Presença de transtornos mentais comuns em adolescentes brasileiros e fatores associados ao consumo alimentar, hábitos de vida e ambiente escolar

Abstract

Introduction: Common Mental Disorders (CMD) mainly refer to depressive and anxiety disorders. Due to the high prevalence among adolescents, the need to investigate factors that may be associated with CMD in this age group is justified. Objective: to verify whether individual, family, and environmental factors are associated with Common Mental Disorders among Brazilian adolescents, based on data from the Study of Cardiovascular Risks in Adolescents (ERICA). Methods: the data used was obtained from the ERICA cross-sectional study, from which three original articles were written. For the construction of the CMD variable, the Goldberg General Health Questionnaire (GHQ-12) was used, with a cut-off point of five. In the articles, Principal Component Analysis (PCA) was performed to identify consumption patterns and living practices. Sample complexity was considered using the Stata svy command, with a significance of 5%. Article 1: logistic regression models were used to identify associations between patterns of healthy living practices, living with parents and presence of CMD. Article 2: Logistic Regression Models were used to identify associations between dietary patterns, breakfast consumption and the practice of having the main meals accompanied by the family with CMD. Article 3: The association between school characteristics, individual characteristics and the presence of CMD was estimated by using multilevel logistic models. The final model was adjusted for non-modifiable individual variables, modifiable individual variables, family, and socioeconomic characteristics. Results: 71,553 adolescents from 1,247 public and private schools in 124 Brazilian cities were included. Article 1: adolescents belonging to the second (OR: 0.73; IC95% 0.65–0.82) or third tercile (OR: 0.44; IC95% 0.39–0.50) of the standard of living practices healthy were less likely to have CMD. Adolescents who lived with no parent (OR: 1.44; 95% CI 1.16–1.78) were associated with a higher chance to present CMD compared to those who lived with at least one parent. Article 2: Two patterns were found: a Healthy Dietary pattern and an Unhealthy Dietary pattern. Adolescents classified in the second (OR: 0.79; IC95% 0.70–0.89) or third (OR: 0,86; IC95% 0.77–0.96) tercile of the healthy eating pattern had a lower chance of presenting TMC. Eating breakfast a few times (OR: 0.71; 95%CI 0.61–0.83) or almost every day/every day (OR: 0.54; 95%CI 0.47–0.62), and the practice of having the main meals with the family a few times (OR: 0.69; 95%CI 0.57–0.84) or almost every day/every day (OR: 0.50; 95%CI 0.44–0.58) decreased the chance of CMD. Article 3: there was a direct association with the type of private administrative dependency of the school (OR: 1.11; 95%CI 1.08–1.15), the presence of advertising of ultra-processed foods (UPF) (OR: 1.10; 95%CI 1.06–1.14), from the second to the fourth quartile of UPF consumption, and waist-to-height ratio (OR: 2.16; 95%CI % 1.94–2.41) with TMC. Conclusion: it was verified the direct association between food intake, lifestyle habits (having the main meals with the family and eating breakfast), individual characteristics (waist-height ratio and living with parents) and school environment characteristics (administrative dependence of the school and the presence of ultra-processed food advertising) with the presence of CMD in Brazilian adolescents.