Association of mental health distress and lifestyle of students: a nationwide cross sectional survey of Pakistani adolescents

Background: Lifestyle behaviors significantly impact mental health, yet remained poorly identified. Thus, the objective was to examine the relationship between mental health problems (loneliness, anxiety and plan to suicide)... [ view full abstract ]

Background: Lifestyle behaviors significantly impact mental health, yet remained poorly identified. Thus, the objective was to examine the relationship between mental health problems (loneliness, anxiety and plan to suicide) and combined health risk behaviors (sedentary behavior, fast food consumption, soft drink intake, smoking & substance use) of adolescents using the Global School Health Survey (GSHS) of Pakistani adolescents.
Methods: We obtained data from a cross sectional study conducted in Pakistan (2009). Secondary data analysis was performed on 4541 school adolescents of mean age 14 years. Association of combined health risk behaviors and loneliness, anxiety and plan to suicide were assessed using univariate and multivariate logistic regression analysis by complex sample method.
Results: Out of total respondents; 39.2%, 22%, 5.8%, and 1.2% exhibited one, two, three and four or more health risk behaviors respectively. 12.1% reported feeling lonely; 8.3% stated anxiety problems and 7.5% planned to suicide. The result of regression analysis indicated significant association between health risk behaviors and mental health problems in adolescents. Multiple logistic regression showed that adolescents who were involved in four or more health risk behaviors had greater odds of (OR 2.86, 95% CI 1.38 5.91, p value 0.0044) loneliness; (OR 2.41, 95% CI 1.25 4.63, p value 0.008) anxiety and (OR 4.5, 95% CI 2.56 7.94, p value <0.001) suicide planning as compared to those adolescents who were not involved in any of health risk behavior after adjusting for sociodemographic and other cofounding factors.
Conclusion: There was a strong association between combined risk factors of unhealthy lifestyle with loneliness, anxiety, and plan to suicide among Pakistani school going adolescents and health interventions should target adolescents who are in the transition age of developing into adulthood.
Key words:
Health risk behaviors, Adolescents, Loneliness, Anxiety and Suicide