A latent class analysis of psychological symptoms and health risk behaviors among Chinese adolescents

Abstract Multiple health risk behaviors (HRBs) tend to co-occur which increase risks of mental disorder. In this study, we identified the association between latent class of HRBs and psychological symptoms in Chinese adolescents. We assessed 22 628 Chinese adolescents from November 2015 to January 2016. The average age of the students were (15.36 ± 1.79), among which there were 10 990 male students and 11 638 female students. A latent class analysis was applied to identity HRBs patterns. The multivariable logistic regression models were utilized to examine the association between HRBs patterns and psychological symptoms. Four latent classes were identified, characterized as low-risk class, moderate-risk class 1 (smoking/ alcohol use (AU)/screen time (ST)), moderate-risk class 2 (unhealthy losing weight (ULW)/ problematic mobile phone use (PMPU)), and high-risk class (ULW/smoking/AU/ST/ PMPU), which were 71.2 %, 3.2 %, 22.3 %, and 3.3 % of involved participants, respectively. Compared to the low-risk class, moderate-risk class 1, moderate-risk class 2, and high-risk class showed that adjusted OR (95 %CI) value of 1.97 (1.68–2.32), 3.98 (3.72–4.26) and 6.38 (CI: 5.47–7.44) were significantly associated with psychological symptoms (P