Multiple behavioural risk factors and mental health complaints among adults in Estonia

Abstract Background Behavioural risk factors are inter-related and often coincide, resulting in potentially worse mental health outcomes. This study explores the association between multiple behavioural risk factors and mental health among adults in Estonia. Methods We used nationally representative survey data from 2020 (n = 6404) to study the co-occurrence of lifestyle risk factors (smoking, alcohol consumption, physical inactivity, unhealthy diet, drug use, and high screen time) in relation to mental health indicators. Latent class analysis (LCA) was used to identify lifestyle risk profiles, while regression analysis was used to examine associations. Results Mental health outcomes were more frequent among females and younger respondents, but 54.4% of respondents reported having at least one mental health problem. Using LCA, three lifestyle classes were identified: multiple risk factors (17.9% of respondents), healthy lifestyle (76.1%), and drug use lifestyle (5.9%). Compared to individuals in healthy lifestyle class, respondents in multiple risk factors had higher odds for experiencing depressiveness (OR 1.46; CI 1.24-1.72), stress (OR 1.26; CI 1.06-1.49), and suicidal thoughts (OR 1.50; CI 1.26-1.80), as well as self-reported diagnoses of depression and insomnia, and using medications, such as antidepressants, hypnotics and sedatives. Respondents in drug use lifestyle had 1.5-2.5 times higher odds for all mental health items compared to healthy lifestyle class with largest difference found for suicidal thoughts (OR 2.46; CI 1.92-3.16) and medication use (OR 2.58; CI 1.91-3.47). Conclusions The current data highlights the importance of preventive measures targeting multiple behavioural risk factors, given that these factors often coincide. Moreover, the study showed a high proportion of individuals with at least one mental health problem, highlighting the necessity to continue efforts in preventive and interventive methods. Key messages • The study highlights the significant association between multiple behavioural risk factors and mental health outcomes. • The study also emphasizes the importance of focused interventions targeting multiple behavioural risk factors to address the increased risk of mental health problems.