Support for the link between adolescent mental health problems and subsequent perinatal depression: a 20-year prospective cohort study

ObjectivesThis study aims to examine associations, predictors and pharmacological treatment of chronic pain and mental health problems among Syrian refugees in a longitudinal perspective.DesignProspective cohort study.SettingWe collected survey data among Syrian refugees in Lebanon granted resettlement to Norway (self-administered questionnaires) and at follow-up 1 year after arrival in Norway (structured telephone interviews).ParticipantsAdult Syrian refugees attending mandatory pretravel courses in Lebanon in 2017–2018 were invited to participate. In total, 353 individuals participated at both time points.Primary and secondary outcomesWe examined the cross-sectional associations between pain, mental health and migration-related exposures at baseline and follow-up and assessed whether associations changed significantly with time. Furthermore, we investigated the longitudinal association between mental health at baseline and pain at follow-up. We also evaluated temporal changes in use of analgesics and psychotropic drugs.ResultsWhile most refugees reported improved health from the transit phase in Lebanon to the early resettlement phase in Norway, a few had persisting and intertwined health problems. Most migration-related stressors were more closely associated with chronic pain and mental health problems after resettlement as compared with the transit phase. In parallel, poor mental health was associated with chronic pain in the follow-up (adjusted risk ratio (ARR) 1.5 (1.0, 2.2)), but not at baseline (ARR 1.1 (0.8, 1.5)). Poor mental health at baseline was a statistically significant predictor of chronic pain at follow-up among those not reporting chronic pain at baseline. At both timepoints, one in four of those with chronic pain used analgesics regularly. None with mental health problems used antidepressants daily.ConclusionsProviders of healthcare services to refugees should be attentive to the adverse effect of postmigration stressors and acknowledge the interrelations between pain and mental health. Possible gaps in pharmacological treatment of pain and mental health problems need further clarification.

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Explaining ethnic variations in adolescent mental health: a secondary analysis of the Millennium Cohort Study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02167-w ◽

2021 ◽

Author(s):

Gargie Ahmad ◽

Sally McManus ◽

Laia Bécares ◽

Stephani L. Hatch ◽

Jayati Das-Munshi

Keyword(s):

Mental Health ◽

Social Support ◽

Cohort Study ◽

Young People ◽

Household Income ◽

Mental Health Problems ◽

Adolescent Mental Health ◽

Health Problems ◽

Millennium Cohort Study ◽

Black African

Abstract Purpose The relationship between ethnicity and adolescent mental health was investigated using cross-sectional data from the nationally representative UK Millennium Cohort Study. Methods Parental Strengths and Difficulties Questionnaire reports identified mental health problems in 10,357 young people aged 14 (n = 2042 from ethnic minority backgrounds: Mixed n = 492, Indian n = 275, Pakistani n = 496, Bangladeshi n = 221, Black Caribbean n = 102, Black African n = 187, Other Ethnic Group n = 269). Univariable logistic regression models investigated associations between each factor and outcome; a bivariable model investigated whether household income explained differences by ethnicity, and a multivariable model additionally adjusted for factors of social support (self-assessed support, parental relationship), participation (socialising, organised activities, religious attendance), and adversity (bullying, victimisation, substance use). Results were stratified by sex as evidence of a sex/ethnicity interaction was found (P = 0.0002). Results There were lower unadjusted odds for mental health problems in boys from Black African (OR 0.15, 95% CI 0.04–0.61) and Indian backgrounds (OR 0.42, 95% CI 0.21–0.86) compared to White peers. After adjustment for income, odds were lower in boys from Black African (OR 0.10, 95% CI 0.02–0.38), Indian (OR 0.40, 95% CI 0.21–0.77), and Pakistani (OR 0.49, 95% CI 0.27–0.89) backgrounds, and girls from Bangladeshi (OR 0.18, 95% CI 0.05–0.65) and Pakistani (OR 0.63, 95% CI 0.41–0.99) backgrounds. After further adjustment for social support, participation, and adversity factors, only boys from a Black African background had lower odds (OR 0.16, 95% CI 0.03–0.71) of mental health problems. Conclusions Household income confounded lower prevalence of mental health problems in some young people from Pakistani and Bangladeshi backgrounds; findings suggest ethnic differences are partly but not fully accounted for by income, social support, participation, and adversity. Addressing income inequalities and socially focused interventions may protect against mental health problems irrespective of ethnicity.

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Socioeconomic and sex inequalities in parent-reported adolescent mental ill-health: Time trends in four British birth cohorts

10.31219/osf.io/3zn2h ◽

2022 ◽

Author(s):

Eoin McElroy ◽

Marc Tibber ◽

Pasco Fearon ◽

Praveetha Patalay ◽

George Ploubidis

Keyword(s):

Mental Health ◽

Cohort Study ◽

Mental Health Problems ◽

Adolescent Mental Health ◽

Health Problems ◽

Housing Tenure ◽

Behavioural Problems ◽

Emotional And Behavioural Problems ◽

Birth Cohorts ◽

Over Time

BackgroundStudies using symptom-based screeners have suggested that mental health problems have increased in adolescents in recent decades, however, few studies have explicitly tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, few studies have explored whether changes in socioeconomic position (SEP) and sex inequalities across generations have impacted trends in adolescent mental health. MethodsUsing structural equation modelling, we explore sex differences in harmonised parent-reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS’58; N= 11,398), the 1970 British Cohort Study (BCS’70; N= 8,161), the 1991-92 Avon Longitudinal Study of Parents and Children (ALSPAC’91; N= 5,304), and the 2001 Millennium Cohort Study (MCS’01; N= 10,384). We also delineate associations between four harmonised indicators of childhood SEP and adolescent mental health, and test whether changes in SEP account for increases in mental ill-health over time. Results We found an increase in the latent means of parent-reported emotional and behavioural problems across time in both males and females in more recent cohorts, with the exception of ALSPAC’91. Sex-inequalities did not change over time, with females having consistently higher emotional problems. The associations between the four indicators of SEP and emotional problems were strongest in the MCS’01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in all of the cohorts, with housing tenure again more strongly associated with problems in the MCS’01. Inconsistent mediation (i.e. regression suppression) suggested that the increases in mental health problems occurred despite broadly improving average socio-economic conditions. ConclusionsOur findings suggest that parent-reported adolescent mental health problems have risen in recent generations and that this trend is not due solely to reporting styles. A failure to address widening inequalities may result in further increases in mental ill-health amongst disadvantaged young people.

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