Increasing self-reported suicide attempts by adolescents in Greece between 1984 and 2007.

PURPOSE: This study examines trends in self-reported suicide attempts by Greek adolescents. METHODS: Data were obtained from five nationwide school probability surveys, each of approximately 8,000-10,000 adolescents aged 14-18 years, carried out from 1984 to 2007. Students answered an anonymous questionnaire in their classrooms supervised by research assistants. Logistic regression analysis used as dependent variable any self-reported suicide attempts and as independent variables basic sociodemographic information and the year of the survey. RESULTS: Self-reported suicide attempts doubled in prevalence from 7.0% in 1984 to 13.4% in 2007. Female gender (odds ratio OR 2.49, 95% confidence interval CI 2.30-2.71), living in a single parent family (OR 1.91, CI 1.73-2.11), lower paternal education (OR 1.20, CI 1.10-1.31) and living in a major city (OR 1.17, CI 1.08-1.27 for Greater Athens and OR 1.13, CI 1.00-1.28 for Thessaloniki) were significantly associated with suicide attempts. A larger increase among males, from 2.4 to 8.4%, compared to females (11.5 to 17.9%) contributed to a decrease in gender differences. CONCLUSIONS: Changes in Greek society during the last 30 years, including loosening of family ties, increased drug use and stress because of the demands of school work, are hypothesised to have had an impact on the increasing trend in suicide attempts among adolescents.

Emotional, behavioural problems and cigarette smoking in adolescence: findings of a Greek cross-sectional study.

BACKGROUND: Although several studies have reported findings concerning the association between smoking and emotional/behavioural problems, little research has investigated this association after controlling for confounding factors which have been found to be significantly correlated with both cigarette smoking and emotional/behavioural problems and may have a strong effect on the relationship between adolescents' mental health and smoking. The present study attempted to assess the association between adolescents' smoking status and their emotional/behavioural problems after controlling for a number of possible confounders (i.e. age, gender, parental smoking status, exposure to family smoking, family socioeconomic status, adolescents' leisure time) in a Greek nation-wide school-based sample. METHODS: Participants completed a questionnaire which retrieved information about age, gender, family socioeconomic status, smoking status, parental smoking, adolescents' leisure time and emotional/behavioural problems. Data were modelled using multiple logistic regression analysis with adolescents' smoking status as the dependent variable. RESULTS: A total of 1194 (i.e. 63% response rate) of self-reported questionnaires (40.1% boys, 59.9% girls; 12-18 years old) were returned. Data from 1030 participants with full data were analyzed. Cigarette smoking was strongly associated with higher levels of emotional/behavioural problems (p < 0.001) and the association was not moderated (OR = 1.13, 95% CI: 1.08-1.18) after controlling for the effects of other covariates. Emotional symptoms, conduct problems and hyperactivity/inattention were all significantly associated with adolescents' current smoking. CONCLUSIONS: This study supports the association between smoking and emotional/behavioural problems among adolescents. Addressing adolescents' needs regarding their emotional/behavioural health could be helpful in the development of effective anti-smoking strategies in school environment and elsewhere.

Adolescents' wellbeing and functioning: relationships with parents' subjective general physical and mental health.

BACKGROUND: This study aimed at examining the relationship between parental subjective health status and adolescents' health-related quality of life (HRQoL) as well as the role of gender, socioeconomic status, presence of chronic health care needs and social support on the above interaction. METHODS: Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1,194) aged 11-18 years and their parents (N = 973) in 2003. Adolescents' and parents' status was assessed, together with reports of socio-economic status and level of social support. Various statistical tests were used to determine the extent to which these variables were related to each other. RESULTS AND DISCUSSION: Parental subjective mental health status was significantly correlated with adolescents' better physical and psychological wellbeing, moods and emotions, parent-child relationships, school environment and financial resources. Parental subjective physical health status was strongly associated with more positive adolescents' self-perception. Adolescents' male gender, younger age, absence of chronic health care needs, high social support, and higher family income were positively associated with better HRQoL. CONCLUSIONS: This study reinforces the importance of parental subjective health status, along with other variables, as a significant factor for the adolescents' HRQoL.

The factor structure of the Strengths and Difficulties Questionnaire (SDQ) in Greek adolescents.

BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) is a practical, economic and user-friendly screening instrument of emotional and behavioural problems in children and adolescents. This study was aimed primarily at evaluating the factor structure of the Greek version of the SDQ. METHODS: A representative nationwide sample of 1,194 adolescents (11 to 17 years old) completed the questionnaire. Confirmatory factor analysis (CFA) was conducted to assess the factor structure of the SDQ. RESULTS: CFA supported the original five-factor structure. The modification of the model provided some improvements. Internal consistency was acceptable for total difficulties, emotional symptoms and prosocial behaviour scale, moderate for hyperactivity/inattention scale and inadequate for peer and conduct problems scale. Older adolescents (aged 15 to 17 years) reported more hyperactivity/inattention and conduct problems than younger ones (aged 11 to 14 years) and girls reported more emotional symptoms and less prosocial behaviour problems than boys. Adolescents of low socioeconomic status (SES) reported more difficulties than those of medium and high SES. CONCLUSION: The Greek SDQ could be potentially considered as a community-wide screening instrument for adolescents' emotional and behavioural problems.

Psychopathology and mental health service utilization by immigrants' children and their families.

To investigate the psychopathology of immigrants' children and psychiatric service utilization by the immigrant families, data were collected from the files of all 35 immigrant children seen over a 3-year period at the Community Mental Health Centre of the Athens University Psychiatric Department. Immigrant children were matched by age, gender and intake date with 70 Greek children. Data concerned information about the child's place of birth, current living conditions, parents' country of origin, social and economic situation, occupations and educational status, social insurance, psychiatric history, referral source, diagnostic and therapeutic services rendered, number of sessions and outcome. Utilization of services was assessed 6 months after intake. No significant differences were found regarding family's structure and parents' psychopathology. However, immigrant families had significantly worse economic situations, lower status jobs, worse housing and were usually uninsured. No significant differences were observed regarding service utilization parameters, except concerning 'cooperation with other services' No differences were found regarding frequency or type of psychiatric diagnosis. However, 91% of the immigrant group received a psychosocial diagnosis as opposed to 49% of the Greek group. Immigrant children did not present more serious or diverse psychopathology than did Greek children. Immigrant families had equal levels of service utilization as Greek families. However, it was apparent that immigrant families did not apply for help as readily as their Greek counterparts.