Department of Public Health Sciences, Mälardalen University, Västerås, Sweden.
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
PLoS One. 2024 Mar 8;19(3):e0300294. doi: 10.1371/journal.pone.0300294. eCollection 2024.
The aim of this study is to investigate the extent to which school-related factors, such as school liking, participation in decision-making, school-related parental support, teachers' support, and school physical environment, explain trends in mental health problems. The problems considered are psychosomatic symptoms (PSS), depressive symptoms (DS), suicidal ideations (SI), and suicide attempts (SA) among Swedish adolescents of varying socioeconomic status (SES) from 2004 to 2020.
We analyzed data collected through repeated cross-sectional surveys from 19,873 15-year-old students at schools in a county in Sweden. Boys and girls each constituted 50% of the participants. We fitted linear and logistic regression models to investigate associations between the school-related factors and trends in mental health problems.
Increased school-related parental support and school liking were cross-sectionally associated with decreased PSS, DS and SI, with school liking also associated with decreased SA. Conducive school physical environment was also found to be cross-sectionally associated with lower PSS and DS scores. Over time, mental health problems have shown a general increase among adolescents in the low SES group and a decrease among those in the high SES group. While school-related factors explained the improvement in mental health in the high SES group, we found such association only between parental support trends in PSS and DS, along with participation and trends in SA over time among adolescents in the low SES group.
The results show that school-related factors play significant roles in influencing adolescent mental health. The influence, however, varied across SES gradients over time. This suggests that working against inequities in school-related factors would help address inequities in mental health.
本研究旨在探讨学校相关因素（如学校喜好、参与决策、与学校相关的父母支持、教师支持和学校物理环境）在多大程度上解释了心理健康问题的趋势。所考虑的问题包括身心症状（PSS）、抑郁症状（DS）、自杀意念（SI）和自杀企图（SA），这些问题存在于瑞典不同社会经济地位（SES）的青少年中，时间跨度为 2004 年至 2020 年。
我们分析了来自瑞典一个县学校的 19873 名 15 岁学生重复横断面调查的数据。参与者中男孩和女孩各占 50%。我们拟合了线性和逻辑回归模型，以调查学校相关因素与心理健康问题趋势之间的关联。
增加与学校相关的父母支持和学校喜好与 PSS、DS 和 SI 的减少呈横断面相关，学校喜好也与 SA 的减少相关。有利的学校物理环境也与较低的 PSS 和 DS 分数呈横断面相关。随着时间的推移，低 SES 组青少年的心理健康问题普遍增加，高 SES 组青少年的心理健康问题则减少。虽然学校相关因素解释了高 SES 组青少年心理健康的改善，但我们仅发现了父母支持在 PSS 和 DS 方面的趋势，以及低 SES 组青少年 SA 的参与和趋势之间存在这种关联。
结果表明，学校相关因素在影响青少年心理健康方面发挥着重要作用。然而，这种影响随着时间的推移在 SES 梯度上有所不同。这表明，解决学校相关因素的不平等问题将有助于解决心理健康的不平等问题。
