Invisible risk group among adolescents at risk of mental ill-health

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Invisible risk group among adolescents at risk of mental ill-health Adolescents with high media use, reduced sleep and low physical activity comprise an 'invisible-risk' group that has high prevalence of psychiatric symptoms, according to a large international study led by researchers at Karolinska Institutet. The results of the study are published in the February issue of World Psychiatry.

Over 12,000 adolescents (14-16 years old) in eleven European countries answered questionnaires covering different risk behaviours and psychiatric symptoms. Statistical analyses of the results identified three risk groups among the adolescents. Individuals who scored high on all examined risk behaviours clustered in the 'high-risk' group (13 per cent of the adolescents). The 'low-risk' group (58 per cent) consisted of responders who had no or very low frequency of risk behaviours.

However, i addition to these two expected groups a third group labelled the 'invisible risk' group was identified. Youths in this group were characterised by high media use, sedentary behaviour and reduced sleep. These behaviours are generally not associated with mental health problems by observers such as teachers and parents. However, adolescents in the 'invisible' risk group had similar prevalence of suicidal thoughts, anxiety, subthreshold depression and depression as the 'high' risk group.

"As many as nearly 30 per cent of the adolescents clustered in the 'invisible' group that had a high level of psychopathological symptoms. While the 'high' risk group is easily identified by behaviour such as alcohol and drug use, parents and teachers are probably not aware of that adolescents in the 'invisible' risk group are at risk", says Vladimir Carli, at the National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet, first author of the study.

The study is the first to estimate the overall prevalence of a wider range of risk behaviours and lifestyles and their association with symptoms of mental ill-health among European adolescents. The results indicate that both risk behaviours and psychopathology are relatively common in this population. It also shows that all risk behaviours and symptoms increase with age, which is in concordance with earlier studies. Most risk behaviours were more common among boys. Emotional psychiatric symptoms such as depression, anxiety and thoughts of suicide were more common among girls.

### The study is part of the large Saving and Empowering Young Lives in Europe (SEYLE) project, a collaboration between 12 European countries and the United States, an led by principal investigator Danuta Wasserman at NASP, Karolinska Institutet. It was conducted with financial support by the European Commission (FP7 Health).

Publication: "A newly identified group of adolescents at 'invisible' risk for psychopathology and suicidal behavior: findings from the SEYLE study", Vladimir Carli, Christina W. Hoven, Camilla Wasserman, Flaminia Chiesa, Guia Guffanti, Marco Sarchiapone, Alan Apter, Judit Balazs, Romuald Brunner, Paul Corcoran, Doina Cosman, Christian Haring, Miriam Iosue, Michael Kaess, Jean Pierre Kahn, Helen Keeley, Vita Postuvan, Pilar Saiz, Airi Varnik, and Danuta Wasserman, World Psychiatry 2014;13:7886, online 3 February 2014.

Website of the journal: http://www.world-psychiatry.com

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