Discrepant trends in mental health complaints among younger and older adolescents in Sweden: an analysis of WHO data 1985-2005.

PURPOSE

To elucidate the time trends in self-reported mental health complaints (internalizing problems) among school children in Sweden during a time characterized by economic downturns and upturns, with a focus on possible differences across grades and genders.

METHODS

The study uses nationwide and repeated cross-sectional data collected five times during 1985-2005 among students in Sweden in grades 5, 7, and 9. The number of participating students each year varied between 2,933 and 4,421. The attrition rates varied between 10% and 15% in the participating schools. Data were subjected to descriptive analysis and multinomial logistic regression using a composite measure of self-reported mental health complaints.

RESULTS

The study results show significantly higher rates of mental health complaints in 2005/2006 compared with 1985/1986 among older adolescents, in particular girls, whereas the rates are almost unchanged among younger boys and girls. Only among girls in grade 9 has there been a successively (linear) increase of mental health complaints across years of investigations.

CONCLUSIONS

The increasing rates of mental health complaints among older adolescents, in particular girls, are a cause for concern and a challenge for public health work. By showing discrepant time trends among younger and older adolescents, the results of the study nuance the predominant and unambiguous notions about continuously deteriorating mental health among children and adolescents in Sweden. To address hypotheses concerning the causes of the discrepant time trends, suggestions are made for comparative cross-country analyses based on data from Sweden and other European countries.