Psychopathology is associated with reproductive health risk in European adolescents

Pietro Gambadauro, Vladimir Carli, Camilla Wasserman, Gergö Hadlaczky, Marco Sarchiapone, Alan Apter, Judit Balazs, Julio Bobes, Romuald Brunner, Doina Cosman, Christian Haring, Christina W. Hoven, Miriam Iosue, Michael Kaess, Jean Pierre Kahn, Elaine McMahon, Vita Postuvan, Airi Värnik, Danuta Wasserman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Reproductive and mental health are key domains of adolescent wellbeing but possible interrelationships are poorly understood. This cross-sectional study evaluated the association between psychopathology and reproductive health risk among European adolescents. Methods: A structured self-report questionnaire was delivered to 12,395 pupils of 179 randomly selected schools in 11 European countries within the EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) project. The questionnaire included items about sexual initiation and reproductive health risk factors, such as number of sexual partners, frequency of condom use, and pregnancy involvement. Psychopathology was evaluated with validated instruments and/or ad-hoc questions. Results: Of 11,406 respondents (median age 15; interquartile range [IQR] 14-15; 57% females), 18.8% reported sexual initiation. Sixty percent of them also reported at least one reproductive risk factor. Sexual initiation was significantly more common among pupils older than 15 years (38% versus 13.2% younger pupils) and males (21.3% versus 16.9% females). It was also more common among pupils with depression (age/sex-adjusted odds ratio [aOR] 1.871), anxiety (aOR 2.190), severe suicidal ideation (aOR 2.259), self-injurious behaviour (aOR 2.892), and suicide attempts (aOR 3.091). These associations were particularly strong among pupils ≤15 years old and, for overt psychopathology, among pupils with low non-sexual risk behaviour profile and females. Depression (aOR 1.937), anxiety (aOR 2.282), severe suicidal ideation (aOR 2.354), self-injurious behaviour (aOR 3.022), and suicide attempts (aOR 3.284) were associated with higher reproductive health risk, defined by an increasing number of coexisting reproductive risk factors. Conclusions: These findings suggest an alignment between mental and reproductive health risk and support the value of cross-domain collaboration in adolescent health. The association between psychopathology and reproductive health risk, as well as its variations with age, sex, and associated risk behaviours, should be considered when designing health-promoting or disease-preventing interventions for adolescents.

Original languageEnglish
Article number186
JournalReproductive Health
Issue number1
StatePublished - 6 Nov 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 The Author(s).


SEYLE was approved by the European Commission, as a precondition for funding, as well as by the local research ethics committees of each national recruiting centre [22]. An external advisor from the University of Basel, Switzerland, provided independent ethical assessment and supervision of the project [23].

FundersFunder number
European Union Seventh Framework Program
Seventh Framework Programme223091
Seventh Framework ProgrammeHEALTH-F2–2009-223091


    • Adolescence
    • Behaviour
    • Mental health
    • Psychopathology
    • Reproductive health
    • SEYLE study
    • Sexual initiation


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