OBJECTIVES: This study examined (non-)monotonic time trends in psychological and somatic complaints among adolescents, along with gender differences. METHODS: Repeated cross-sectional Health Behaviour in School-aged Children (HBSC) data from 1994 to 2022 covering 15-year-old adolescents from 41 countries (N = 470,797) were analysed. Three polynomial logistic regression models (linear, quadratic, cubic) were tested for best fit, including separate analyses by gender and health complaints dimension. RESULTS: Time trend patterns varied by gender and health complaints dimension. Increases were found in 82.3% of cases (linear 25%, quadratic U-shaped 28.7%, cubic 28.7%), while 14% showed no clear trend, and 3.7% decreased. Boys typically showed linear increases or no clear trend over time, whereas girls generally showed cubic or U-shaped trends. Psychological complaints often displayed U-shaped or cubic patterns, whereas somatic complaints mostly showed linear increases. CONCLUSION: Psychological and somatic complaints demonstrated diverse time trend patterns across countries, with non-monotonic patterns (U-shaped and cubic) frequently observed alongside linear increases. These findings highlight the complexity of changes within countries over three decades, suggesting that linear modelling may not effectively capture this heterogeneity.

• Keywords
• HBSC, adolescence, cross-national, gender differences, mental health,
• MeSH
• Global Health MeSH
• Humans MeSH
• Adolescent MeSH
• Medically Unexplained Symptoms MeSH
• Cross-Sectional Studies MeSH
• Sex Factors MeSH
• Somatoform Disorders epidemiology   MeSH
• Adolescent Health * trends   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH