Poor Subjective Health Research Articles

Hwa-Byung (Anger Syndrome) in the MZ Generation of Republic of Korea: A Survey.

Background/Objectives: Hwa-byung (HB), traditionally observed in middle-aged Korean women, was investigated among the MZ generation in Republic of Korea to investigate its prevalence, associated factors, and perceptions. Methods: An online survey was conducted with 449 Korean adults in the Republic of Korea born between 1980 and 2005. The participants completed questionnaires that assessed HB symptoms, emotional labor, psychological distress, and HB perceptions. Data were analyzed using Chi-squared tests, t-tests, and bivariate logistic regression. Results: The prevalence of HB in the MZ generation was 36.3%. Significant HB predictors included female sex (odds ratio [OR] = 2.314), poor subjective health (OR = 3.207), higher HB trait scores (OR = 1.155), depression (OR = 1.145), and state anger (OR = 1.087). Only 44.54% of the participants were aware that HB is a diagnosed mental disorder and 34.97% knew that it could be treated at traditional Korean medicine (TKM) clinics. Despite the limited awareness, 49% expressed interest in TKM treatment for HB, in which acupuncture, herbal medicine, and mind-body medicine are the preferred modalities. Conclusions: This study revealed a high HB prevalence among the MZ generation in the Republic of Korea, which challenges traditional perceptions of this syndrome. These findings highlight the need to reevaluate HB conceptualization and treatment approaches for younger generations. Future research should focus on longitudinal studies, qualitative investigations of the evolving HB cultural context, and the development of targeted awareness and intervention programs to address this significant mental health issue in contemporary Korean society.

National Trends in the Prevalence of Self-Perceived Overweight Among Adolescents Between 2005 and 2022: Nationwide Representative Study.

Despite several studies on self-evaluation of health and body shape, existing research on the risk factors of self-perceived overweight is insufficient, especially during the COVID-19 pandemic. This study aims to identify the risk factors affecting self-perceived overweight and examine how the prevalence of self-perceived overweight has changed before and during the COVID-19 pandemic. Specifically, we analyzed the impact of altered lifestyles due to COVID-19 on this phenomenon. The data used in the study were obtained from middle and high school students who participated in the Korean Youth Risk Behavior Web-based Survey (N=1,189,586). This survey was a 2-stage stratified cluster sampling survey representative of South Korean adolescents. We grouped the survey results by year and estimated the slope in the prevalence of self-perceived overweight before and during the pandemic using weighted linear regression, as well as the prevalence tendencies of self-perceived overweight according to various risk factors. We used prevalence ratios to identify the risk factors for self-perceived overweight. In addition, we conducted comparisons of risk factors in different periods to identify their associations with the COVID-19 pandemic. The prevalence of self-perceived overweight was much higher than BMI-based overweight among 1,189,586 middle and high school participants (grade 7-12) from 2005 to 2022 (female participants: n=577,102, 48.51%). From 2005 to 2019 (prepandemic), the prevalence of self-perceived overweight increased (β=2.80, 95% CI 2.70-2.90), but from 2020 to 2022 (pandemic) it decreased (β=-0.53, 95% CI -0.74 to -0.33). During the pandemic, individuals with higher levels of stress or lower household economic status exhibited a more substantial decrease in the rate of self-perceived overweight. The prevalence of self-perceived overweight tended to be higher among individuals with poor academic performance, lower economic status, poorer subjective health, and a higher stress level. Our nationwide study, conducted over 18 years, indicated that self-perceived overweight decreased during the COVID-19 period while identifying low academic performance and economic status as risk factors. These findings suggest the need for policies and facilities to address serious dieting and body dissatisfaction resulting from self-perceived overweight by developing counseling programs for adolescents with risk factors such as lower school performance and economic status.

Influence of Depression and Subjective Health Status on COVID-19 Vaccine Acceptance: Based on the 2021 Community Health Survey

Background: Coronavirus Disease 2019 (COVID-19) is a novel coronavirus identified in 2019 that exhibited an exceptionally rapid spread. Although the development and administration of COVID-19 vaccines progressed quickly, concerns about side effects and safety persisted. This study utilized data from the 2021 Community Health Survey to analyze the relationship between COVID-19 vaccination and psychosocial factors, including depression and subjective health status.Methods: Analysis included 203,449 individuals, excluding those who had not received or were ineligible for the COVID-19 vaccine, based on the 2021 Community Health Survey. The chi-square tests assessed sociodemographic and health status differences related to vaccination status. Subjective health status was categorized based on survey responses as ‘good’ or ‘poor,’ and depression was assessed using the self-reported Patient Health Questionnaire-9. The association between depression, subjective health status, and vaccination status was examined using chi-square tests, followed by multiple logistic regression to determine independent effects.Results: Vaccination rates were higher among the elderly, those with lower education, higher income, healthcare workers, and individuals with lower depression, higher subjective health, and chronic conditions like hypertension or diabetes. Significantly lower vaccination rates were observed in those with lower subjective health and Patient Health Questionnaire-9 scores ≥5 or ≥10. Among individuals with chronic illnesses, those with good subjective health had the lowest odds for non-vaccination (odds ratio=0.42; 95% confidence interval, 0.39-0.45), while those without chronic illnesses and poor subjective health had the highest odds (odds ratio=1.89; 95% confidence interval, 1.76-2.02).Conclusions: This study found significantly higher odds ratios for vaccine non-receipt among individuals with lower levels of depression and subjective health status. Incorporating psychosocial factors such as depression and subjective health status may be crucial in developing strategies to enhance vaccination rates during future outbreaks of novel infectious diseases.

Exploring the Relationship between Health Literacy and Depression among Individuals with Chronic Conditions: Insights from the KCHS.

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40-1.54), residential district (OR 1.43, 95% CI 1.39-1.50), unemployment (OR 1.47, 95% CI 1.41-1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40-1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14-2.51), fair subjective health status (OR 1.74, 95% CI 1.63-1.90), poor subjective health status (OR 4.33, 95% CI 4.05-4.63), and stress (OR 4.56, 95% CI 4.36-4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68-0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population.

Association between financial anxiety and subjective health and physical fatigue perceptions among mothers of 18-month-old infants

Objective Poverty is a factor that affects children's health through its role in parental depression and stress. While the association between financial status and depression or quality of life scores of mothers has been previously reported in Japan, no study has focused on mothers' subjective health and physical fatigue perceptions. This study aimed to examine the relationship between mothers' financial anxiety and subjective health and physical fatigue perceptions.Methods We conducted a survey in parents attending routine health checkups for their 18-month-old infant in a single area of City A between November 2017 and October 2019. After excluding those for whom the required analysis data were missing, we analyzed data from 779 parents who responded to the survey and consented to the use of their children's health checkup data. The response variables were maternal subjective health and physical fatigue perceptions, and the explanatory variables were the presence of financial anxiety in mothers at their child's 3- or 18-month health checkups and financial anxiety situation in both periods. Financial anxiety was classified into four groups according to status at the 3- and 18-month time points. The independence of the qualitative variables among these four groups was verified using Fisher's exact test, and the relationship between financial anxiety and maternal subjective health and physical fatigue perceptions was evaluated using logistic regression analysis.Results Financial anxiety was present in 54 mothers (6.9%) and 46 mothers (5.9%) at the 3- and 18-month checkup, respectively. Analysis of financial anxiety in both periods showed that 695 mothers (89.2%) had no financial anxiety at either time point, 30 (3.9%) had financial anxiety only at the 18-month checkup, 38 (4.9%) had financial anxiety only at the 3-month checkup, and 16 (2.1%) had financial anxiety at both time points. At the 18-month checkup, the odds ratios of poor subjective health and severe physical fatigue perceptions were 3.85 (95% confidence interval [CI]; 1.34-11.05) and 6.58 (95% CI; 2.18-19.85), respectively, among the mothers who had financial anxiety at both time points compared to those who had no financial anxiety at either time point.Conclusion Financial anxiety may affect mothers' health. Therefore, mothers should be provided with solution-oriented support geared toward mitigating financial anxiety, in coordination with affiliated organizations, if financial anxiety is detected.

The factors related to depressive symptoms in urban older adults in South Korea: a study based on the Seoul Aging Survey

PurposeThis study aims to comprehensively examine the determinants of depression among urban older adults in Seoul, utilizing the social-ecological model to address multifaceted influences.MethodsA comprehensive analysis was conducted using data from the 2022 Seoul Aging Survey, which surveyed 2,914 individuals aged 65 and above. A multiple logistic regression analysis was performed to identify factors contributing to depressive symptoms, including socio-demographic characteristics, health behaviors and status, research accessibility, social support, and environmental influences.ResultsThis study revealed that poor subjective health (OR = 1.47) and the presence of multiple chronic diseases (OR = 1.59) significantly increased the risk of depressive symptoms among urban older adults. From a social support standpoint, living alone was associated with a higher risk of depression (OR = 1.66), low food security (OR = 2.56), and low digital competency (OR = 2.70) were all significant predictors of depressive symptoms. Additionally, a lack of engagement with cultural facilities (OR = 2.15) was identified as a critical environmental factor contributing to depression.ConclusionsThe findings underscore the need for comprehensive policy and practical interventions aimed at preventing chronic disease, enhancing social support networks, improving digital literacy, ensuring food security, and expanding access to healthcare and cultural facilities. Such measures are crucial in mitigating depression among urban older adults, thereby enhancing their overall well-being and quality of life.

Determinants of food insecurity among adults residing in peri-urban municipal settings in Flanders, Belgium

Food insecurity is a global public health issue associated with noncommunicable diseases. Individual factors are strongly associated with food insecurity, but there is limited literature on the broader impact of both the social and food environments on food insecurity in non-English speaking European countries, given that the research was predominantly conducted in Anglophone settings. In addition, these studies have mostly been conducted in urban areas. Therefore, this study aimed to identify the main determinants of food insecurity among adults living in peri-urban areas in Flanders, Belgium. Data on socio-demographics, neighborhood social cohesion, social isolation, and perceived food environments were collected from 567 adults through a self-administered questionnaire, and objective data on the food environment were obtained through (commercial) databases on food outlets. Food insecurity was measured using the USDA Household Food Security Survey Module. Multivariable logistic regression models revealed that lower socioeconomic status (OR14.11,95%CI:4.72;61.11), reasonable (OR4.16,95%CI: 2.11;8.47) to poor and very poor (OR6.54,95%CI: 2.11;8.47) subjective health status, and living in private (OR7.01, 95% CI:3.0;17.0) or government-assisted (OR6.32,95%CI: 3.13;13.26) rental housing significantly increased the odds of food insecurity. Additionally, residing in a neighborhood with low (OR2.64, 95% CI:1.13;6.26) to medium (OR2.45,95% CI:1.21;5.11) social cohesion, having a neutral opinion (OR4.12,95%CI:1.51;11.54) about the availability of fruit and vegetables in one's neighborhood, and having an opinion that fruit and vegetable prices are too expensive (OR5.43,95% CI 2.26;14.4) significantly increased the odds of experiencing food insecurity. This study underscores the need for policies that consider factors related to social and food environments, in addition to individual factors, to effectively address food insecurity.

Biopsychosocial factors of quality of life among middle-aged adults living alone in South Korea: a secondary data analysis using the 2017 Korea Community Health Survey

BackgroundThis study aimed to investigate quality of life (QoL) in middle-aged adults living alone and identify comprehensive biological, psychological, interpersonal, and contextual factors related to QoL using the dynamic biopsychosocial model. As a secondary analysis, this study used data from the 2017 Korea Community Health Survey conducted by the Korea Disease Control and Prevention Agency.MethodsAmong the total 228,381 respondents, 10,639 middle-aged individuals aged 40–64 years from single-person households (5,036 men and 5,603 women) were included in the analysis. QoL was measured using the EuroQoL-5 Dimension (EQ-5D). The EQ-5D descriptive statistics were provided according to biological, psychological, interpersonal, and contextual factors. Considering the data structure of the multistage stratified cluster sampling method, a complex samples general linear model statistic was used to identify the predictors of QoL.ResultsQoL was lower in those who had undesirable psychological status (e.g., more depressive symptoms, poor subjective health, and higher perceived stress), less engagement in social networking (less frequent contact with friends and less frequent participation in social activities such as religious activities, friendship gathering, and leisure), and lower physical, behavioral, and socioeconomic factors.ConclusionsThis study’s findings indicate that psychological and interpersonal factors should be addressed and prioritized to improve the QoL of middle-aged adults living alone. By providing many opportunities for easily accessible social activities that meet the needs and interests of this demographic, their QoL can be improved through strengthening social support.

The social class of orthopedic rehabilitation patients: Are there differences in subjective health, return to work motivation, and participation in aftercare interventions?

This longitudinal quasi-experimental study examines the relationship between social class, subjective health, motivation to return to work (RTW) following medical rehabilitation, and participation in aftercare interventions, utilizing the Social Cognitive Theory of Social Class. To do so, a prospective multicentric study was conducted. The analysis was based on data from N = 1044 orthopedic rehabilitation patients in three clinics in Germany. Latent growth curve models, fixed-effect linear regression models, and multilevel binomial logistic regression were employed for data analysis. As hypothesized, the findings demonstrate that lower social class is associated with poorer subjective health, while higher social class is linked to increased solipsistic motives, characterized by pursuing personal goals in the context of RTW. Conversely, individuals from lower social classes exhibit contextualist motives, which indicate a focus on social and environmental threats influencing their motivation to RTW. Surprisingly, social class does not significantly impact participation in aftercare interventions, probably due to low variance and potentially the successful inclusion within the German healthcare system. These findings emphasize the importance of considering diverse motivation profiles derived from the Social Cognitive Theory of Social Class. The study contributes to our understanding of the social determinants of health and has implications for reducing health disparities by highlighting the motivational aspects, including solipsistic and contextualist motives, associated with social class.

Bullying experiences in childhood and health outcomes in adulthood.

This study examines whether the experience of being bullied at school has a long-term impact on three health outcomes in adulthood in Japan: subjective health, mental health, and activity restriction due to health conditions. We employed a random effects model and the Karlson-Holm-Breen method to decompose the total effect of being bullied at school on health inequality into a direct effect and an indirect effect working through intervening factors including education, marriage, economic well-being, and social networks. We used the Japanese Life Course Panel Surveys 2007-2020 (waves 1-14), a nationally representative panel data set that includes 2,260 male and 2,608 female respondents. The results demonstrate that for both men and women, the direct effect of being bullied at school was strong and significant. Bullying experiences in childhood had a long-term impact on health outcomes in adulthood, regardless of social background and mediating factors of education, marriage, economic well-being, and social networks. Bullying victimization increased the risk of poor subjective health, low mental health scores, and activity restriction due to health conditions. Intervening factors (especially economic well-being and friendship) mediated the association between bullying experiences and all health outcomes, but their contributions were modest. Policy measures not only to prevent bullying during childhood but also to alleviate its negative consequences in adulthood should be considered to help people who have encountered adverse childhood experiences.

Predictors of Subjective Health Among Spouses and Its Relations With Happiness: A Multilevel Analysis in a Nationwide Survey in Turkey

The current study aims to examine predictors of subjective health, including its relation with happiness, at the individual and family levels. For this purpose, we analyzed data collected from spouses representing each family (9,634 families, N = 19,268). A multilevel analysis was conducted to examine both individual- and family-level variables associated with subjective health evaluations. Individual-level variables were gender, age, education, employment, presence of chronic illness, smoking, alcohol use, and individual happiness. Family-level variables were socioeconomic status, number of children, household size, length of the marriage (in a year), presence of an elderly person who needs care in the household, presence of a disabled person who needs care in the household, and family happiness. The results showed that subjective health is enhanced by being man, younger, employed, highly educated, free from chronic illness, and experiencing greater levels of happiness at the individual level. In addition, poorer subjective health is associated with caring for an elderly or disabled family member and having a higher number of children in the household at the family level. However, individuals had better subjective health at the family level when socioeconomic status was higher, greater family happiness, and greater household size existed. The current study is important since research that simultaneously considers individual- and family-level happiness has been scarce in the literature. Thus, the findings would enhance the current understanding of the link between happiness and health.

Factors Influencing Health-related Quality of Life in Adult Women

Objectives: The present study investigates the association between the health-related quality of life of Korean adult women and their socio-demographics, health behavior, and psychological characteristics. Methods: The analysis was carried out using the 8th Korea National Health and Nutrition Examination Survey data (KNHNES) in the second year (2020), and the subjects consisted of 2,181 adult women between the ages of 19-64. A multivariate linear regression analysis was performed, employing three models to identify factors related to health-related quality of life as the dependent variable. In Model 1, socio-demographic characteristics were considered. While Model 2 includes both socio-demographics and health behavior characteristics. In Model 3, psychological characteristics as well as socio-demographic and health behavior characteristics were considered. Results: The health-related quality of life of adult women in late adulthood, post-menopause, low household income, and poor subjective health status were found to be low in the analysis of socio-demographic characteristics. For the health behavior characteristics, the health-related quality of life showed significant differences with respect to smoking, drinking, sleeping, and physical activity but these variables were not identified as the affecting factors. For the psychological characteristics, depression and perceived stress were found to be factors lowering the health-related quality of life. Conclusions: To enhance the health-related quality of life of adult women, prevention and proper management of depression and stress for those with poor health behavior are needed with special care and support for post-menopause women with low household income and poor subjective health status.

Concordance of Characteristics and Metabolic Syndrome in Couples: Insights from a National Survey.

Background and Objective: There is insufficient evidence on whether the concordance of sociodemographic, behavioral, and nutritional characteristics between spouses correlates with the concordance of metabolic syndrome (MetS) between spouses, or if a spouse's characteristics are directly linked to their own MetS. This study seeks to evaluate the association between the concordance of characteristics and the concordance of MetS in couples and investigate whether a spouse's attributes are linked to their partner's MetS. Methods: Analyzing data from the Korea National Health and Nutrition Examination Survey 2019-2021, 1824 couples with complete data, including MetS parameters, sociodemographic details, health behaviors, and dietary information, were included. General linear model and logistic regression were employed. Results: Among couples, 10.7% exhibited concordant MetS, with spousal concordance ranging from 1.3% to 81.5% for nonoptimal characteristics. Multivariate analysis revealed that the odds of both partners having MetS increased by 1.04-1.61 times with a higher mean age of the couple and higher concordance in lower education, poor subjective health, insufficient strength exercise, and excessive carbohydrate consumption. When accounting for both individual and spousal factors, the odds of MetS rose with the higher mean age of the couple, having a spouse with MetS, their own characteristics (lower education, poor subjective health, insufficient strength exercise, and sedentary behavior for husbands and wives; alcohol consumption and insufficient walking for husbands; and excessive carbohydrate intake for wives), and spousal factors such as smoking (in husbands) and lower education, lower economic status, and excessive carbohydrate intake (in wives). In wives, spousal sedentary behavior and poor subjective health were linked to decreased odds. Conclusions: The findings suggest a connection between MetS concordance and shared characteristics in couples, as well as an association between both spousal MetS status and characteristics and their own MetS.

Factors Affecting Abdominal Obesity: Analyzing National Data.

The purpose of this study is to understand the factors affecting abdominal obesity. A secondary data analysis was conducted to analyze 5262 individuals' data from the 2020 Korea National Health and Nutrition Examination Survey. The prevalence of obesity was slightly higher in men than women, while abdominal obesity was more prevalent in women. A higher correlation with obesity was observed in young and middle-aged individuals, unmarried individuals, urban residents, those with good subjective health, low-stress perception, moderate alcohol consumption, nonsmokers, regular aerobic exercisers, and those getting more than seven hours of sleep. In contrast, middle-aged and elderly individuals, married individuals, rural residents, those with an elementary school or lower education level, those with low-to-moderate income, those with fair or poor subjective health, high stress perception, nondrinkers, smokers, nonregular aerobic exercisers, and those getting less than seven hours of sleep had a higher correlation with abdominal obesity. Health education suggests that everyone should maintain healthy lifestyle habits, such as getting sufficient sleep, exercise, smoking cessation, and moderate drinking. Specifically, diverse health management support focusing on population groups with demographic factors related to the risk of obesity and abdominal obesity is necessary.

우울감 노인의 정신상담 이용행태 및 영향요인 연구

Objectives This study aims to validate the influencing factors of psychological counseling utilization in elderly individuals with depression based on the Andersen Behavioral Model, which consists of predisposing factors, enabling factors, and need factors, and to provide foundational data for promoting the utilization of psychological counseling.
 Methods Using data from the 2021 Community Health Survey, we conducted complex sample cross-tabulation, univariate logistic regression analysis, and complex sample logistic regression analysis through the SPSS 20 program to identify the factors influencing the utilization of psychological counseling among 5,859 elderly individuals aged 65 and older who experienced depression.
 Results Predisposing factors included being female, younger age, higher education level, and being separated, divorced, or widowed. Enabling factors included not having unmet medical needs. Need factors included having poor subjective health status and perceiving stress, which were associated with higher utilization of psychological counseling.
 Conclusions This suggests the need for the development of strategies to promote the utilization of psychological counseling for elderly individuals with depression, with particular emphasis on prioritizing older age, lower education levels, and those with unmet medical needs.

The relationship and affecting factors between oral health and frailty in the older people: A cross-sectional study.

To investigate the connection between oral health and frailty in older people and to determine the affecting factors. The research was a community-based cross-sectional study. A Family Health Center conducted a study on 321 older people. Data were collected face-to-face using the Personal Information Form, Geriatric Oral Health Assessment Index, and Edmonton Frailty Scale. Factors affecting oral health and frailty were examined using the MANOVA test and the relationship between them was examined using Pearson's correlation test. It was determined that 52.6% of the participants had poor oral health and 56.1% had different levels of frailty. Education was effective on the Geriatric Oral Health Assessment Index scale score. The presence of chronic disease, frequency of tooth/denture brushing, age, education, and sex were effective on the Edmonton Frailty Scale. When the partial eta square values were examined, it was determined that the variable that had the highest impact on the GOHAI and EFS scale scores was educational status. It was determined that there was a significant negative relationship between participants' oral health and frailty scores (r=-0.539, p<.001). It was determined that more than half of the older individuals included in the study had poor subjective oral health and varying levels of frailty. The influencing factors were determined through multivariate advanced analysis. This relationship and affecting factors are important in providing appropriate early detection and care to older people.

Association Between Atopic Dermatitis and Suicidal Behaviors in North Korean Adolescent Defectors From 2011 to 2019.

To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.

Inconsistencies in self-reported diabetes in a large panel study: the Survey of Health, Ageing and Retirement in Europe (SHARE)

BackgroundThe validity of self-reported chronic conditions has been assessed by comparing them with medical records or register data in several studies. However, the reliability of self-reports of chronic diseases has less often been examined. Our aim was to assess the proportion and determinants of inconsistent self-reports of diabetes in a long panel study.MethodsSHARE (Survey of Health, Ageing and Retirement in Europe) includes 140,000 persons aged ≥ 50 years from 28 European countries and Israel. We used data from waves 1 to 7 (except wave 3) collected between 2004 and 2017. Diabetes was assessed by self-report. An inconsistent report for diabetes was defined as reporting the condition in one wave, but denying it in at least one later wave. The analysis data set included 13,179 persons who reported diabetes, and answered the question about diabetes in at least one later wave. Log-binomial regression models were fitted to estimate crude and adjusted relative risks (RR) with 95% confidence intervals (CI) for the associations between various exposure variables and inconsistent report of diabetes.ResultsThe proportion of persons with inconsistent self-reports of diabetes was 33.0% (95% CI: 32.2%—33.8%). Inconsistencies occurred less often in persons taking antidiabetic drugs (RR = 0.53 (0.53—0.56)), persons with BMI ≥ 35 kg/m2 versus BMI < 25 kg/m2 (RR = 0.70, (0.64—0.77)), and poor versus excellent subjective health (RR = 0.87 (0.75—1.01)). Inconsistencies occurred more often in older persons (RR = 1.15 (1.12—1.18) per 10 years increase of age), and persons not reporting their age at diabetes onset (RR = 1.38 (1.31—1.45)).ConclusionIn SHARE, inconsistent self-report of diabetes is frequent. Consistent reports are more likely for persons whose characteristics make diabetes more salient, like intake of antidiabetic medication, obesity, and poor subjective health. However, lack of attention in answering the questions, and poor wording of the items may also play a role.

Celiac disease symptom profiles and their relationship to gluten-free diet adherence, mental health, and quality of life

BackgroundA subgroup of adults with celiac disease experience persistent gastrointestinal and extraintestinal symptoms, which vary between individuals and the cause(s) for which are often unclear.MethodsThe present observational study sought to elucidate patterns of persistent symptoms and the relationship between those patterns and gluten-free diet adherence, psychiatric symptoms, and various aspects of quality of life (QOL) in an online sample of adults with celiac disease. U.S. adults with self-reported, biopsy-confirmed celiac disease (N = 523; Mage = 40.3 years; 88% women; 93.5% White) voluntarily completed questionnaires as part of the iCureCeliac® research network: (a) Celiac Symptoms Index (CSI) for physical symptoms and subjective health; (b) Celiac Dietary Adherence Test for gluten-free diet adherence; (c) PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey for psychiatric symptoms and QOL. Symptom profiles were derived using latent profile analysis and profile differences were examined using auxiliary analyses.ResultsLatent profile analysis of CSI items determined a four-profile solution fit best. Profiles were characterized by: (1) little to no symptoms and excellent subjective health (37% of sample); (2) infrequent symptoms and good subjective health (33%); (3) occasional symptoms and fair to poor subjective health (24%); (4) frequent to constant symptoms and fair to poor subjective health (6%). Profiles 2 and 3 reported moderate overall symptomology though Profile 2 reported relatively greater extraintestinal symptoms and Profile 3 reported relatively greater gastrointestinal symptoms, physical pain, and worse subjective health. Profiles differed on anxiety and depression symptoms, limitations due to physical and emotional health, social functioning, and sleep, but not clinical characteristics, gluten-free diet adherence, or QOL. Despite Profile 3’s moderate symptom burden and low subjective health as reported on the CSI, Profile 3 reported the lowest psychiatric symptoms and highest quality of life on standardized measures.ConclusionsAdults with celiac disease reported variable patterns of persistent symptoms, symptom severity, and subjective health. Lack of profile differences in gluten-free diet adherence suggests that adjunctive dietary or medical assessment and intervention may be warranted. Lower persistent symptom burden did not necessarily translate to better mental health and QOL, suggesting that behavioral intervention may be helpful even for those with lower celiac symptom burden.

Subjective health status, health behaviours, and high-risk behaviours as factors associated with adolescent mental health

This study aimed to examine the associations between socio-demographic factors, health complaints, health behaviours, high-risk behaviours and mental health difficulties in a representative sample of 11-, 13- and 15-year-old adolescents in Latvia. The study used data from the international Health Behaviour in School-aged Children (HBSC) study year 2017/2018 Latvian database. Statistical modelling was performed to explore the odds of mental health difficulties measured by the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 4412 students. Overall, 155 (8.0%) boys and 209 (10,3%) girls had an “abnormal” level of mental health difficulties. In a binomial logistic regression model, the gender and socioeconomic status-adjusted odds ratios of scoring “abnormal” on the SDQ were higher for adolescents with poor subjective health, low quality of life, inadequate body image, those having multiple health complaints, less than 7 hours of sleep on weekdays, low level of physical activity, smoking cigarettes or e-cigarettes, drinking alcohol or having a problematic level of social media use. We conclude that female gender, low socioeconomic status, poor subjective health indicators, poor health behaviours and high-risk behaviours are significant factors associated with adolescent psychopathology and should be considered important targets for public health and preventive interventions.