Relevance of well-being, resilience, and health-related quality of life to mental health profiles of European adolescents: results from a cross-sectional analysis of the school-based multinational UPRIGHT project

Abstract

Purpose: The existing evidence suggests that a complete evaluation of mental health should incorporate both psychopathology and mental well-being indicators. However, few studies categorize European adolescents into subgroups based on such complete mental health data. This study used the data on mental well-being and symptoms of mental and behavioral disorders to explore the mental health profiles of adolescents in Europe.

Methods: Data collected from adolescents (N = 3767; mean age 12.4 [SD = 0.9]) from five European countries supplied the information on their mental well-being (personal resilience, school resilience, quality of life, and mental well-being) and mental and behavioral disorder symptoms (anxiety, depression, stress, bullying, cyber-bullying, and use of tobacco, alcohol, or cannabis). Multiple correspondence analysis and cluster analysis were combined to classify the youths into mental health profiles.

Results: Adolescents were categorized into three mental health profiles. The "poor mental health" profile (6%) was characterized by low levels of well-being and moderate symptoms of mental disorders. The "good mental health" profile group (26%) showed high well-being and few symptoms of mental disorders, and the "intermediate mental health" profile (68%) was characterized by average well-being and mild-to-moderate symptoms of mental disorders. Groups with higher levels of well-being and fewer symptoms of mental disorders showed lower rates of behavioral problems. Mental well-being indicators strongly contributed to this classification.

Conclusion: Adolescents with the "intermediate" or "poor" mental health profiles may benefit from interventions to improve mental health. Implications for school-based interventions are discussed.

Trial registration number (trn) and date of registration: ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019.

Keywords: Mental disorders; Mental health promotion; Prevention; School interventions; Well-being; Youth.

Fig. 1

Graphical representation of the two dimensions of the multiple correspondence analysis (MCA) and the cluster analysis. a Black dots represent the categories of mental health variables and the conduct problems included in the MCA; only the most representative entries are labeled as "scale: category". The closer the points, the stronger the association between them. The categories are numbered from the lowest response options of the scale, 1, to the highest option (depending on the variable, from 3 to 5). Average values are around the middle of the map. The first dimension identified the gradient of mental health status, from the worst values (left) to the best values (right), and it explains 58.4% of the variability. The second dimension identifies the extreme values of the scales (down) and explains 15.2% of the variability. WB mental well-being, HRQoL health-related quality of life (KIDSCREEN-10), R-PC resilience-personal competence, R-SC resilience-social competence, R-SS resilience-structured style, R-SR resilience-social resources, R-FC resilience-family cohesion, SR school resilience, PS perceived stress, D depression, A anxiety disorder, Fight involved in a physical fight during last 12 months, Bullying involved bullying others during last 2 months, CBullied cyber-bullied during last 2 months, CBullying involved in cyber-bullying others during last 2 months, Bullied bullied during last 2 months, Smoking ever-smoked tobacco, Drinking ever drunk alcohol, Drunk ever become very drunk, Cannabis ever used cannabis. b Cluster 1: represents the distribution of adolescents with "good mental health"; Cluster 2: adolescents with "intermediate mental health"; and Cluster 3: participants with "poor mental health"

Fig. 2

Conduct problems (fighting, bullying, cyber-bullying, and substance use) in the three clusters. Data represent the percentage of participants for each variable. All differences between clusters are statistically significant, p < 0.050. Cluster 1: adolescents with "good mental health"; Cluster 2: adolescents with "intermediate mental health"; and Cluster 3: adolescents with "poor mental health"