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Abstract Background Studies of time trends in Nordic adolescents' mental health have often relied on analyses of adolescents’ psychosomatic symptoms. In this study, we examine adolescents' self-reports on mental health in the context of the dual factor model, which encompasses both overt manifestations of mental health symptoms and subjective perception of one's health status. Method The objective of this study was to employ a person-oriented approach utilizing cluster analysis to discern time trends in mental health profiles of Nordic adolescents, using their psychosomatic complaints and their perception of their overall health as cluster variables. The resulting health profiles were then subjected to a comparative analysis with regard to different measures of psychological and social adjustment. The mental health profiles were based on data from the Health Behaviour in School-aged Children (HBSC) survey, which was conducted among almost 50000 15-year-olds in five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) between 2002 and 2022. Results Mental health profiles exhibiting comparable content were observed in all Nordic countries, including profiles indicating adequate health, perceived good health, perceived poor health, high psychosomatic complaints, and dual health problems (defined as both high psychosomatic complaints and perceived poor health). These health profiles showed similar trends over time in the Nordic countries. Significant gender differences were observed. In 2002, adequate health was the dominant profile for both sexes. After 20 years, however, the high psychosomatic profile became the most common profile among girls. Among the three risk profiles, namely perceived poor health, high psychosomatic complaints and dual health problems, adolescents in the dual problems profile had the most psychological and social adjustment problems. Conclusions The comparatively lower incidence of adjustment problems among adolescents in the high psychosomatic profile relative to the dual mental health group challenges the prevailing view that there has been a sharp increase in mental health problems among Nordic adolescents. This view was largely based on the observed rise in psychosomatic symptoms. Indeed, there was a doubling in the proportion of adolescents in the high psychosomatic complaints profile between 2002 and 2022. This increase was considerably more pronounced than that observed for the dual health problems profile which exhibited most problems.

Background: Variable-oriented analyses of time trends in the ease of communicating with mothers and fathers in the Swedish HBSC (Health and Behavior in School-aged Children) dataset show that communication problems with fathers, but not with mothers, positively predict mental health problems among adolescents. This similarity across years is likely to lead to high structural stability in person-oriented analyses across survey years, providing opportunities to uncover typical communication patterns in a robust way. A person-oriented method, cluster analysis, was used in this study to clarify these variable-oriented findings on the prediction of mental health problems. Methods: The Swedish HBSC dataset of 15-year-olds for 2002, 2006, 2010, 2014, and 2018, with a total of 9255 participants, was used for variable- and person-oriented analyses. Results: Person-oriented analyses of ease of communication with the mother and ease of communication with the father show that poor communication with both parents is associated with the worst mental health problems. They also show that when there is poor communication with mothers, in most cases, adolescents also have poor communication with fathers. The variable-oriented analyses do not show that mental health problems are highest when adolescents find it difficult to communicate with both parents. Conclusions: Person-oriented analyses offer the possibility of drawing more specific conclusions about family conditions that affect adolescents’ mental health. More generally, person-oriented analyses are likely to clarify the results of variable-oriented analyses in many other areas also.

BackgroundStudies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health.ObjectiveTo investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents.MethodA dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007).ResultsFour mental health profiles were identified by a cluster analysis which combined all five data collections—Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls.ConclusionThe study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contrast to the long-term increase in mental health problems seen in many countries, this Swedish study did not find an increase among young persons, both boys and girls, with the poorest mental health, the Poor mental health profile. Rather, the most substantial increase over the survey years, predominantly between 2010 and 2018, was found among the 15-year-olds with High psychosomatic symptoms only.