title: Mental health problems of Dutch adolescents: the association with adolescents' and their parents' educational level.
abstract: BACKGROUND
  We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred.
  
  
  METHODS
  Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings.
  
  
  RESULTS
  A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents.
  
  
  CONCLUSIONS
  There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.
authors.affiliation: Department of Social Medicine, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. jano.havas@socmed.unimaas.nl
authors.forename: Jano
authors.initials: J
authors.lastname: Havas
authors.forename: Hans
authors.initials: H
authors.lastname: Bosma
authors.forename: Cor
authors.initials: C
authors.lastname: Spreeuwenberg
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Feron
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019955:Conduct Disorder / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D010290:Parents; D000297:Psychology, Adolescent; D012044:Regression Analysis; D012737:Sex Factors; D012920:Social Behavior Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires