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Aletta Jacobs School of Public Health

Together for more healthy years
Agenda Junior Research Meet-up

Parallel session 2B: (Psycho)social aspects of public health

Fabio Porru - Associations of university student life challenges with mental health and self-rated health: a longitudinal study with 6 months follow-up

Background
Mental health problems among university students are highly prevalent. This study investigates to what extent student life challenges are associated with university students’ mental and self-rated health, and whether changes in these challenges are associated with changes in university students’ health.

Methods
In a longitudinal study sample of 568 Italian university students, health was assessed with the Mental Health Inventory-5 (MHI-5) and a single item concerning self-rated health from the Short Form 36 (SF36) Health Survey at baseline and at six months follow-up (scales range from 0 to 100). Student life challenges were investigated using six subscales of the Higher Education Stress Inventory (HESI), ranging from 1 to 4). A between-within model was used to investigate whether a higher exposure to life challenges is associated to poorer health (between model) and whether changes in student life challenges were associated with changes in health (within model).

Results
A higher score in student life challenges was associated with poorer mental (b ranging from 5.3 to 10.3) and self-rated health (b ranging from 3.1 to 9.6). An increase in student life challenges within individuals was associated with worse mental and self-rated health, in particular for workload (b up to -5.9), faculty shortcomings (b up to -5.7), unsupportive climate (b up to -5.6).

Discussion
Exposure to and changes in student life challenges are associated with university students’ health. Our findings suggest that tackling student life challenges with interventions at environmental and individual level may improve mental and self-rated health among university students.

Keywords: Mental health, Psychological distress, Student life challenges

Aranka Ballering - Sex differences in the trajectories to diagnosis in patients with common somatic symptoms: a primary care patient cohort study

Background
Although differences between women and men in their primary care trajectories that lead to a diagnosis are found in multiple diseases, little insight exists into sex differences in diagnostic trajectories for common somatic symptoms.

Aim
This study aims to quantify differences between women and men in diagnostic interventions (i.e. physical examinations, laboratory diagnostics, diagnostic imaging and specialist referrals), as well as their consequences for final diagnoses, of patients with common somatic symptoms in primary care.

Methods
We used primary care registration data obtained from 2014 to 2018 derived from the Dutch Family Medicine Network (N=34,268 episodes of care related to common somatic symptoms). We used multilevel multiple logistic regression analyses to assess the association between female sex and diagnostic interventions, and disease diagnoses, when patients presented somatic symptoms. We used structural equation modelling to estimate a mediation model with multiple parallel mediators to assess whether the different rate of diagnostic interventions conducted in female patients led to fewer disease diagnoses than in male patients.

Results
Female patients received less physical examinations (OR=0.81, 95%CI=0.76-0.86), diagnostic imaging (OR=0.92, 95%CI=0.84-0.99) and specialist referrals (OR=0.85, 95%CI=0.79-0.91) than male patients, but more laboratory diagnostics (OR=1.24, 95%CI=1.17-1.32). Women received a disease diagnosis less often than men for their common somatic symptoms (OR=0.94, 95%CI=0.89-0.98). Due to the fewer diagnostic interventions conducted in female patients, women received less disease diagnoses, thus females’ symptoms remained more often unexplained.

Conclusion
This study shows that sex inequalities are present in primary care diagnostic trajectories of patients presenting common somatic symptoms and that these lead to unequal health outcomes between women and men. GPs have to be aware of these inequalities to ensure equal high-quality care for all patients.

Keywords: Sex differences, primary care, common somatic symptoms

Last modified:14 January 2021 7.32 p.m.