Increasing prevalence of emotional symptoms in higher socioeconomic strata: Trend study among Danish schoolchildren 1991–2014

Aims: The aims of this study were: (a) to examine trends in daily emotional symptoms among 11- to 15-year-olds from 1991 to 2014 in Denmark, and (b) to examine trends in social inequality in daily emotional symptoms, that is, whether the differences in prevalence between adolescents with parents of varying occupational social class changed over time. Methods: We combined seven comparable cross-sectional Health Behaviour in School-aged Children surveys (N=31,169). Daily emotional symptoms were measured by the HBSC Symptom Check List and occupational social class (OSC) by students’ reports about parents’ occupation. We calculated absolute (per cent) differences in emotional symptoms between high and low OSC and relative differences by odds ratio for emotional symptoms by parents’ OSC. Results: Eight per cent reported at least one daily emotional symptoms, with an increasing trend from 1991 to 2014 (p<0.001). The prevalence in high, middle and low OSC was 6.2%, 7.4% and 10.6% (p<0.0001). From 1991 to 2014, there was an increase in the prevalence of daily emotional symptoms in high (p<0.0001) and middle (p<0.0001) but not low OSC (p=0.4404). This resulted in a diminishing absolute social inequality in emotional symptoms. The statistical interaction between OSC and survey year was significant (p=0.0023) and suggests a diminishing relative social inequality in emotional symptoms from 1991 to 2014. Conclusions: There was an increasing prevalence of daily emotional symptoms from 1991 to 2014 and a diminishing social inequality in prevalence of daily emotional symptoms in terms of both absolute and relative social inequality.