Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents.

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older?

BACKGROUND: Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS: One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS: Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS: The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.

What types of injuries did seriously injured pedestrians and cyclists receive in a Swedish urban region in the time period 2003-2017 when Vision Zero was implemented?

OBJECTIVES: The aim of the study is to examine what types of injuries that seriously injured pedestrians and cyclists received in urban road spaces from 2003 to 2017 in the Swedish region of Västmanland, when the road safety policy Vision Zero was implemented. STUDY DESIGN: This is a cross-sectional data annually collected over a period of fifteen years. METHODS: Data from health care for 403 seriously injured pedestrians and cyclists were retrieved from the registry STRADA (Swedish Traffic Accident Data Acquisition) and cross-referenced with the National Road Database to see if any Vision Zero measures had previously been implemented at the crash location. The study includes injuries from both single and multiple crashes on roads, pavements, and tracks for walking and cycling (road space). Statistical analysis was performed by descriptive statistics, chi-square tests, and multiple logistic regression analyses. RESULTS: Pedestrians were seriously injured in lower extremities more than cyclists, whereas more cyclists were seriously injured in the head. During the period, pedestriansꞌ head injuries decreased significantly, but injuries in lower extremities increased significantly. In addition, for cyclists, there was a shift from decreased probability of head injuries to increased probability of injuries in lower extremities related to increased age. For pedestrians, pavements/tracks were associated with a decreased probability of a majority of injury outcomes but for cyclists only for severe injury outcomes. CONCLUSIONS: From 2003 to 2017, there was a shift among seriously injured pedestrians, with head injuries decreasing and injuries in lower extremities increasing. This shift was probably related to an ageing population in the region, given that increased age among both pedestrians and cyclists was associated with a decreased probability of head injuries but increased probability of injuries in lower extremities. On Vision Zero roads, there was a decreased probability of pedestrians receiving serious injury to more than one bodily region. An increased number of older people combined with policies for more active mobility such as walking and cycling are a challenge for road authorities in urban areas.

Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey.

OBJECTIVE: To examine how physical activity and physical mobility are related to obesity in the elderly. STUDY DESIGN: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. METHODS: Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. RESULTS: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. CONCLUSION: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

Individuals developing schizophrenia are hidden among adolescent substance misusers.

BACKGROUND: Strategies are needed to identify youth developing schizophrenia. The present study aimed to determine whether adolescents treated for substance misuse were at elevated risk to develop schizophrenia, whether this risk has changed since the late 1960s, and whether substance misuse in adolescence predicted poorer outcomes through adulthood. METHOD: In a Swedish city, since the mid-1960s there has been only one clinic for adolescent substance misuse. Three samples from this clinic were studied: 1992 individuals treated from 1968 to 1971 followed to age 50 years; 1576 treated from 1980 to 1984 followed to age 35 years; and 180 treated in 2004 followed to age 22 years. Each clinical sample was matched on age, sex and place of birth to an equal, or larger, number of randomly selected individuals from the general population. Schizophrenia, substance use disorders, physical disorders related to substance misuse, criminal convictions, poverty and death were identified using national registers. RESULTS: Individuals treated for substance misuse in adolescence were at increased risk to subsequently develop schizophrenia: in males the increase was approximately four-fold and in females between five- and seven-fold. There was no difference in risk for those treated in 1968-1971 and from 1980 to 1984 when cannabis use increased from 37.6% to 49.8% of the clinical samples. Among males who developed schizophrenia, treatment for substance misuse was associated with increased risk of substance use disorders and criminal convictions through adulthood. CONCLUSIONS: Treatment programmes for adolescents misusing substances include a disproportionate number developing schizophrenia. Early detection and treatment have the potential to improve long-term outcomes.

Multiple adverse outcomes over 30 years following adolescent substance misuse treatment.

OBJECTIVE: To compare outcomes over 30 years experienced by individuals who as adolescents entered substance misuse treatment and a general population sample. METHOD: All 1992 individuals seen at the only clinic for substance misusing adolescents in Stockholm from 1968 to 1971 were compared to 1992 individuals randomly selected from the Swedish population, matched for sex, age and birthplace. Death, hospitalization for physical illness related to substance misuse, hospitalization for mental illness, substance misuse, criminal convictions and poverty were documented from national registers. RESULTS: Relative risks of death, physical illness, mental illness, substance misuse, criminal convictions and poverty were significantly elevated in the clinic compared to the general population sample. After adjustment for substance misuse in adulthood, the risks of death, physical and mental illness, criminality and poverty remained elevated. CONCLUSION: Adolescents who consult for substance misuse problems are at high risk for multiple adverse outcomes over the subsequent 30 years.