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

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Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary
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Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary
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Heim Pál National Pediatric Institute, 1131 Budapest, Hungary
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School of Ph.D. Studies, Semmelweis University, 1085 Budapest, Hungary
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Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
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Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden
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Department of Health Sciences, University of Molise, 86100 Campobasso, Italy
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Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel
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Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
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Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany
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Department of Child and Adolescent Psychiatry, University of Regensburg, 93053 Regensburg, Germany
13
National Suicide Research Foundation, Cork, Ireland
14
Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Research Division for Mental Health, University for Medical Information Technology (UMIT), 6060 Hall in Tirol, Austria
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Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, 54003 Nancy, France
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Mental Health Department, PINT, University of Primorska, 6000 Koper, Slovenia
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University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland
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Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, 10120 Tallinn, Estonia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1698; https://doi.org/10.3390/ijerph15081698
Received: 17 June 2018 / Revised: 3 August 2018 / Accepted: 7 August 2018 / Published: 9 August 2018
(This article belongs to the Special Issue Stress, Coping, and Resilience in Adolescents)
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. View Full-Text
Keywords: anxiety; physical morbidity; self-rated heath; comorbidity; categorical diagnostic model; dimensional diagnostic model; adolescent; SEYLE anxiety; physical morbidity; self-rated heath; comorbidity; categorical diagnostic model; dimensional diagnostic model; adolescent; SEYLE
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Balázs, J.; Miklósi, M.; Keresztény, A.; Hoven, C.W.; Carli, V.; Wasserman, C.; Hadlaczky, G.; Apter, A.; Bobes, J.; Brunner, R.; Corcoran, P.; Cosman, D.; Haring, C.; Kahn, J.-P.; Postuvan, V.; Kaess, M.; Varnik, A.; Sarchiapone, M.; Wasserman, D. Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being. Int. J. Environ. Res. Public Health 2018, 15, 1698.

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