32061 adolescents (49% girls) in middle and upper secondary schools in a county of Sweden. We fitted two linear and two logistic regressions with gender and socioeconomic status (SES) as predictors, and by interacting them with year of survey, we examined if they are associated with trends in mental health problems. Results Psychosomatic and depressive symptoms remained stable overtime (β = -0.04, p = 0.12; and β = 0.007, p = 0.69, respectively). Trend in depressive symptoms has declined overtime only for girls (β = -0.07, p < 0.005) while gender did not have effect on the trend in psychosomatic symptoms. Both psychosomatic (β = -0.09, p < 0.001) and depressive (β = -0.08, p < 0.001) symptoms have declined overtime only among those with high SES. Trends in both suicidal ideations and attempts were stable. Suicidal ideations declined overtime only for the girls (OR = 0.86, CI = 0.82 - 0.91, p < 0.001). However, gender did not have significant effect on trends in suicidal attempts. Both suicidal ideations (OR = 0.97, CI = 0.95 - 0.99, p = 0.02) and suicidal attempts (OR = 0.98, CI = 0.96 - 0.99, p = 0.007) declined overtime among those with higher SES. Conclusions Mental health problems seem to decrease from 2004 to 2020, however only for girls and adolescents with high SES. This indicates an increase in health inequalities especially for youth with low SES. Key messages Mental health problems declined in the last two decades, especially among girls. Adolescents with low SES did not show the same mental health improvement, which indicated that health inequalities in adolescent mental health seem to have increased in the last two decades.