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Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being

Author

Listed:
  • Judit Balázs

    (Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary
    Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary)

  • Mónika Miklósi

    (Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary
    Heim Pál National Pediatric Institute, 1131 Budapest, Hungary)

  • Agnes Keresztény

    (Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary
    School of Ph.D. Studies, Semmelweis University, 1085 Budapest, Hungary)

  • Christina W. Hoven

    (Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA)

  • Vladimir Carli

    (National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden)

  • Camilla Wasserman

    (Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
    Department of Health Sciences, University of Molise, 86100 Campobasso, Italy)

  • Gergö Hadlaczky

    (National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden)

  • Alan Apter

    (Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel)

  • Julio Bobes

    (Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain)

  • Romuald Brunner

    (Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany
    Department of Child and Adolescent Psychiatry, University of Regensburg, 93053 Regensburg, Germany)

  • Paul Corcoran

    (National Suicide Research Foundation, Cork, Ireland)

  • Doina Cosman

    (Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania)

  • Christian Haring

    (Research Division for Mental Health, University for Medical Information Technology (UMIT), 6060 Hall in Tirol, Austria)

  • Jean-Pierre Kahn

    (Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, 54003 Nancy, France)

  • Vita Postuvan

    (Mental Health Department, PINT, University of Primorska, 6000 Koper, Slovenia)

  • Michael Kaess

    (Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany
    University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland)

  • Airi Varnik

    (Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, 10120 Tallinn, Estonia)

  • Marco Sarchiapone

    (Department of Health Sciences, University of Molise, 86100 Campobasso, Italy)

  • Danuta Wasserman

    (National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden)

Abstract

Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability ( p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses ( p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions ( p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health ( p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.

Suggested Citation

  • Judit Balázs & Mónika Miklósi & Agnes Keresztény & Christina W. Hoven & Vladimir Carli & Camilla Wasserman & Gergö Hadlaczky & Alan Apter & Julio Bobes & Romuald Brunner & Paul Corcoran & Doina Cosman, 2018. "Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being," IJERPH, MDPI, vol. 15(8), pages 1-12, August.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:8:p:1698-:d:162791
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    References listed on IDEAS

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    2. Marie-Christine Taillefer & Gilles Dupuis & Marie-Anne Roberge & Sylvie LeMay, 2003. "Health-Related Quality of Life Models: Systematic Review of the Literature," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 64(2), pages 293-323, November.
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    Cited by:

    1. Alina Cosma & András Költő & Yekaterina Chzhen & Dorota Kleszczewska & Michal Kalman & Gina Martin, 2022. "Measurement Invariance of the WHO-5 Well-Being Index: Evidence from 15 European Countries," IJERPH, MDPI, vol. 19(16), pages 1-12, August.
    2. Nagisa Mori & Azusa Arimoto & Etsuko Tadaka, 2022. "Exploring an Applied Ecological Model of the Effects of Household, School, and Community Environments on Adolescent Mental Health in Japan," IJERPH, MDPI, vol. 19(24), pages 1-15, December.

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