Abstract
Background
Decreasing mental wellbeing among adolescents underscores the need to understand long-term consequences for public health. In earlier studies, low self-rated health (SRH) and health complaints (HC) in adolescence have predicted later morbidity, medication use and health care visit in general. Here we study if they predict severe psychiatric morbidity. Considering that older adolescents report low SRH and HC more often than younger ones, we study if age at survey matters. We study, too, how important predictors SRH and HC are compared to known social determinants for psychiatric morbidity.
Methods
Our longitudinal data consists of surveys to 12-, 14-, 16-, and 18-year-old Finns, measured biennially in 1981–1997 (n = 58 339) and linked with national registries (hospital care, socioeconomic) up to 2018. The follow-up time was 21–37 years. The association of low SRH and daily HC with the first psychiatric hospital care (yes/no) were studied by Kaplan Meyer curves and Cox proportional hazards ratios (HR) at each age. Family sociodemographic background and school achievement were control variables.
Results
Low SRH and daily HC at each age predicted psychiatric morbidity, but rather in the long-term. Age variation was small (HRs 1.46–2.02 for SRH; 1.90–2.19 for HC). All sociodemographic variables and school achievement predicted later psychiatric care, but HRs for them were mainly lower compared to those of low SRH and daily HC. In adjusted models, low SRH and daily HC were the strongest predictors among 12 and 18-year-olds, while among 14–16-year-olds poorer school performance, SRH and HC were the strongest predictors.
Conclusions
Both low SRH and daily HC in adolescence provide a prognostic effect for later psychiatric morbidity, with a minor effect of age at survey. In middle adolescence, school achievement is an important predictor of later wellbeing and mental health, too.
Key messages
• Both low self-rated health and daily health complaints in adolescence provide a prognostic effect for later psychiatric morbidity.
• In middle adolescence, school achievement is an important predictor of later wellbeing and mental health, too.