title: Internalizing disorders and quality of life in adolescence: evidence for independent associations.
abstract: OBJECTIVE
  To investigate whether internalizing disorders are associated with quality of life (QoL) in adolescents, even after accounting for shared risk factors.
  
  
  METHODS
  The sample comprised 102 adolescents from a community cross-sectional study with an oversampling of anxious subjects. Risk factors previously associated with QoL were assessed and divided into five blocks organized hierarchically from proximal to distal sets of risk factors.
  
  
  RESULTS
  Multiple regression analysis yielded a hierarchical model accounting for 72% of QoL variance. All blocks were consistently associated with QoL (p < 0.05), accounting for the following percentages of variance: 12% for demographics; 5.2% for family environment; 37.8% for stressful events; 10% for nutritional and health habits; and 64.2% for dimensional psychopathological symptoms or 22.8% for psychiatric diagnoses (dichotomous). Although most of the QoL variance attributed to internalizing symptoms was explained by the four proximal blocks in the hierarchical model (43.2%), about 21% of the variance was independently associated with internalizing symptoms/diagnoses.
  
  
  CONCLUSIONS
  QoL is associated with several aspects of adolescent life that were largely predicted by our hierarchical model. Our findings reinforce the hypothesis that internalizing disorders and internalizing symptoms in adolescents have a high impact on QoL and deserve proper clinical attention.
authors.affiliation: Graduate Program in Medical Sciences, Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Salum
authors.affiliation: Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry, HCPA, Porto Alegre, RS, Brazil.
authors.forename: Diogo A
authors.initials: DA
authors.lastname: DeSousa
authors.affiliation: Center for Child and Adolescent Health Studies (NESCA), HCPA, Porto Alegre, RS, Brazil.
authors.forename: Vera L
authors.initials: VL
authors.lastname: Bosa
authors.affiliation: Center for Child and Adolescent Health Studies (NESCA), HCPA, Porto Alegre, RS, Brazil.
authors.forename: Ilaine
authors.initials: I
authors.lastname: Schuch
authors.affiliation: Center for Child and Adolescent Health Studies (NESCA), HCPA, Porto Alegre, RS, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Goldani
authors.affiliation: Graduate Program in Medical Sciences, Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Luciano R
authors.initials: LR
authors.lastname: Isolan
authors.affiliation: Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry, HCPA, Porto Alegre, RS, Brazil.
authors.forename: Stefania P
authors.initials: SP
authors.lastname: Teche
authors.affiliation: Graduate Program in Medical Sciences, Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Marcelo P
authors.initials: MP
authors.lastname: Fleck
authors.affiliation: Graduate Program in Medical Sciences, Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Rohde
authors.affiliation: Graduate Program in Medical Sciences, Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
authors.forename: Gisele G
authors.initials: GG
authors.lastname: Manfro
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008960:Models, Psychological; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012307:Risk Factors; D012647:Self-Assessment; D012931:Social Environment; D011795:Surveys and Questionnaires; D055815:Young Adult