Those who were teenagers in 1990 were healthier than their children, i.e. teenagers in 2019. has declined remarkably, the disability burden of these chronic diseases, primarily in the area of mental health, has increased “worryingly” around the world. Mental disorders diagnosed in European adolescents have increased by 32% in 30 years, even if we still have few important data at European national level.
An extensive summary work published on The Lancet che analizza i dati del Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) del 2019, un enorme campionamento su una serie di determinanti sociali che impattano sulla salute, che negli ultimissimi anni epidemiologi in tutto il mondo stanno utilizzando per le proprie research. Health during childhood and adolescence should not be underestimated: it is believed that approximately 70% of premature deaths occurring in adulthood result from health-related behaviors initiated during this period.
These data confirm those of another large review which included 29 studies carried out on more than 80,000 young people, published in the summer of 2021 in another large medical journal: JAMA, which shows that one in four adolescents has symptoms of depression. with cases doubling in the past two years, while one in five show signs of an anxiety disorder.
The indicators used to estimate the quality of life of a population, in this case adolescents, are generally three in number: mortality, years of life lost (acronym: Years of Live Lost – YLL), and years lived with disability (DALY). Overall, according to the study published in The Lancet, it appears that today 85% of adolescents between the ages of 10 and 19 die of chronic illnesses, especially cancer. Mental disorders, on the other hand, are the main cause of years of life lost and years lived with some form of disability in all EU Member States and in all age groups studied.
Added to these phenomena is the trend towards increasing disabilities due to diabetes, with an alarming increase in cases of type 2 diabetes among adolescents; and the long-term effects of COVID-19 on obesity and type 1 diabetes.
As our readers like to go into statistics, the article uses the so-called Spearman correlation, between DALY rates and socio-demographic indices, precisely to try to understand if, in this case too, a link emerges between the health status and demographics. and economic characteristics. Well, it comes out. The results show that sex-related differences are greater in young adults. Although males have higher mortality and a greater burden attributed to substance use disorders, females have a higher disability burden, particularly attributable to mental disorders, with a new mortality burden related to eating disorders. An example of how the approach to these issues should also be gender-targeted.
What data do we have in Italy?
In many cases the problem is underfunding, in many countries, of policies to prevent risky behavior and to intercept frailty among children. Of course, leadership around these elements could be strengthened by better access to data sources to facilitate rapid response to rapid changes in adolescent health and wellbeing, but there is not much data to the moment, write the authors.
Indeed, there are no comprehensive Italian epidemiological data on adolescent mental health. The Istituto Superiore di Sanità’s PASSI surveillance, one of the most comprehensive on mental health, does not include those under 18. A good source of data is HBSC – Health Behavior in School-aged Children, in which Italy also participates. This is an international multicentre study, in collaboration with the Regional Office for Europe of the World Health Organization and designed to study the health status of young people and their social context. However, Hbsc only affects three age groups: 11, 13 and 15 years old.
In Italy, five data collections have been carried out since 2002 (2002, 2006, 2010, 2014 and 2018) promoted and financed by the Ministry of Health / CCM, coordinated by the Universities of Turin, Padua and Siena and carried out in collaboration with the Ministry of National Education, University and Research and the Regions. Since 2017, the DPCM on “registers and surveillance” has included the Surveillance of behavioral risks at the age of 11-17 years among the surveillance systems of national and regional importance, identifying in the Istituto Superiore di Sanità the national level body at which it is established. However, even in this case, mental health is not “mapped” in detail, but is included in a series of other behavioral macro-indicators, such as nutrition, alcohol consumption, physical activity , smoking, drugs, bullying.
Previous literature has already widely demonstrated that mental disorders are the main causes of disability in adolescents and that the onset of the first mental disorder occurs in one third of individuals before the age of 14, in almost half at 18 and around two-thirds before age. of 14. Yet it appears that only 20-40% of adolescents with mental health problems are diagnosed by health services and only 25% receive adequate treatment.
Depression, anxiety disorders and Covid-19: how do we measure mental health? The Lancet study
Think, Count, Speak: How do you measure child and adolescent mental health?
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