The objective of this study was to estimate the incidence and age of onset of mental disorders diagnosed by gender and socioeconomic status (SES) in children, adolescents, and young adults up to 30 years of age in the whole population of the Basque Country (Spain).All mental health diagnoses documented in Basque Health Service records from 1 January 2003 to 31 December 2018, were classified into eight clusters: anxiety, attention deficit hyperactivity disorder (ADHD), conduct disorders, depression, psychosis/personality disorders, substance use, eating disorders, and self-harm. We calculated incidence and cumulative incidence for each cluster, disaggregated by gender, and socioeconomic status (SES). Poisson regression analyses were performed.Overall, 9,486,853 person-years of observation were available for the 609,281 individuals included. ADHD and conduct disorders were diagnosed in the first decade, anxiety and depression disorders in the second and third decades, and psychosis/personality and substance use in the third. The cumulative incidence at 18 years of age for any type of disorder was 15.5%. The group with low SES had a statistically significantly higher incidence of all eight clusters. The incidence of ADHD, conduct disorders, depression, psychosis/personality disorders, and substance use was higher in males and that of anxiety, eating disorders and self-harm was higher in females.The incidence of mental disorders is high among children, adolescents, and young adults in the Basque Country underlining the need for preventive interventions. Marked differences by gender and SES highlight mental health inequalities, especially for depression and psychosis in low SES males.
Resilience is the ability of an individual or community to adapt to life challenges or adversities while maintaining mental health and well-being. In the multi-systemic resilience paradigm, human development and resilience is embedded in adaptive systems and in their interactions. Although the relationship between school systems and adolescents' mental wellbeing is established, there is no agreement on how to recognize and evaluate the most relevant aspects of the school community, acting at collective level, to boost positive socio-emotional and educational outcomes in children and adolescents. This study presents the development and preliminary validation of a new and theory-driven construct and instrument, the School Resilience Scale for Adults (SRS). School Resilience comprises five interrelated constructs (i.e. Positive relationships, Belonging, Inclusion, Participation, and Mental health awareness) connected theoretically to wellbeing and resilience in children and adolescents. The scale development was theory-driven, and the instrument was tested in four European counties in the frame of the UPRIGHT project (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers). Overall, 340 adults participated, 129 teachers and school staff, and 211 relatives of teenagers. The sample was randomly split for two studies: (1) an Exploratory Factor analysis (ESEM), and (2) Confirmatory Factor (CFA) analysis. In the exploratory analysis, Chi-Square difference test and model fit indices point towards the five-factor solution over a three-factor solution. The confirmatory study indicated that a five-factor model (RMSEA = 0.038, CFI = 0.96, TLI = 0.95, SRMR = 0.045) was slightly better than a second-order model (RMSEA = 0.046, CFI = 0.94, TLI = 0.93, SRMR = 0.05). Convergent and discriminant validities were partially demonstrated. Alpha and omega reliability coefficients verified the measurement model of the scale. The results confirmed that a multidimensional construct of School Resilience, defined as a collective resilience factor, embedded in the school staff, family members, and adolescents' interrelated systems can be characterized and measured. Further studies must determine its role in the promotion of adolescents' resilience, mental wellbeing, educational outcomes, and in their positive adaptation in challenging contexts.
Resilience is the process and outcome of healthy adaptation despite significant adversity. Proliferation of research on the resilience construct has led to scientific concerns about the operationalization and measurement of resilience for assessment science and practice. Various studies that have investigated the psychometric properties and construct validity of the Resilience Scale for Adolescents (READ) have yielded inconsistent findings, which could partly be due to variations in the methodological approaches. This study investigated the factor structure and construct validity of the READ in four European regions participating in the Universal Preventive Resilience Intervention Globally Implemented in Schools to Improve and Promote Mental Health for Teenagers (UPRIGHT) project. Participants included adolescents aged 10–15 years from Spain ( n = 391, females = 51%), Iceland ( n = 379, females = 55%), Italy ( n = 460, females = 55%), and Poland ( n = 316, females = 51%). The five-factor model of the READ was similar across gender and participating regions. Construct validity of the READ was supported. After establishing construct separability, incremental validity was supported (except for the social competence subscale). The READ is a valid and reliable measure of protective factors involved in resilience and demonstrates promise for cross-cultural applicability. Recommendations for measuring resilience and validating the READ in future investigations are provided.
Zachowania dobrostanu i samodzielności przez osoby starsze wynika z wdrażania zasad „dobrego starzenia się” opartego na aktywności i uczestnictwie w życiu zawodowym i społecznym oraz promocji zdrowego stylu życia. Coraz większe znaczenie przypisuje się rozpowszechnieniu zespołu słabości wśród pacjentów w wieku podeszłym. Pacjenci ci charakteryzują się zwiększoną wrażliwością na bodźce, upośledzoną zdolnością do radzenia sobie z wewnętrznymi i środowiskowymi czynnikami stresogennymi, a także posiadają ograniczoną zdolność do utrzymania stanu fizjologicznej i psychospołecznej homeostazy W takich przypadkach konieczne jest wsparcie pacjentów opieką zintegrowaną polegającą na wsparciu środowiska oraz najnowszej technologii. Zapewnienie mieszkańcom województwa dolnośląskiego wysokiej jakości życia, dopasowanie usług społecznych do potrzeb mieszkańców oraz sama integracja społeczna są zgodne ze Strategia Integracji Społecznej na Dolnym Śląsku. Dlatego też, na Dolnym Śląsku wsparcie takich pacjentów technologią, zostało zapoczątkowane pilotażem projektu CareWell i WRP®. Zastosowanie nowych technologii wymaga kampanii społecznej, informacji w mediach i wzbudzenia społecznego zaciekawienia, wręcz mody na ich stosowanie. Pozwoli to na doskonalenie nowych usług, obniżenie kosztów i poprawę bezpieczeństwa ludzi. W miejsce kosztownej opieki specjalistycznej pacjenci w wieku podeszłym uzyskują opiekę indywidualizowaną, lokowaną w środowisku, mniej kosztowną lecz bardziej intensywną. Projekt FOCUS zajmuje się zmniejszeniem obciążenia zespołem słabości w populacji osób w wieku podeszłym w Europie z uwzględnieniem wzmocnienia wsparcia środowiskowego. Celem projektu SUNFRAIL jest poprawa identyfikacji, zapobiegania i zarządzanie zespołem słabości oraz opieką nad wielochorobowością wśród osób po 65 roku życia mieszkających w społeczności lokalnej przez regionalne ośrodki i instytucje krajów UE.