Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries.

BACKGROUND: The present study aims to estimate childhood overweight and obesity prevalence and their association with individual and population-level correlates in Eastern and Western European countries. METHODS: Data were obtained from the School Children Mental Health in Europe, a cross-sectional survey conducted in 2010 in Italy, Germany, the Netherlands, Romania, Bulgaria, Lithuania and Turkey. The sample consists of 5,206 school children aged 6 to 11 years old. Information on socio-demographics, children's height and weight, life-style and parental attitude were reported by the mothers. Country-level indicators were obtained through several data banks. Overweight and obesity in children were calculated according to the international age and gender-specific child Body Mass Index cut-off points. Multivariable logistic regression models included socio-demographic, lifestyle, mothers' attitude, and country-level indicators to examine the correlates of overweight. RESULTS: Overall prevalence was 15.6% (95% CI = 19.3-21.7%) for overweight and 4.9% (95% CI = 4.3-5.6%) for obesity. In overweight (including obesity), Romanian children had the highest prevalence (31.4%, 95% CI = 28.1-34.6%) and Italian the lowest (10.4%, 95% CI = 8.1-12.6%). Models in the pooled sample showed that being younger (aOR = 0.93, 95% = CI 0.87-0.97), male (aOR = 1.24, 95% CI = 1.07-1.43), an only child (aOR = 1.40, 95% CI = 1.07-1.84), spending more hours per week watching TV (aOR = 1.01, 95% CI =1.002-1.03), and living in an Eastern Country were associated with greater risk of childhood overweight (including obesity). The same predictors were significantly associated with childhood overweight in the model conducted in the Eastern region, but not in the West. Higher Gross Domestic Product and Real Domestic Product, greater number of motor and passenger vehicles, higher percentage of energy available from fat, and more public sector expenditure on health were also associated with lower risk for childhood overweight after adjusting for covariables in the pooled sample and in the east of Europe, but not in the West. CONCLUSIONS: Prevalence rates of overweight and obesity in school children is still high, especially in Eastern regions, with some socio-demographic factors and life-styles associated with being overweight. It is also in the Eastern region itself where better macro-economic indicators are related with lower rates of childhood overweight. This represents a public health concern that deserves special attention in those countries undertaking economic and political transitions

Journal of Affective Disorders

Background Bullying involvement is associated with suicidal ideation among adolescents, yet there are no studies examining this issue among younger children. Methods The School Children Mental Health in Europe study was conducted in seven countries in 2010 using similar methods to collect cross-sectional data from children, parents, and teachers. Suicidal ideation and thoughts of death were assessed using the Dominic Interactive among children. Parent and teacher reports were used to determine bullying involvement. The sample comprised n = 5,183 children ages 6 to 11 identified as bullies (n = 740, 14.3%), victims (n = 945, 18.2%), bully-victims (n = 984, 18.2%) and not involved in bullying (n = 2,514, 48.5%). Multivariate logistic regressions were used to assess the association of bullying involvement with suicidal ideation and thoughts of death. Results Suicidal ideation was reported by 13.3% of those not involved in bullying, 17.1% of victims, 19.6% of bullies and 24.4% of bully-victims. Similarly, thoughts of death were reported by 19.0% of victims, 24.3% of bullies, and 25.0% of bully-victims. Children identified as being involved were more likely than those not involved to report suicidal ideation in bivariate analyses. When controlling for psychopathology and for maternal distress among other factors, the association remained significant for bullies (AOR=1.30, 95%CI=1.01–1.66), bully-victims (AOR=1.54, 95%CI=1.22–1.94), but not for victims (AOR=1.02, 95%CI=0.80–1.30). Limitations The study is cross-sectional. The assessment of bullying may have underestimated victimization. Conclusions The association of bullying involvement and child suicidal ideation is present among elementary school children across Europe, using multiple informants to avoid shared variance biases, and adjusting for key factors.European Unio

The school children mental health in Europe (SCMHE) project: design and first results

Background : The School Children Mental Health in Europe (SCMHE) project aims to build up a set of indicators to collect and monitor children's mental health in an efficient and comparable methodology across the EU countries. It concerns primary schools children aged 6 to 11 years a range where few data are available whereas school interventions are promising. Methods : Three informants were used: parents, teachers and children. In selecting instruments language, instruments were selected according to the easiness to translate them: SDQ (Strengths and Difficulties Questionnaire) for parents and teachers and DI (Dominic Interactive). A two-step procedure was used: schools randomization then six children by class in each grade. Results : 9084 children from seven countries (Italy, Netherlands, Germany, Romania, Bulgaria, Lithuania, and Turkey) completed the Dominic Interactive in their own language. 6563 teachers and 6031 parents completed their questionnaire, and a total of 5574 interviews have been completed by the 3 informants. The participation rate of the children with parents in the participating schools was about 66.4%. As expected teachers report more externalised problems and less internalised problems than parents. Children report more internalised problems than parents and teachers. Boys have consistently more externalised problems than girls and this is the reverse for internalised problems. Combining the diverse informants and impairment levels children with problems requiring some sort of mental health care were about 9.9%: 76% did not see any mental health professional: 78.7% In Eastern countries 63.1% in Western Europe

The association between mental health problems and asthma among European school children

Background and objectives: To examine the prevalence of two ISAAC (International Study of Asthma and Allergies in Childhood) asthma indicators in 7 European countries and their relationship with mental health disorders in children 6–12 years. Methods: A cross-sectional survey of 5712 school children aged 6–12 years using a video Self-administered instrument: Dominic Interactive and the Strengths and Difficulties Questionnaire (SDQ) for parents and teachers. Asthma indicators were 12 month “Wheezing or whistling in the chest” (WWC) and “Severe Asthma” (SA) based on number of attacks of wheezing, sleep disturbance due to wheezing, and limits to speech. Results: On average 7.31% of the children had WWC, from 15.09% in Turkey to 1.32% in Italy; SA 2.22% on average ranged from 4.78% in Turkey to 0% in Italy. Generalized Anxiety Disorder (GAD) from child self-reports was significantly associated with WWC and SA even after adjustment for covariates. Based on parent and teacher combined reports, emotional problems were found to have significant associations with 12-month WWC after adjustment, as well as “any problems” which summarized externalizing and internalizing disorders Emotional, hyperactivity, conduct disorders were not associated with SA. Conclusion: Asthma indicators very much differ across countries. Asthma indicators are associated with childhood GAD. Childhood self-reported mental health seems more related to Asthma indicators than parents/teachers combined reports.European Commissio

Self-reported fears and mental health in elementary school children across Europe

Fears are common in the general population and particularly among children. The number of fear subtypes (animals, natural environment, situational, blood-injection-injury or other type) has been shown to be associated with psychopathology. Furthermore, there is evidence suggesting that some subtypes may be more often associated with mental disorders than others. The present study uses data from a large cross sectional survey, the School Children Mental Health in Europe (SCMHE) study, conducted in eight European countries on children ages 6 through 13-years-old attending elementary school (n = 9613). Fear subtypes and self-reported mental health were assessed using the Dominic Interactive (DI), a self-administered computerized image-based questionnaire. The findings show that the number of fear subtypes is strongly associated with self-reported internalizing and externalizing problems. In addition, adjusting for the number of subtypes, fear of animals was less likely than other fears to be associated with psychopathology. The findings support the notion that children who report excessive and generalized fear should be targeted for prevention, consistent with research identifying childhood onset generalized specific phobia as a probable precursor to subsequent psychopathology

Parental use of corporal punishment in Europe: intersection between public health and policy.

Studies have linked the use of corporal punishment of children to the development of mental health disorders. Despite the recommendation of international governing bodies for a complete ban of the practice, there is little European data available on the effects of corporal punishment on mental health and the influence of laws banning corporal punishment. Using data from the School Children Mental Health Europe survey, the objective of this cross-sectional study was to examine the prevalence and legal status of corporal punishment across six European countries and to evaluate the association between parental use of corporal punishment and children's mental health. The study found that odds of having parents who reported using occasional to frequent corporal punishment were 1.7 times higher in countries where its use is legal, controlling for socio-demographic factors. Children with parents who reported using corporal punishment had higher rates of both externalized and internalized mental health disorders

Comparing the prevalence of mental health problems in children 6–11 across Europe

Background: Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6–11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Methods: Data were collected on 7682 children for whom either parent- or teacher SDQ were completed. Results: The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems. Conclusions: As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress