Comorbidity of physical and anxiety symptoms in adolescent: Functional impairment, self-rated health and subjective well-being

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; Christian Haring; Jean Pierre Kahn; Vita Postuvan; Michael Kaess; Airi Varnik; Marco Sarchiapone; Danuta Wasserman

doi:10.3390/ijerph15081698

Comorbidity of physical and anxiety symptoms in adolescent: Functional impairment, self-rated health and subjective well-being

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, Christian Haring, Jean Pierre Kahn, Vita Postuvan, Michael Kaess, Airi Varnik, Marco Sarchiapone, Danuta Wasserman

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

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.

Original language	English
Article number	1698
Journal	International Journal of Environmental Research and Public Health
Volume	15
Issue number	8
DOIs	https://doi.org/10.3390/ijerph15081698
State	Published - 9 Aug 2018
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: This research was supported through Coordination Theme 1 (Health) of the European Union Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. Acknowledgments: The authors were independent of the funders in all aspects of study design, data analysis, and writing of this manuscript. The Project Leader and Coordinator of the SEYLE project is Professor in Psychiatry and Suicidology Danuta Wasserman, Karolinska Institutet (KI), Head of the National Centre for Suicide Research and Prevention of Mental Ill-Health and Suicide (NASP), at KI, Stockholm, Sweden. Other members of the Executive Committee are Marco Sarchiapone, Department of Health Sciences, University of Molise, Campobasso, Italy; Senior lecturer Vladimir Carli, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden; Christina Hoven and Anthropologist Camilla Wasserman, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA. The SEYLE Consortium comprises centers in 12 European countries. Site leaders for each respective center and country are: Danuta Wasserman (NASP, Karolinska Institutet, Sweden, Coordinating Centre), Christian Haring (University for Medical Information Technology, Austria), Airi Varnik (Estonian-Swedish Mental Health & Suicidology Institute, Estonia), Jean-Pierre Kahn (University of Nancy, France), Romuald Brunner (University of Heidelberg, Germany), Judit Balazs (Vadaskert Child and Adolescent Psychiatric Hospital, Hungary), Paul Corcoran (National Suicide Research Foundation, Ireland), Alan Apter (Schneider Children’s Medical Centre of Israel, Tel-Aviv University, Tel Aviv, Israel), Marco Sarchiapone (University of Molise, Italy), Doina Cosman (Iuliu Hatieganu University of Medicine and Pharmacy, Romania), Vita Postuvan (University of Primorska, Slovenia) and Julio Bobes (University of Oviedo, Spain). Stella Reiter-Theil from Basel University, Switzerland is ethical advisor to the SEYLE study. Judit Balázs was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.

Funders	Funder number
European Union Seventh Framework Program
Seventh Framework Programme	223091
Magyar Tudományos Akadémia
Seventh Framework Programme	HEALTH-F2-2009-223091

Keywords

Adolescent
Anxiety
Categorical diagnostic model
Comorbidity
Dimensional diagnostic model
Physical morbidity
SEYLE
Self-rated heath

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/ijerph15081698

Cite this

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. (2018). Comorbidity of physical and anxiety symptoms in adolescent: Functional impairment, self-rated health and subjective well-being. International Journal of Environmental Research and Public Health, 15(8), Article 1698. https://doi.org/10.3390/ijerph15081698

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Balázs, J, Miklósi, M, Keresztény, A, Hoven, CW, Carli, V, Wasserman, C, Hadlaczky, G, Apter, A, Bobes, J, Brunner, R, Corcoran, P, Cosman, D, Haring, C, Kahn, JP, Postuvan, V, Kaess, M, Varnik, A, Sarchiapone, M & Wasserman, D 2018, 'Comorbidity of physical and anxiety symptoms in adolescent: Functional impairment, self-rated health and subjective well-being', International Journal of Environmental Research and Public Health, vol. 15, no. 8, 1698. https://doi.org/10.3390/ijerph15081698

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AU - Balázs, Judit

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AU - Hoven, Christina W.

AU - Carli, Vladimir

AU - Wasserman, Camilla

AU - Hadlaczky, Gergö

AU - Apter, Alan

AU - Bobes, Julio

AU - Brunner, Romuald

AU - Corcoran, Paul

AU - Cosman, Doina

AU - Haring, Christian

AU - Kahn, Jean Pierre

AU - Postuvan, Vita

AU - Kaess, Michael

AU - Varnik, Airi

AU - Sarchiapone, Marco

AU - Wasserman, Danuta

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Comorbidity of physical and anxiety symptoms in adolescent: Functional impairment, self-rated health and subjective well-being

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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