Depression and alcohol use disorder (AUD) are frequently co-occurring in adolescence, which often goes undetected in routine care. While this may potentially compromise treatment effectiveness and lead to a less favourable long-term prognosis, few longitudinal studies have followed this group into adulthood. The aim of this study was to explore the risk for adult depression, anxiety disorders, suicidality, and AUD in adolescents with concurrent depression and AUD. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study. Diagnostic interviews were conducted in adolescence (age 16-17) and adulthood (around age 30). Adolescents with concurrent depression and AUD (n = 38) were compared with peers having only depression (n = 189) or neither of the conditions (n = 144). Logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adolescents with concurrent depression and AUD were more likely than their non-affected peers to experience adult depressive episodes (aOR, 5.33; 95% CI, 2.22–12.83), anxiety disorders (4.05; 1.77–9.27), suicidality (5.37; 2.28–12.66), and AUD (7.68; 2.59–22.81). Notably, 34% of adolescents with both depression and AUD subsequently experienced both these conditions as adults, compared to 7% of adolescents with only depression. Adolescents suffering only from depression were less likely than those with both conditions to experience suicidality (0.44; 0.21–0.95) and AUD in adulthood (0.18; 0.07–0.44). These findings underscore the clinical imperative to identify adolescents with this comorbidity. Recognition of the poor long-term prognosis can inform targeted interventions for this vulnerable group, ultimately improving health and well-being throughout the life course.

Aims: The transition from adolescence to young adulthood, often referred to as ‘emerging adulthood’, is a challenging period in life, and mental health problems are common. Although a large number of studies have shown that social support is linked with fewer mental health problems, few longitudinal studies have examined these associations during this life phase. The aim of the current study was to examine the associations between perceived social support from different sources – family, friends and significant other – at age 17–18 and symptoms of depression and anxiety at age 20–21. Methods: Data were obtained from the cohort study Futura01 based on a Swedish national sample of adolescents attending grade 9 in 2016/2017. We used survey information from 2019 (age 17–18) and 2022 (age 20–21) and linked registry information (N=2722). Symptoms of depression and anxiety were measured by the Patient Health Questionnaire-4 (PHQ-4) at age 20–21. Perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) at age 17–18. Control variables included sociodemographic characteristics and indicators of mental health problems at age 17–18. Binary logistic regressions were performed. Results: When mutually adjusting for all sources of perceived social support, family support at age 17–18 had inverse associations with symptoms of both depression and anxiety at age 20–21. Perceived support from friends was associated with subsequent symptoms of anxiety only. Conclusions: Perceived social support can be a protective factor against mental health problems in emerging adulthood. The family serves a particularly important source of social support.

Background  Recent studies have documented a range of adverse health outcomes associated with excessive social media use among adolescents. Fewer studies have examined potential protective factors in this context. Our study aims to bridge this gap by exploring the relationship between Problematic Social Media Use (PSMU) and poor Self-Reported Health (SRH) among Swedish adolescents, while also examining the potential buffering role of family support.

Methods  The data was sourced from the 2017/18 cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study, encompassing 3,135 students aged 11, 13, and 15 years. PSMU was measured using the Social Media Disorder Scale and categorized into three levels: low risk of PSMU, moderate risk of PSMU and having PSMU. Poor SRH was defined as a binary variable, with ‘Less than good health’ as the outcome category. Family support was measured using three items that quantified the level of emotional support received, categorized into an index of low, moderate, and high family support. Logistic regression analyses were performed to examine the association between PSMU and poor SRH, adjusting for age, gender, and family affluence. The potential moderating effect of family support was analyzed by including variables to test for both multiplicative and additive interaction between PSMU and family support on the risk of poor SRH.

Results  After adjustment for covariates, the results revealed a graded association between PSMU and poor SRH, with adolescents classified as having PSMU showing the highest odds of poor SRH, followed by those at moderate risk for PSMU. No statistically significant interaction was found on the multiplicative scale. The additive interaction analysis indicated potential trends of a buffering effect of high family support on the risk of poor SRH among adolescents with PSMU, although this was not statistically confirmed [due to small numbers in some of the cells].

Conclusions  Our study revealed a significant, graded relationship between PSMU and poor SRH, highlighting the need to limit excessive social media use among adolescents to prevent health issues. The finding, that high family support may serve as a potential protective factor against poor SRH in adolescents with PSMU underscores the role of family engagement in safeguarding adolescent well-being.

Background: Previous research has shown that exposure to bullying is linked to long-term adverse mental health consequences. However, prospective studies examining the persistence of bullying, using information from repeated time points, are limited. The aim of this study was to examine, firstly, the extent to which exposure to bullying among adolescents in Sweden changes between grades 9 (age 15-16) and 11 (age 17-18) (i.e., before and after the transition from lower to upper secondary school); secondly, whether being bullied in grade 9 or 11 is associated with depression and anxiety symptoms at age 20-21; and thirdly, if being bullied in both grade 9 and 11 is linked to an even higher likelihood of subsequent depression and anxiety symptoms. Potential differences by gender were investigated throughout.

Methods: Data was derived from the Swedish cohort study Futura01 involving individuals attending grade 9 in the school year 2016/17 (n = 2323). We utilised self-reported information from three survey waves conducted in 2017, 2019, and 2022, and linked registry information on sociodemographic characteristics. Bullying was assessed using a single item in waves 1 and 2. Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4) in wave 3. Gender stratified binary logistic regressions were performed.

Results: Among those who were bullied in grade 9, 22.6% of males and 35.8% of females continued to experience bullying in grade 11. For females, exposure to bullying in grade 9 or 11 was associated with an increased likelihood of reporting depression and anxiety symptoms at age 20-21, with the highest odds for those bullied at both time points. For males, only one statistically significant association was identified - specifically, between being bullied in grade 9 and subsequent depression symptoms.ConclusionsFor a majority of adolescents who experience bullying in lower secondary school, but not all, the transition to upper secondary school proves to be beneficial as the bullying typically does not persist. However, bullying can have long-term health effects, in particular for females. These findings emphasise the importance of effective measures to address bullying within schools.

Introduction: Previous research has shown associations between parental problem drinking and adverse mental health outcomes in children. However, while many studies assess parental alcohol problems based on clinical measures, longitudinal studies that investigate the impact of potentially less severe levels of parental alcohol problems are scarce. The aim of this study was to examine if the existence and severity of child-reported parental problem drinking in adolescence is associated with symptoms of depression and anxiety in young adult men and women.

Methods: Data was obtained from the Swedish national cohort study Futura01, including 3143 participants born in 2001 who were surveyed in 2017 (age 15–16) and 2022 (age 20–21). Parental problem drinking was measured at age 15–16 with the short version of The Children of Alcoholics Screening Test. Depression and anxiety symptoms were measured at age 20–21 with the Patient Health Questionnaire-4. Registry information on gender, parental education and parental country of birth were included as covariates.

Results: The results demonstrated an exposure-response pattern, with greater severity of parental problem drinking associated with an increased probability of reporting depression and anxiety symptoms 5 years later. The association between parental problem drinking and subsequent depression symptoms was however present only in females.

Discussion and Conclusions: Adolescents exposed to parental problem drinking have elevated risks of long-term adverse mental health. These risks increase with greater severity of parental problem drinking. It is thus crucial with efforts preventing parental problem drinking and efforts promoting health among children and adolescents who are exposed.

Background  Loneliness and belonging refer to social connectedness and are associated with young people’s health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17–18-years-olds who were followed over 3 years, and the associations that these aspects share with young people’s psychosomatic complaints during these ages.

Methods  Swedish cohort data collected among late adolescents (age 17–18 in 2019) who were followed up in young adulthood (age 20–21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated.

Results  Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups.

Conclusions  Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.

Introduction: Much research into the links between parental problematic alcohol use and adolescent substance use has focused on clinically diagnosed parental alcohol disorders. Few prior studies have utilised validated measures of adolescents’ perception of parental alcohol problems and considered the severity of these problems. This study examined the associations between the severity of perceived parental alcohol problems and adolescents’ drinking patterns in a Swedish national sample.

Methods: We used survey information from grade 9 and 11 students (15–18 years) from 2021 (n = 9,227). Perceived parental alcohol problems were measured by the short version of The Children of Alcoholics Screening Test (CAST-6). The outcomes were: alcohol consumption during the past 12 months, frequent heavy episodic drinking (HED), and early alcohol debut (before age 14). Sociodemographic characteristics were adjusted for.

Results: Binary logistic regressions showed that the severity of perceived parental alcohol problems was associated with alcohol consumption during the past 12 months (low severity OR 1.53, p < 0.001; moderate severity OR 1.85, p < 0.001; high severity OR 2.52, p < 0.001), HED (low severity OR 1.16, n.s.; moderate severity OR 1.31, n.s.; high severity OR 1.64, p < 0.01), and early alcohol debut (low severity OR 1.57, p < 0.001; moderate severity OR 1.65, p < 0.001; high severity OR 2.20, p < 0.001).

Conclusions: Adolescents with perceived parental alcohol problems are more likely to have risky drinking patterns themselves, and the likelihood becomes higher with increased severity. Effective interventions for children whose parents have drinking problems are important, and should also take the severity of the parents’ drinking problem into account.

Aims: Psychosomatic complaints are common in youth and are often assumed to indicate stress. Although several studies have confirmed that a cross-sectional association exists, few have empirically investigated whether or not perceived stress influences psychosomatic complaints. The objective of the present study was to build upon previous research by exploring whether changes in perceived stress over time are associated with corresponding changes in psychosomatic complaints. This analytical approach takes unmeasured time-invariant confounding into account, thereby offering more robust evidence for a causal association between the variables under study.

Methods: Data was derived from the Swedish national cohort study Futura01, with information from 2,708 participants aged 17–18 in 2019 and 20–21 in 2022. Perceived stress was measured by Cohen’s Perceived Stress Scale. Psychosomatic complaints were measured by questions on the frequency of stomach aches, headaches and difficulties falling asleep, which were added to an index. Information on gender, parental education, and parental country of birth was derived from registries. Linear regression analyses were conducted and the first difference (FD) approach was used.

Results: Perceived stress and psychosomatic complaints exhibited cross-sectional associations at both time points. The FD analyses showed that increases in perceived stress were associated with increases in psychosomatic complaints, and this was the case irrespective of sociodemographic characteristics.

Conclusions: This study provides further empirical support for the assumption that psychosomatic complaints can be partially attributed to stress. Societal efforts aimed at reducing stressors and strengthening coping resources and strategies among young people may help mitigate perceived stress and, consequently, the likelihood of developing psychosomatic complaints.

Background: School pressure is a significant stressor in the lives of adolescents, recognised to be associated with psychosomatic complaints. Therefore, the exploration of potential buffering factors is a relevant task. This study aimed to examine the association between school pressure and psychosomatic complaints and the potentially moderating role of physical activity in a Swedish national sample of adolescents. Methods: Data were derived from the 2017/2018 Swedish Health Behaviour in School-aged Children (HBSC) survey, involving 3,745 participants aged 11–15 years. School pressure and physical activity were measured using single items. Psychosomatic complaints were assessed through an additive index based on the frequency of eight complaints. Covariates included gender, grade, and family affluence. Results: Linear regression analyses demonstrated a positive graded association between school pressure and psychosomatic complaints, while an inversely graded association was observed between physical activity and psychosomatic complaints. Physical activity did, however, not moderate the link between school pressure and psychosomatic complaints. Conclusion: Even though physical activity did not serve as a buffer, the direct effects of school pressure and physical activity on psychosomatic complaints suggest that supporting young people in managing school demands and promoting their engagement in physical activities could be effective measures in alleviating psychosomatic complaints.

Objective Trust and health are both fundamental elements of a socially sustainable society. While much research has shown that trust is associated with better mental health outcomes in adults, studies of young people are relatively scarce, despite the fact that mental health problems are common in young ages. In particular, there are few longitudinal studies that cover different dimensions of trust. Building on a previous study on trust and psychosomatic complaints in adolescents, the aim was to examine the links between generalised and institutional trust in adolescence and depression and anxiety symptoms in young adulthood. Data was obtained from a Swedish cohort study with self-reported information on generalised and institutional trust at ages 15–16 and 17–18 and depression and anxiety symptoms at age 20–21 (n = 2,668). Covariates included sociodemographic characteristics and indicators of prior mental health status.

Results Binary logistic and linear regressions showed that higher levels of generalised trust at ages 15–16 and 17–18 were inversely associated with depression and anxiety symptoms at age 20–21. Institutional trust was however not linked with subsequent depression and anxiety symptoms when adjusting for generalised trust and covariates. The findings indicate that generalised trust is a social determinant for mental health in young people.