Aims: To investigate predictors and common mental disorder outcomes of subjective social status in different gender and age groups of Swedish employees. Methods: Data from eight waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH), collected between 2006 and 2020, were used (n=12,925). Fixed effects models were used to investigate whether changes in demographic and socioeconomic factors predicted changes in subjective social status and whether changes in subjective social status, in turn, affected symptoms of depression and sleep disturbances. The analyses were stratified by gender (female/male) and age (21–35/36–50 years). Results: Across groups, the most consistent predictors of changes in subjective social status were being promoted during the past two years and a change in occupational status. An increase in subjective social status was associated with a decrease in symptoms of depression among women in both age groups and among men in the older age group. The association was stronger in younger women than in older women (p=0.042). For both women and men in the older age group, an increase in subjective social status was associated with a decrease in symptoms of sleep disturbances. Conclusions: Occupational level was the most important predictor of subjective social status across groups, and subjective social status predicted common mental disorder, even after adjusting for socioeconomic status indicators. Changes in subjective social status affected young working women’s depressive symptoms in particular, while older workers showed an association between subjective social status and symptoms of sleep disturbances.

Background

The sibling bond is often the longest relationship in an individual’s life, spanning both good and bad times. Focusing on the latter, we investigated whether a cancer diagnosis in one adult sibling is predictive of psychiatric illness in the other, and if any such effect differs according the ‘sociodemographic closeness’ between the siblings in terms of sex, age, education, marital status and residence.

Methods

We used hospital records to identify psychiatric diagnoses (2005–2019) in a Swedish total-population cohort born in 1953, and cancer diagnoses (2005–2017) in their full siblings. By means of emulated clinical trials, the cohort member’s risk of a diagnosis within two years following a first exposure (or non-exposure) to a sibling’s cancer was analyzed through Cox regression.

Results

Exposed cohort members had a higher risk of psychiatric diagnosis than unexposed (HR = 1.15; CI: 1.08–1.23), with men displaying a higher risk (1.19; CI: 1.09–1.31) than women (HR = 1.11; CI: 1.01–1.22). Sub-analyses of the exposed group showed that women with a cancer-stricken sister had a higher risk of adverse psychiatric outcomes (HR = 1.31; CI: 1.07–1.61) than women with a cancer-stricken brother. Furthermore, unmarried cohort members ran a higher risk, both when the cancer-stricken sibling was married (HR = 2.03; CI: 1.67–2.46) and unmarried (HR = 2.61; CI: 2.16–3.15), than in cases where both siblings were married. No corresponding difference were detected for ‘closeness’ in age, education and residence.

Conclusions

In line with theories of linked lives, our findings suggest that negative events in one sibling’s life tend to ‘spill over’ on the other sibling’s wellbeing, at least during the 15-year-long period leading up to retirement age.

Research about the Flynn effect, the secular rise in IQ, is heavily based on conscript data from successive male birth cohorts. This inevitably means that two distinct phenomena are mixed: fertility differences by IQ group ('compositional Flynn effect'), and any difference between parents and children ('within-family Flynn effect'). Both will influence trends in cognitive ability. We focused on the latter phenomenon, exploring changes in cognitive abilities during adolescence within one generation, and between two successive generations within the same family. We identified determinants and outcomes in three linked generations in the Stockholm Multigenerational Study. School and conscript data covered logical/numerical and verbal scores for mothers at age 13, fathers at 13 and 18, and their sons at 18. Raw scores, and change in raw scores, were used as outcomes in linear regressions. Both parents' abilities at 13 were equally important for sons' abilities at 18. Boys from disadvantaged backgrounds caught up with other boys during adolescence. Comparing fathers with sons, there appeared to be a positive Flynn effect in logical/numeric and verbal abilities. This was larger if the father had a working-class background or many siblings. A Flynn effect was only visible in families where the father had low general cognitive ability at 18. We conclude that there is a general improvement in logical/numeric and verbal skills from one generation to the next, primarily based on improvement in disadvantaged families. The Flynn effect in Sweden during the later 20th century appears to represent a narrowing between social categories.

Objectives: To investigate mid-adolescent boys’ and girls’ experiences of school demands, teacher support, and classmate support, and explore the associations of these factors with mental wellbeing.

Methods: Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15–16 years). School demands, teacher support, and classmate support were measured by indices based on three items each. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Linear regression analyses were performed.

Results: Higher demands were associated with lower mental wellbeing. Conversely, mental wellbeing increased with greater teacher support and classmate support. Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental wellbeing was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental wellbeing increased and revealed an inverse association between school demands and mental wellbeing.

Conclusion: The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance wellbeing among students.

We read with interest the recent paper by Sariaslan et al.1 investigating the associations between childhood family income and three outcomes observed later in life: psychiatric disorders, substance misuse and violent crime arrests. The paper contains a careful analysis of a large and relevant dataset of more than 650 000 individuals born in Finland in 1986–96, who were followed from age 15, when income was assessed, until 2017 or 2018. The authors use two types of analysis in the paper: one in which differences in the outcomes are accounted for by variability in income between families (henceforth between-family analysis) and one, the so-called sibling comparison, in which outcome differences are accounted for only by income variability within families (henceforth within-family analysis). In the between-family analysis, the authors find consistent associations between a number of related estimates of childhood family income and the three outcomes (e.g. Figure 2 in the paper). However, and this is the main finding of the paper, these associations between income and the three outcomes completely disappear in the within-family analysis. From this, the authors conclude that ‘[a]ssociations between childhood family income and subsequent risks … were not consistent with a causal interpretation’.

We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.

Background. School is a key social determinant of adolescent health. However, earlier research on psychosocial school conditions has largely focused on their relationship with aspects of adverse health, and fewer studies have examined the links with positive health. The aim of this study was to investigate boys' and girls' experiences of school demands, teacher support, and classmate support and their associations with positive mental well-being.

Methods. Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15-16 years). School demands, teacher support, and classmate support were captured by indices based on multiple items. Positive mental well-being was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBWS). Gender-stratified linear regression analyses were performed, clustering for school class.

Results. Higher demands were associated with lower mental well-being (boys: b=-0.36, p < 0.05; girls: b=-0.65, p < 0.05). Conversely, mental well-being increased with greater teacher support (boys: b = 0.53, p < 0.05; girls: b = 0.56, p < 0.05) and classmate support (boys: b = 0.70, p < 0.05; girls: b = 0.50, p < 0.05). Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental well-being was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental-well-being increased and revealed an inverse association between school demands and mental well-being.

Conclusions. The findings indicate that psychosocial school conditions are important not only for adverse health among adolescents, but also for their positive health. The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance positive health among students.

Key messages. School demands, teacher and classmate support were associated with mental well-being among both boys and girls, although the association with demands was seen only at higher levels of support.

Objectives To provide systematically evaluated evidence of prospective associations between exposure to physical, psychological and gender-based violence and health among healthcare, social care and education workers.

Methods The guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Medline, Cinahl, Web of Science and PsycInfo were searched for population: human service workers; exposure: workplace violence; and study type:prospective or longitudinal in articles published 1990–August 2019. Quality assessment was performed based on a modified version of the Cochrane’s ‘Tool to Assess Risk of Bias in Cohort Studies’.

Results After deduplication, 3566 studies remained, of which 132 articles were selected for full-text screening and 28 were included in the systematic review. A majority of the studies focused on healthcare personnel, were from the Nordic countries and were assessed to have medium quality. Nine of 11 associations between physical violence and poor mental health were statistically significant, and 3 of 4 associations between physical violence and sickness absence. Ten of 13 associations between psychological violence and poor mental health were statistically significant and 6 of 6 associations between psychological violence and sickness absence. The only study on gender-based violence and health reported a statistically non-significant association.

Conclusion There is consistent evidence mainly in medium quality studies of prospective associations between psychological violence and poor mental health and sickness absence, and between physical violence and poor mental health in human service workers. More research using objective outcomes, improved exposure assessment and that focus on gender-based violence is needed.

We assessed whether the level of time-pressure reported by a school's teachers is predictive of student bullying perpetration. We combined data from two surveys conducted in 129 schools in 2016: the Stockholm School Survey performed among students in grades 9 and 11 (n = 10,668), and the Stockholm Teacher Survey carried out among senior level (grades 7-9) and upper secondary school (grades 10-12) teachers (n = 2259). Multilevel path analyses showed that teachers' stress and time-pressure increased with declining school leadership functioning. Teachers' level of time-pressure was, in turn, positively associated with student traditional and cyberbullying behaviour, through its effect on the school staff's tendency (not) to intervene against bullying, but not through the teachers' stress level. We conclude that schools with leadership that provides opportunities for the teachers to focus on their main mission can counteract bullying among the students and therefore indirectly also to promote student health.

Low birth weight has been shown to be related to increased risk of depression later in life - but the evidence is not conclusive. We examined the association of size at birth with repeatedly measured depressive symptoms in 947 individuals from the Northern Swedish Cohort, a community-based age-homogeneous cohort born in 1965, and followed with questionnaires between ages 16 and 43 (participation rate above 90% in all the surveys). Information on birth size was retrieved from archived birth records. Length of gestation was known for a subsample of 512 individuals (54%). We studied the association of birth weight and ponderal index with self-reported depressive symptoms at ages 16, 21, 30 and 43; with the life-course average of depressive symptoms score and with longitudinal trajectories of depressive symptoms retrieved by latent class growth analysis. Socioeconomic background, mental illness or alcohol problems of a parent, exposure to social adversities in adolescence and prematurity were accounted for in the analyses. We did not find any relationship between weight or ponderal index at birth and our measure of depressive symptoms between ages 16 and 43 in a series of different analyses. Adjustment for length of gestation did not alter the results. We conclude that size at birth is not associated with later-life depressive symptoms score in this cohort born in the mid-1960s in Sweden. The time and context need to be taken into consideration in future studies.