Subjective health complaints in adolescence - A cross-national comparison of prevalence and dimensionality

Background: The purpose of this work was to study the prevalence and dimens ionality of subjective health complaints in a cross-national population of adolescents. Methods: The analyses were based on data from a WHO cross-nati onal survey, Health Behaviour in School-aged Children (HBSC). The study inc luded a representative sample of 11, 13 and 15-year-old adolescents from Fi nland, Norway, Poland and Scotland, Data were collected in 1993-1994 and th e total sample included 20,324 adolescents. Subjective health complaints we re measured by the HBSC Symptom Checklist (HBSC-SCL), including headaches, abdominal pain, backache, feeling low, irritability, nevousness, sleeping d ifficulties and dizziness. Descriptive analyses, MANOVA and structural equa tion modelling (EQS) were conducted. Results: Patterns of reporting were co nsistent for all four countries. A large number of students reported a high level of symptoms. The reporting of most symptoms increased with age. Girl s reported significantly more symptoms than boys and the gender differences also increased with age. Structural equation modelling suggests a model of two correlated factors, which can be labelled psychological and somatic. C onclusion: The findings of this study indicate that students report a high level of subjective health complaints already at the age of 11 years, The r eporting of most symptoms increases with age and more so for girls than for boys. The finding of two dimensions that differ qualitatively, suggests th at these dimensions may have different etiologies.