BACKGROUND: Adolescence is a sensitive period accompanied by rapid developmental changes that can result in health complaints. The aim of the study was to describe the trend of subjective health complaints (HBSC-SCL) of Polish adolescents compared to their peers from 30 other countries and to rank all countries based on a proposed standardised measure. MATERIAL AND METHODS: Data from the Health Behaviour in School-Aged Children (HBSC) study collected from 2002 to 2018 were used. The overall number of respondents from 30 countries in the combined sample from five quadrennial rounds was 773,356, including 49.2% boys and 50.8% girls. The HBSC-SCL is a non-clinical measure consisting of eight health complaints, usually analysed in two dimensions of psychological and somatic symptoms. Linear regression analysis was applied to assess the significance of trends of the total index and two subindices in the combined sample and individual countries. RESULTS: A significant increasing trend for the eight-item index appeared in Poland only in 13- and 15-year-olds, while only among 15-year-olds in the combined sample from 30 countries. Standardised country rank varied between -1.85 and 2.48 (worst). The countries that achieved extreme negative values (>=1) are France, Hungary, Italy, and Sweden, and the rank for Italy is considerably higher than for other countries. In Poland, the standardised rank for psychological symptoms exceeded the threshold of +1 in 2018. CONCLUSIONS: The HBSC-SCL index could be useful for monitoring change in adolescent mental health. The proposed method of ranking may allow a broader view of the differences and similarities between countries and help to identify those performing unfavourably against cross-country patterns.

Center for Analysis and Development of Health National Institute of Public Health Ljubljana Slovenia

Centre of Migration Research University of Warsaw Warsaw Poland

CHILD Research Group School of Education and Communication Jönköping University Jönköping Sweden

Department of Child and Adolescent Health Institute of Mother and Child Warsaw Poland

Department of Health Psychology Faculty of Public Health Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

Department of Humanization in Medicine and Sexology University of Zielona Gora Zielona Gora Poland

Faculty of Physical Culture Palacký University Olomouc Olomouc Czechia

Health Research Institute Faculty of Public Health Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

See more in PubMed

Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–25. doi: 10.1016/S0140-6736(11)60827-1. et al. PubMed DOI

Patton GC, Cofey C, Romaniuk H, Mackinnon A, Carlin J, Degenhardt L. The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. Lancet. 2014;383(9926):1404–11. doi: 10.1016/S0140-6736(13)62116-9. et al. PubMed DOI

Riehm KE, Latimer E, Quesnel-Vallée A, Stevens GWJM, Gariépy G, Elgar FJ. Does the density of the health workforce predict adolescent health? A cross-sectional, multilevel study of 38 countries. J Public Health. 2018;41(1):e35–43. doi: 10.1093/pubmed/fdy096. PubMed DOI PMC

Bor W, Dean AJ, Najman J, Hayatbakhsh R. Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Aust N Z J Psychiatry. 2014;48(7):606–16. doi: 10.1177/0004867414533834. PubMed DOI

Cosma A, Stevens G, Martin G, Duinhof E, Walsh S, Garcia-Moya I. Cross-national time trends in adolescent mental well-being from 2002 to 2018 and the explanatory role of schoolwork pressure. J Adolesc Health. 2020;66(6S):S50–8. doi: 10.1016/j.jadohealth.2020.02.010. et al. PubMed DOI PMC

Hendriks AM, Bartels M, Stevens GWJM, Walsh SD, Torsheim T, Elgar FJ, al at. National child and adolescent health policies as indicators of adolescent mental health: a multilevel analysis of 30 European countries. J Early Adolesc. 2020;40(4):537–65. doi: 10.1177/0272431619858413. DOI

Ottová-Jordan V, Smith ORF, Augustine L, Gobina I, Rathmann K, Torsheim T. Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level. Eur J Public Health. 2015;25(Suppl. 2):83–9. doi: 10.1093/eur-pub/ckv033. et al. PubMed DOI

Torsheim T, Revens-Sieberer U, Hetland J, R Välimaa, Danielson M, Overpeck M. Cross-national variation of gender differences in adolescent subjective health in Europe and North America. Soc Sci Med. 2006;62:815–27. doi: 10.1016/j.socscimed.2005.06.047. PubMed DOI

Kroon A. Psychosomatic symptoms of adolescents and age of alcohol onset: examining the moderating role of strictness of alcohol policy [master’s thesis]. Faculty of Social and Behavioural Sciences. Utrecht University; Netherlands:

https://studenttheses.library.uu.nl/search.php?m=advanced&v1=age%20at%20onset . Accessed [April 25, 2021]

Braverman MT, Stawski RS, Samdal O, LE Aarø. Daily smoking and subjective health complaints in adolescence. Nicotine Tob Res. 2016;19(1):102–10. doi: 10.1093/ntr/ntw133. PubMed DOI

Zidkova R, Glogar P, Polackova Solcova I, van Dijk J., Kalman M, Tavel P. Spirituality, religious attendance and health complaints in Czech adolescents. Int. J. Environ. Res. Public Health. 2020;17(7):2339–48. doi: 10.3390/ijerph17072339. et al. PubMed DOI PMC

Heinz A, Catunda C, Duin C van, H Willems. Suicide prevention: using the number of health complaints as an indirect alternative for screening suicidal adolescents. J Afect Disord. 2020;260:61–6. doi: 10.1016/j.jad.2019.08.025. PubMed DOI

Dierckens M, Weinberg D, Huang Y, Elgar F, Moor I, Augustine L. National-level wealth inequality and socioeconomic inequality in adolescent mental well-being: A time series analysis of 17 countries. J Adolesc Health. 2020;66(6S):S21–8. doi: 10.1016/j.jadohealth.2020.03.009. et al. PubMed DOI

Högberg B, Strandh M, Petersen S, Johansson K. Education system stratification and health complaints among school-aged children. Soc Sci Med. 2019;220:159–66. doi: 10.1016/j.socscimed.2018.11.007. PubMed DOI

Weinberg D, Stevens GWJM, Currie C, Delaruelle K, Dierckens M, Lenzi M. Country-level meritocratic beliefs moderate the social gradient in adolescent mental health: a multilevel study in 30 European countries. J Adolesc Health. 2021;68(3):548–57. doi: 10.1016/j.jadohealth.2020.06.031. et al. Mar. PubMed DOI

Zaborskis A, Grincaite M, Lenzi M, Tesler R, MorenoMaldonado C, Mazur J. Social inequality in adolescent life satisfaction: comparison of measure approaches and correlation with macro-level indices in 41 countries. Soc Indic Res. 2019;141:1055–79. doi: 10.1007/s11205-018-1860-0. DOI

Šmigelskas K, Lukoševičiūtė J, Vaičiūnas T, Mozūraitytė K, Ivanavičiūtė U, Milevičiūtė I. Measurement of health and social behaviours in schoolchildren: randomized study comparing paper versus electronic mode. Slov J Public Health. 2019;58(1):1–10. doi: 10.2478/sjph-2019-0001. et al. PubMed DOI PMC

Gariepy G, McKinnon B, Sentenac M, Elgar FJ. Validity and reliability of a brief symptom checklist to measure psychological health in school-aged children. Child Indic Res. 2016;9(2):47184. doi: 10.1007/s12187-015-9326-2. DOI

Wang D, Wang C, Chen S, Zuo C, Dong D, Wang Y. Psychometric properties of the subjective health complaints for Chinese children: parent- and self-reports. Curr Psychol. 2018;39:2357–65. doi: 10.1007/s12144-018-9943-2. DOI

Inchley J, Currie D, Budisavljevic S, Torsheim T, Jåstad A, Cosma A. Spotlight on adolescent health and wellbeing: findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. International report: Key findings. Copenhagen: WHO Regional Office for Europe; 2020. at: https://www.euro.who.int/__data/assets/pdf_file/0006/442959/Spotlight-on-adolescent-health-and-well-being-HBSC-survey-summary-enghttps://apps.who.int/iris/bitstream/handle/10665/332091/9789289055000-eng.pdf et al. Accessed [February 5, 2021]

Hetland J, Torsheim T, LE Aarø. Subjective health complaints in adolescence: dimensional structure and variation across gender and age. Scand J Public Health. 2002;30(3):223–30. doi: 10.1080/140349402320290953. PubMed DOI

Potrebny T, Wiium N, Haugstvedt A, Sollesnes R, Torsheim T, Wold B. Health complaints among adolescents in Norway: A twenty-year perspective on trends. PLoS One. 2019;14(1):e0210509. doi: 10.1371/journal.pone.0210509. et al. Jan 9. PubMed DOI PMC

Due P, Damsgaard MT, Madsen KR, Nielsen L, Rayce SB, Holstein BE. Increasing prevalence of emotional symptoms in higher socioeconomic strata: trend study among Danish schoolchildren 1991-2014. Scand J Public Health. 2019;47(7):690–4. doi: 10.1177/1403494817752520. PubMed DOI

Eriksson C, Trabs Damsgaard M. Att mäta och värdera psykisk hälsa bland ungdomar- om vägval, möjligheter, svårigheter och ofullständig kunskap. Soc Med Tidskr. 2020;95(5-6):743–59.

P Löfstedt, L Wiklander, M Corell. Varför har den psykiska ohälsa ökad bland barn och unga i Sverige under perioden 1985-2014? Soc Med Tidskr. 2020;95(5-6):793–803.

Låftman S., Saminathen Granvik, Modin M.,, Löfstedt B.. Excellent self-rated health among Swedish boys and girls and its relationship with working conditions in school: a cross-sectional study. Int. J. Environ. Res. Public Health. 2021;18(3):1310. doi: 10.3390/ijerph18031310. P. PubMed DOI PMC

Sweeting H, West P, Young R, Der G. Can we explain increases in young people’s psychological distress over time? Soc Sci Med. 2010;71(10):1819–30. doi: 10.1016/j.socscimed.2010.08.012. PubMed DOI PMC

Lager AC, Bremberg SG. Association between labour market trends and trends in young people’s mental health in ten European countries 1983-2005. BMC Public Health. 2009;9:325. doi: 10.1186/1471-2458-9-325. Sep 8. PubMed DOI PMC

Larsson AK, Boersma K. Historiskt perspektiv på ungas psykiska ohälsa. Medicinsk diskurs och självskattad hälsa under 1970-och 2010-talen. Soc Med Tidskr. 2020;95(5-6):760–70.

Svensson M, Berlin M, Ginsberg Y, Barnevik Olsson M, State M. Depressioner och ångestsyndrom bland barn och unga förknippa med långsiktiga konsekvenser, en nationell register-studie. Soc Med Tidskr. 2020;95(5-6):771–82. et al.

Woynarowska B, Mazur J. Zmiany w zdrowiu i samopoczuciu psychospołecznym młodzieży szkolnej w okresie transformacji ustrojowej. Przegl Pediatr. 2002;32(3):218–22.

Kleszczewska D, Małkowska-Szkutnik A, Nałęcz H, Mazur J. Zachowania sedentarne a nieswoiste dolegliwości psychosomatyczne młodzieży szkolnej. Ped Pol – Pol J Pediatr. 2017;92(5):553–60. doi: 10.1016/j.pepo.2017.06.005. DOI

Małkowska-Szkutnik A, J Mazur. Burden of chronic conditions and subjective complaints as factors modifying the way polish students are functioning at school. Int J Psycho-Educ Sci. 2019;8(1):55–63.

Kleszczewska D, Mazur J, Bucksch J, Dzielska A, Brindley C, Michalska A. Active transport to school may reduce psychosomatic symptoms in school-aged children: data from nine countries. Int J Environ Res Public Health. 2020;17(23):8709. doi: 10.3390/ijerph17238709. Nov 24. PubMed DOI PMC

Tabak I, Mazur J. Social support and family communication as factors protecting adolescents against multiple recurrent health complaints related to school stress. Dev Period Med. 2016;20(1):27–39. Jan-Mar. PubMed

Mazur J, Tabak I, Kołoło H. Czynniki ryzyka i ochronne wśród uwarunkowań subiektywnych dolegliwości młodzieży 15-letniej. Protective factors as determinants of subjective complaints in 15-year-old adolescents. Przegl Epidemiol. 2008;62(3):633–41. PubMed

Gaspar de Matos M, Kleszczewska D, Gaspar T, Dzielska A, Branquinho C, Michalska A. Making the best out of youth: The Improve the Youth project. J Community Psychol. 2021 Feb 26. et al. [In press.] PubMed DOI

Puls Medycyny. https://pulsmedycyny.pl/dr-maciej-pilecki-oreformie-psychiatrii-dzieciecej-potrzebne-sa-programy-profilak-tyczne-o-wczesnym-rozpoznawaniu-problemow-psychicznych-u-dzieci-1004708 At. Accessed [March 21, 2021]

Schnohr CW, Molcho M, Rasmussen M, Samdal O, de Looze M, Levin K. Trend analyses in the health behaviour in school-aged children study: methodological considerations and recommendations. Eur J Public Health. 2015;25(Suppl 2):7–12. doi: 10.1093/eurpub/ckv010. et al. Apr. PubMed DOI

Three Decades of Adolescent Health: Unveiling Global Trends Across 41 Countries in Psychological and Somatic Complaints (1994-2022)