The primary objective of our study was to assess measurement invariance (by grade and sex) of the 7-item Generalized Anxiety Disorder (GAD-7) and 10-item Center for Epidemiologic Studies Depression Revised (CESD-R-10) scales in a sample of adolescents in Canada. If measurement invariance was demonstrated, our secondary objective was to estimate differences in scale scores across these subgroups. We used data from 59,052 adolescents in Year 7 (2018–19) of the COMPASS school-based study. Measurement invariance was tested within a multigroup confirmatory factor analysis framework. Differences in scale scores were estimated using mixed linear regression which accounted for school-level clustering and adjusted for relevant confounders. Both the GAD-7 and CESD-R-10 demonstrated strict measurement invariance by sex and grade in our sample. Mean scale scores were higher among adolescents in grade 12 compared to grade 9 (β_GAD-7 = 0.91, p < .001; β_CESD-R-10 = 0.99, p < .001) and among female adolescents compared to males (β_GAD-7 = 3.36, p < .001; β_CESD-R-10 = 2.58, p < .001). Findings support the validity of the GAD-7 and CESD-R-10 for screening risk of generalized anxiety and depression among Canadian adolescents, and further indicate that differences observed in scale scores across subgroups reflect actual differences in risk for generalized anxiety and major depression, respectively.

Our aim was to examine measurement invariance of the Flourishing Scale (FS)—a concise measure of psychological wellbeing—across two study samples and by population characteristics among Canadian adolescents. Data were retrieved from 74,501 Canadian secondary school students in Year 7 (2018–2019) of the COMPASS Study and from the original validation of the FS (n = 689). We assessed measurement invariance using a confirmatory factor analysis in which increasingly stringent equality constraints were specified for model parameters between the following groups: study sample (i.e., adolescents vs. adults), gender, grade, and ethno-racial identity. In all models, full measurement invariance of the FS across all sub-groups was demonstrated. Our findings support the validity of the FS for measuring psychological wellbeing among Canadian adolescents in secondary school. Observed differences in FS score among subgroups therefore represent true differences in wellbeing rather than artifacts of differential interpretation.

Objective Efforts to describe the current state of research are needed to advance the field of physical-mental multimorbidity (ie, the co-occurrence of at least one physical illness and at least one mental disorder) among children and youth. Our objective was to systematically explore the breadth of physical-mental multimorbidity research in children and youth and to provide an overview of existing literature topics. Design Scoping review. Methods We conducted a systematic search of four key databases: PubMed, EMBASE, PsycINFO and Scopus as well as a thorough scan of relevant grey literature. We included studies of any research design, published in English, referring to physical-mental multimorbidity among children and youth aged ≤18 years. Studies were screened for eligibility and data were extracted, charted and summarised narratively by research focus. Critical appraisal was employed using the modified Quality Index (QI). Results We included 431 studies and 2 sources of grey literature. Existing research emphasises the co-occurrence of anxiety, mood and attention disorders among children with epilepsy, asthma and allergy. Evidence consists of mostly small, observational studies that use cross-sectional data. The average QI score across applicable studies was 9.1 (SD=1.8). Conclusions There is a pressing need for more robust research within the field of child physical-mental multimorbidity.

As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences. We used online data collected from 7150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sex-stratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students’ mental health, individual characteristics, and school neighborhood characteristics. Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aOR_Female = 1.04, 95 %CI[1.01–1.07]; aOR_Male = 1.06, 95 %CI[1.013–1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR = 0.96, 95 %CI[0.94–0.98]), controlling for current substance use. Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.

Introduction Little is known about gender differences in associations between weight control intentions and mental health in adolescents. Our objective was to examine these associations in a large sample of adolescent girls and boys. Methods Using data from Year 6 (2017–18) of the COMPASS study (n = 57 324), we performed a series of multivariable linear regressions to examine whether weight control intentions (gain, lose, stay the same, no intention) were associated with depression, anxiety and self-concept, while adjusting for relevant covariates including body mass index. Models were stratified by self-reported gender. Results Compared to those with no intentions, girls who intended to lose weight reported higher symptoms of depression (B = 0.52, p $lt; 0.001) and anxiety (B = 0.41, p $lt; 0.001) and poorer self-concept (B = 2.06, p $lt; 0.001). Girls who intended to gain weight also reported higher symptoms of depression (B = 0.54, p $lt; 0.001), anxiety (B = 0.50, p $lt; 0.001) and self-concept (B = 1.25, p $lt; 0.001). Boys who intended to lose weight reported greater symptoms of depression (B = 0.26, p $lt; 0.001) and anxiety (B = 0.33, p $lt; 0.001) and poor self-concept (B = 1.10, p $lt; 0.001). In boys, weight-gain intentions were associated with greater symptoms of anxiety (B = 0.17, p $lt; 0.05), but not depression or self-concept. Conclusion Intentions to gain or lose weight were associated with symptoms of mental disorder and poor self-concept in our large sample of adolescents, and these relationships differed in boys and girls. These findings have important implications for school-based programs promoting healthy weight and body image.