Lifestyle, appearance satisfaction and depressive symptoms in 13-16 years old Norwegian adolescents - A cross-sectional study.

Purpose: To examine gender-specific associations between multiple lifestyle-related risk factors, appearance satisfaction and depressive symptoms in a sample of Norwegian adolescents (13-16 years of age), and to study the role of appearance satisfaction as a possible confounder in the associations between lifestyle and depressive symptoms. Materials and methods: Data were obtained from Ungdata, a cross-sectional national survey of adolescents in Norway. In total 4379 subjects were included in the study. We constructed a lifestyle risk index and used multiple logistic regressions to examine the associations between lifestyle-related risk factors, appearance satisfaction, and depressive symptoms. Results: High screen time and use of alcohol were significantly associated with depressive symptoms among girls, while high screen time, tobacco and cannabis use were significantly associated with depressive symptoms among boys. An additive relationship was observed between the lifestyle risk index scores and the likelihood of depressive symptoms for both genders, the relationship being strongest among boys. Low appearance satisfaction was strongly associated with depressive symptoms, especially among boys, and identified as an important confounder in the associations between lifestyle and depressive symptoms, particularly among girls. Conclusions: High screen time was the most prevalent lifestyle risk behavior independently associated with depressive symptoms. Multiple lifestyle changes and improvement of appearance satisfaction should be included in measures targeting adolescents for the prevention and treatment of depressive symptoms. Future studies should elaborate on the gender differences in other adolescent age groups. Appearance satisfaction should be acknowledged as an important confounder in future studies of lifestyle and depressive symptoms.

Sleep problems and mental health among young Norwegian adolescents.

PURPOSE: The present study investigated the associations between the aspects of sleep problems and mental health in Norwegian young adolescents. MATERIALS AND METHODS: Adolescents (12-13 years) were recruited from the primary schools in Telemark County, Norway. Sleep related problems were assessed by asking parents three questions related to their childrens' sleep quality, sleep sufficiency, and daytime sleepiness. Parents reported data on mental health by the extended version of the Strengths and Difficulties Questionnaire (SDQ), and information on the child's physical activity, screen time, eating pattern, gender, and background variables. Height and weight were objectively measured. Complete data were obtained for 690 adolescents. RESULTS: Multiple logistic regressions were used. Bivariate analyses indicated important associations between the sleep aspects and mental health. When adjusting the sleep variables for each other, lifestyle factors and background variables, sleep quality problems were associated with any psychiatric problem (ORadj: 4.0, CI: 2.0-8.2), emotional problems (ORadj: 15.1, CI: 3.4-66.8), and hyperactivity-inattention problems (ORadj: 5.1, CI: 2.2-12.1). Daytime sleepiness problems were associated with any psychiatric problem (ORadj: 2.3, CI: 1.2-4.4), and hyperactivity-inattention problems (ORadj: 2.5, CI: 1.1-5.5). Bivariate associations between problems with sufficient sleep and mental health problems lost the significance when adjusted for other sleep variables. CONCLUSIONS: The results indicate that different aspects of sleep problems may be important underlying factors for mental health problems in adolescents, independently of lifestyle factors, BMI-category, gender, and background variables. This highlights the importance of examining specific sleep problems when investigating associations between sleep and mental health.

A 12-year National Study of Suicide by Jumping From Bridges in Norway.

Studies from several countries suggest that erecting fences on bridges more commonly used for suicide by jumping may be an effective way of reducing the risk of suicide by jumping from these bridges. Distribution of suicides by jumping off bridges has not yet been studied on a national level in any country. This study included all suicides by jumping from high places registered in the Norwegian Cause of Death Registry (COD) in the period 1999-2010 (n = 319). Combining data from the COD registry and information from police records, 71 cases of suicide by jumping off a bridge were identified involving 36 bridges. This form of suicide constituted approximately 1% of all suicides in Norway in the period 1999-2010. Almost half of these suicides were registered at only 6 bridges. Three Norwegian bridges were secured during the observation period of this study. Two bridges had barriers installed on the full length of the bridge with 11 suicides registered before barriers were installed, and none after. On the 1 bridge that was only partially secured, no change in numbers of suicides was observed after barriers were installed. One-third of jumps from bridges occurred over land. We found that although suicide by jumping off bridges was a relatively rare event, there is a potential for saving lives by installing physical barriers on bridges that are more commonly used for suicide by jumping.

Gender-specific association of weight perception and appearance satisfaction with slimming attempts and eating patterns in a sample of young Norwegian adolescents.

OBJECTIVE: To examine gender-specific associations of weight perception and appearance satisfaction with slimming attempts and eating patterns among young Norwegian adolescents. DESIGN: Cross-sectional study. Adolescent dietary data were reported by parents using a retrospective FFQ. Eating patterns were identified using principal component analysis. Adolescents' reported weight perception, appearance satisfaction and slimming attempts were analysed using cross-tabulation and Pearson's χ 2 test. Associations between perceived weight, appearance satisfaction and slimming attempts/eating patterns were examined using multiple logistic regression analysis. SETTING: Primary schools, Telemark, Norway. SUBJECTS: Children (n 469), mean age 12·7 (sd 0·3) years, and parents. RESULTS: Gender differences were observed in self-perceived weight and appearance satisfaction. Girls were most satisfied with appearance when feeling thin, boys when feeling just the right weight. Perceived overweight was the main predictor of slimming attempts across genders (adjusted OR=15·3; 95 % CI 6·0, 39·1 for girls; adjusted OR=18·2; 95 % CI 5·8, 57·3 for boys). Low appearance satisfaction was associated with slimming attempts (adjusted OR=3·3; 95 % CI 1·0, 10·5) and a dieting eating pattern (adjusted OR=2·8; 95 % CI 1·5, 5·2) in girls. Perceived underweight was associated with a junk/convenience eating pattern in boys (adjusted OR=2·8; 95 % CI 1·2, 6·4). CONCLUSIONS: Gender differences were observed in subjective body concerns. Perceived overweight was the main predictor of slimming attempts by both genders. Different aspects of body dissatisfaction were related to different food behaviours in boys and girls. Health professionals should be aware of these gender differences when planning health promotion programmes targeting young adolescents.

Associations between overweight, peer problems, and mental health in 12-13-year-old Norwegian children.

Overweight and mental health problems represent two major challenges related to child and adolescent health. More knowledge of a possible relationship between the two problems and the influence of peer problems on the mental health of overweight children is needed. It has previously been hypothesized that peer problems may be an underlying factor in the association between overweight and mental health problems. The purpose of the present study was to investigate the associations between overweight, peer problems, and indications of mental health problems in a sample of 12-13-year-old Norwegian schoolchildren. Children aged 12-13 years were recruited from the seventh grade of primary schools in Telemark County, Norway. Parents gave information about mental health and peer problems by completing the extended version of the Strength and Difficulties Questionnaire (SDQ). Height and weight were objectively measured. Complete data were obtained for 744 children. Fisher's exact probability test and multiple logistic regressions were used. Most children had normal good mental health. Multiple logistic regression analysis showed that overweight children were more likely to have indications of psychiatric disorders (adjusted OR: 1.8, CI: 1.0-3.2) and peer problems (adjusted OR: 2.6, CI: 1.6-4.2) than normal-weight children, when adjusted for relevant background variables. When adjusted for peer problems, the association between overweight and indications of any psychiatric disorder was no longer significant. The results support the hypothesis that peer problems may be an important underlying factor for mental health problems in overweight children.

Eating patterns and mental health problems in early adolescence--a cross-sectional study of 12-13-year-old Norwegian schoolchildren.

OBJECTIVE: To investigate the association between eating patterns and mental health problems in young Norwegian adolescents (12-13 years of age). DESIGN: Cross-sectional study. Dietary information was reported by parents using a retrospective FFQ. Eating patterns were identified using principal component analysis. The Strengths and Difficulties Questionnaire was used to measure mental health problems. The association between eating patterns and mental health problems was examined using multiple logistic regression analysis. SETTING: Primary schools, Telemark County, Norway. SUBJECTS: Children (n 1095) aged 12-13 years and their parents. RESULTS: Children with high scores on a 'varied Norwegian' eating pattern were less likely to have indications of any psychiatric disorders (adjusted OR = 0·5; 95 % CI 0·3, 1·0) and hyperactivity-inattention disorders (adjusted OR = 0·4; 95 % CI 0·2, 0·8) than children with low scores on this pattern. Children with high scores on a 'junk/convenient' eating pattern were more likely to have indications of hyperactivity-inattention disorders (adjusted OR = 3·4; 95 % CI 1·3, 8·6) than children with low scores on this pattern. Children with high scores on a 'snacking' eating pattern were more likely to have indications of conduct/oppositional disorders (adjusted OR = 3·8; 95 % CI 1·2, 11·5) than those with low scores on this eating pattern. CONCLUSIONS: We identified a significant association between eating patterns and mental health problems in young adolescents, independently of physical activity, sedentary activity and background variables. A diverse diet rich in unrefined plant foods, fish and regular meals was associated with better mental health, while energy-dense, nutrient-poor diets and irregular meals were associated with poorer mental health.

Is there a specific relationship between childhood sexual and physical abuse and repeated suicidal behavior?

OBJECTIVE: Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior. METHOD: Seventy-four subjects, 65% of whom were women, consecutively admitted to a general hospital after having made a suicide attempt, were interviewed as part of the intake interview about prior suicide attempts and self-mutilation and received DSM-IV diagnoses. Sexual abuse, physical abuse, neglect, antipathy from parents, loss of parents, and severe discord in the family before the age of 18, were covered by the Childhood Experience of Care and Abuse (CECA) interview schedule. RESULTS: The prevalence of severe sexual abuse was 35%, severe physical abuse 18%, neglect 27%, antipathy 34%, loss of caregiver 37% and exposure to family violence 31%. Physical and sexual abuse were independently associated with repeated suicide attempts when controlling for the effects of the other childhood adverse factors. No other childhood adversity was related to chronic suicidal behavior. The odds ratio of exposure to sexual or physical abuse was highest among those who both repeated suicide attempts and self-mutilated. CONCLUSION: Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior.