Gender differences in negative mood states in secondary school students: health survey in Catalonia (Spain)

Objective: To determine the prevalence of negative mood states in adolescents according to gender, toanalyze variability among schools, and to evaluate the associated factors.Methods: A cross-sectional study with a cluster design was carried out. We administered the High-schoolstudents health survey to a sample of 9,340 students (aged 14-16 years) in the third and fourth year ofCompulsory Secondary Education in Catalonia, Spain, during the 2005-6 academic year. The main outcome measure was evidence of a negative mood state. A multilevel logistic regression model stratified bygender was used to identify the factors associated with negative mood states and to determine variabilityamong distinct schools.Results: Approximately 19% of adolescents reported evidence of a negative mood state, with a higherprevalence in girls (25%). The most significant factors associated with negative mood states were “useof tranquilizers” and “having eating disorders” in girls and “not exercising” and “poor self-perception ofhealth status” in boys. In both genders, variability was found among schools in the prevalence of negativemood states (girls: variance = 0.078; p <0.001; boys: variance = 0.079; p = 0.012).Conclusions: The prevalence of negative mood states in adolescent boys and girls was high. Differenceswere observed between genders in the factors related to these health states. The variability observedin the prevalence of negative mood states among distinct schools could not be explained by the studyvariables. Our results emphasize the association between the use of tranquilizers and negative moodstates (AU)

Objetivos: Determinar la prevalencia del estado de ánimo negativo entre alumnos adolescentes segúnsexo, analizar la variabilidad entre escuelas y evaluar los factores asociados.Métodos: Estudio transversal basado en un muestreo por conglomerados bietápico. Administramos unaencuesta de salud a 9340 estudiantes de tercero y cuarto curso de Educación Secundaria Obligatoriade 14 a 16 anos de edad, en Catalu ˜ na, durante el curso escolar 2005-06. La variable principal fue el ˜estado de ánimo negativo. Se usó un modelo de regresión logística multinivel estratificado por sexopara identificar los factores asociados al estado de ánimo negativo y determinar la variabilidad entre lasdiferentes escuelas.Resultados: Aproximadamente el 19% de los adolescentes refirieron un estado de ánimo negativo, siendomás prevalente entre las chicas (25%). En ellas, los factores asociados significativamente con estadosde ánimo negativo fueron «tomar tranquilizantes» y tener trastornos alimentarios, mientras que en loschicos fueron no realizar deporte y tener una mala percepción de su estado de salud. Hay variabilidad enla prevalencia del estado de ánimo negativo según las escuelas en ambos sexos (chicas: varianza = 0,078,p <0,001; chicos: varianza = 0,079, p = 0,012).Conclusiones: La prevalencia del estado de ánimo negativo entre los adolescentes fue alta. Se observarondiferencias entre sexos respecto a los factores relacionados con este estado de salud. Destacó la asociacióndel uso de tranquilizantes con el estado de ánimo negativo. Se observó una variabilidad de la prevalenciadel estado de ánimo negativo entre las diferentes escuelas no explicada por las variables de estudio (AU)

Gender differences in negative mood states in secondary school students: health survey in Catalonia (Spain).

OBJECTIVE: To determine the prevalence of negative mood states in adolescents according to gender, to analyze variability among schools, and to evaluate the associated factors. METHODS: A cross-sectional study with a cluster design was carried out. We administered the High-school students health survey to a sample of 9,340 students (aged 14-16 years) in the third and fourth year of Compulsory Secondary Education in Catalonia, Spain, during the 2005-6 academic year. The main outcome measure was evidence of a negative mood state. A multilevel logistic regression model stratified by gender was used to identify the factors associated with negative mood states and to determine variability among distinct schools. RESULTS: Approximately 19% of adolescents reported evidence of a negative mood state, with a higher prevalence in girls (25%). The most significant factors associated with negative mood states were "use of tranquilizers" and "having eating disorders" in girls and "not exercising" and "poor self-perception of health status" in boys. In both genders, variability was found among schools in the prevalence of negative mood states (girls: variance = 0.078; p <0.001; boys: variance = 0.079; p = 0.012). CONCLUSIONS: The prevalence of negative mood states in adolescent boys and girls was high. Differences were observed between genders in the factors related to these health states. The variability observed in the prevalence of negative mood states among distinct schools could not be explained by the study variables. Our results emphasize the association between the use of tranquilizers and negative mood states.

Gender differences in sexual risk behaviour among adolescents in Catalonia, Spain.

OBJECTIVE: To analyze the factors associated with sexual risk behavior in adolescent girls and boys in order to plan future school health interventions. METHODS: A cross-sectional study with two-stage cluster sampling that included 97 schools and 9,340 students aged between 14 and 16 years old was carried out in 2005-2006 in Catalonia (Spain). For the survey, a self-administered paper-based questionnaire was used. The questionnaire contained items on sociodemographic variables, use of addictive substances and mood states, among other items. These variables were tested as risk factors for unsafe sexual behavior. RESULTS: This study included 4,653 boys and 4,687 girls with a mean age of 15 years. A total of 38.7% of students had had sexual relations at least once and 82.3% of boys and 63.0% of girls were engaged in sexual risk behaviors. The prevalence of sexual relations and risk behaviors was generally higher in boys than in girls, independently of the variables analyzed. Boys had more sexual partners (P<.001) and used condoms as a contraceptive method less frequently than girls (P<.001). Foreign origin was related to unsafe sexual activity in both genders. Alcohol consumption was also a risk factor in boys. CONCLUSIONS: Sexual risk behaviors among adolescents in Catalonia are higher in boys than in girls. Factors related to unsafe sexual activity in boys were foreign origin and alcohol consumption. In girls only foreign origin was a significant risk factor.

Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP).

OBJECTIVE: Previous epidemiological studies have revealed a high prevalence of mental disorders among primary care (PC) patients. However, most studies have methodological limitations (e.g. absence of structured clinical interviews, two-phase designs) that affect the generalizability of their results. The main objective of the present study was to estimate the lifetime and 12-month prevalence of mental disorders in the PC of Catalonia (Spain), using structured clinical interviews and a one-phase design. METHODS: One-phase cross-sectional survey. A representative probability sample without replacement of individuals aged 18 years or older attending PC for a medical visit were interviewed between October 2005 and March 2006. The interviews included SCID-I for depressive and anxiety disorders and the MINI interview for other mental disorders. A total of 3,815 patients from 77 PC centres were included in the statistical analyses. RESULTS: 45.1% of respondents reported at least one lifetime mental disorder and 30.2% reported at least one mental disorder in the previous 12 months. The most common mental disorders were major depression (9.6%), panic disorder (7.0%), specific phobia (6.6%), and generalized anxiety disorder (3.8%). There was a high comorbidity between mood and anxiety disorders, as well as between mental disorders and some chronic physical conditions. CONCLUSIONS: There is a high prevalence and comorbidity of mental disorders in the PC of Catalonia. Public health policies should reinforce the role of family physicians in the detection and treatment of persons with mental disorders.

De la planificación a la acción: principales ámbitos de actuación e instrumentos para la operativización / Planning the action: principal fields of action and operational tools

El Mapa Sanitario, Sociosanitario y de Salud Pública de Cataluña es un instrumento que da criterios para la operativización de las políticas y estrategias que vienen definidas por el Plà de Salut y los Plans Directors y Plans Estratègics del Departament de Salut. La efectividad del Mapa viene determinada por la capacidad de servir a la toma de decisiones en los distintos niveles organizativos y de gestión. Los principales ámbitos de operativización son la planificación operativa, los gobiernos territoriales de salud y las relaciones intersectoriales. Los instrumentos de que nos valemos en el momento de la concreción de las ideas y propuestas estratégicas son: el plan de inversiones en infraestructuras sanitarias, la asignación de recursos y la compra de servicios sanitarios y sociosanitarios orientado fundamentalmente a la compra integrada, así como un enfoque de la evaluación orientado a este objetivo, el sistema de información y la investigación aplicada

The Health, Social Health and Public Healthcare Map of Catalonia is an instrument that provides criteria for putting into operation the policies and strategies defined by the Health Plan and the Master Plansand Strategic Plans of the Department of Health. The effectiveness of the Map is determined by its capacity to help in decision making at the different organisational and management levels. The principaloperational fields are, operations planning, territorial healthcare governments and cross-sector relationships. The tools used when setting ideas and strategic proposals included the healthcare infrastructureinvestment plan, the assignation of resources and the purchasing of health and social-health services aimed fundamentally at integrated purchasing, as well as an evaluation approach geared towards this objective,the information system and the applied research

[Planning the action: principal fields of action and operational tools]. / De la planificación a la acción: principales ámbitos de actuación e instrumentos para la operativización.

The Health, Social Health and Public Healthcare Map of Catalonia is an instrument that provides criteria for putting into operation the policies and strategies defined by the Health Plan and the Master Plans and Strategic Plans of the Department of Health. The effectiveness of the Map is determined by its capacity to help in decision making at the different organisational and management levels. The principal operational fields are, operations planning, territorial healthcare governments and cross-sector relationships. The tools used when setting ideas and strategic proposals included the healthcare infrastructure investment plan, the assignation of resources and the purchasing of health and social-health services aimed fundamentally at integrated purchasing, as well as an evaluation approach geared towards this objective, the information system and the applied research.