ORIGINAL RESEARCH
published: 13 June 2022
doi: 10.3389/ pubh.2022.882707
F on ie s in Public Heal h | www. on ie sin.o g 1June 2022 | Volume 10 | A icle 882707
Edi ed by:
Rosa Magallon,
Uni e si y o Za agoza, Spain
Re iewed by:
Aleksand Klju ˇ
cniko ,
College o In o ma ion Managemen
and Business Adminis a ion, Czechia
Ma ek Vochozka,
Ins i u e o Technology and
Business, Czechia
Manuela T a ona iciene,
Vilnius Gediminas Technical
Uni e si y, Li huania
*Co espondence:
Bea a Ga u o a
[email p o ec ed]
Special y sec ion:
This a icle was submi ed o
Public Men al Heal h,
a sec ion o he jou nal
F on ie s in Public Heal h
Recei ed: 24 Feb ua y 2022
Accep ed: 09 May 2022
Published: 13 June 2022
Ci a ion:
Ga u o a B and Ta hanico a M (2022)
Young Adul s and Sick Lea e Leng h
o Men al Illnesses.
F on . Public Heal h 10:882707.
doi: 10.3389/ pubh.2022.882707
Young Adul s and Sick Lea e Leng h
o Men al Illnesses
Bea a Ga u o a 1
*and Mi iama Ta hanico a 2
1Facul y o Managemen and Economics, Tomas Ba a Uni e si y in Zlín, Zlín, Czechia, 2Facul y o Mining, Ecology, P ocess
Con ol and Geo echnologies, Technical Uni e si y o Košice, Košice, Slo akia
Objec i es: The objec i e was o explo e whe he a sick lea e leng h ela ed o men al
mo bidi y di e s ac oss di e en occupa ional ca ego ies.
Me hods: In he analysis, egis y o sick lea es was analyzed. P o ided analysis is
ocused on he leng h o sick lea es ela ed o men al diseases caused by subs ance
use o o he ac o s. Dependen a iable is he sick lea e leng h, and he independen
a iables a e he ca ego ies o disease and occupa ion. K uskal–Wallis es , Shapi o–Wilk
es , and B own–Fo sy he (B–F) a e used.
Resul s: The e a e di e ences in men al sick lea e leng hs caused by subs ance use
o o he ac o s. In he case o men al illnesses a ibu able o d ugs, di e ences in he
sick lea e du a ion among di e en wo king g oups we e no ound. Conside ing men al
diso de s caused by o he ac o s, he e a e di e ences in he sick lea e du a ion among
di e en wo king g oups.
Conclusions: The e is no e idence o longe sick lea e in people diagnosed wi h men al
diso de ela ed o subs ance use. Di e ences in occupa ional ca ego ies do no ela e
o sick lea e leng h.
Keywo ds: men al diseases, subs ance use, heal h li e acy, young adul s, public heal h
INTRODUCTION
Nowadays, coun ies wi h apidly aging popula ions and low bi h a es ace he challenge
o g owing economic bu den o he u u e gene a ions. This challenge a ac s he a en ion
o policymake s as well as he esea ch eams ac oss he wo ld o examine he heal h and
socioeconomic condi ions and he abili y o young adul s o b ing economic alue o coun y. Mo e
a en ion is paid o men al heal h as young people a e daily exposed o s ess ul li e e en s ha
nega i ely a ec hei heal h. S ess ul e en s may be he consequence o low social s a us, pa en al
and pee ela ionship quali y, social exclusion, e c. (1). People diagnosed wi h ch onic s ess o
exposed o any o he li e e en a e endange ed mo e by men al diseases (2).
Men al heal h is impo an in young people because o he de elopmen o cogni i e, social,
and emo ional being o young people as well. Acco ding o Bi n e al., people exposed o high
le el o s ess in ea ly childhood a e a highe isk o a wide ange o beha io al p oblems o
men al diso de s (3). Global Bu den Disease S udy 2017 (GBD) shows ha men al diso de s ha e
consis en ly o med mo e han 14% o age-s anda dized yea s li ed wi h disabili y (YLDs) o
nea ly h ee decades. Men al diseases ha e >10% p e alence in all 21 GBD egions (4). Se e e
men al illness is di icul o ea , and hus, eno mous pha macological and psychological esou ces
a e needed o in e ene. T ea men and p e en ion o men al diso de s equi e he in e ac ion o
a ious social and biological isk and p o ec i e ac o s h oughou he li e cou se (5). As s a ed by
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
Ma he e al., men al diso de s a e a majo public heal h p oblem
wo ldwide and he leading cause o wo k disabili y (sick lea e and
disabili y pension) in Eu ope. Gene ally, sick lea e becomes mo e
common wi h age; howe e , sick lea e due o men al diso de s
is he mos common in a younge age. Sick lea e due o men al
diso de s has been ound o ha e a nega i e e ec on u u e wo k
li e, such as a highe isk o unemploymen and a lowe income
(6). Salomonsson e al. con i m ha sick lea e due o common
men al diso de s (CMDs) inc eases apidly and p esen s a majo
socie al challenge (7). Ma he e al. emphasize ha sick lea e
due o men al diso de s inc eased he isk o eoccu ing sick
lea e wi hin 2 yea s, disabili y pension and unemploymen ,
independen o gene ics, and sha ed en i onmen (8). Lidwall
e al. s ess ou ha he isk o sick lea e wi h men al diso de
is highe among women compa ed o men, among pe sons aged
30–39 and among pa en s in amilies wi h unde age child en (9).
Subs ance use p esen s high isk o de elopmen o men al
diso de s. Child en and adolescen s a ec ed by alcohol use
migh ha e ad e se heal h e ec s ela ed o men al diso de s.
Lima e al. highligh a bidi ec ional associa ion be ween alcohol
use and men al heal h condi ion, whe e he p esence o one
issue almos doubles he isk o ha ing he o he issue (10).
Acco ding o Ami i and Behnezdad, i can be concluded ha
alcohol consump ion inc eases he isk o sick lea e in wo king
popula ion (11). In he s udy o Malla e al., he au ho s
emphasize he ea ly onse o mos men al diso de s and subs ance
abuse as well as hei pe sis ence in o adul hood. Mo eo e ,
Malla e al. wa n abou he delays in seeking p o essional help,
which nega i ely a ec s no only young people bu also socie y
as well. The e is a necessi y o di e en concep ual amewo ks
o he ea men o you h men al diso de s and ans o ma ion
o p o ided se ices. I is necessa y o no only educe he unme
needs bu also allow a mo e meaning ul explo a ion o he na u e
o such p oblems and he bes way o ea hem (12). Inabili y
o ecognize men al heal h p oblems o younge people hinde s
ea ly de ec ion and help-seeking beha io s (13).
The way people ea hemsel es is highly in luenced by hei
heal h li e acy. Acco ding o Liu, heal h li e acy is an impo an
de e minan o heal h (14). Heal h li e acy is a unc ion o many
ac o s, mos ly social and indi idual. Wi ink and Oos e ha en
s a e ha heal h li e acy is linked o li e acy and en ails people’s
knowledge, mo i a ion, and compe ences o access, unde s and,
app aise, and apply heal h in o ma ion o make judgemen s and
ake decisions in e e yday li e conce ning heal h ca e, disease
p e en ion, and heal h p omo ion o main ain o imp o e quali y
o li e du ing he li e cou se (15).
Acco ding o Flea y e al., he e is a meaning ul ela ionship
be ween heal h li e acy and adolescen s’ heal h beha io s (16).
Duplaga’s esea ch on heal h li e acy, which ook place in Poland,
showed ha lowe heal h li e acy is associa ed wi h a lowe sel -
assessmen o heal h, he p e alence o obesi y and disabili y,
less equen physical ac i i y, lowe consump ion o ui s and
ege ables, and wi h mo e equen hospi aliza ions (17). Ca od-
A al in o ms on he ac o s associa ed wi h poo men al heal h
such as po e y, low educa ional le el, gende disc imina ion,
unheal hy li es yle, iolence, physical ill-heal h, unemploymen ,
social exclusion, and human igh s iola ions (18,19). B ode
e al. admi ha he unique pa icula i ies o child en and young
people ele an o heal h li e acy include hei disease and
heal h- isk p o iles, hei ulne abili y o demog aphic ac o s,
hei social ole and s a us, and hei igh o pa icipa ion (20).
The e a e also gende di e ences in men al heal h o people.
Men al diso de s a ec mo e deeply women compa ed o men
a e e y le el o household income (18). Mo e ulne able g oups
o people a e young people wi h lowe educa ion. Such people
occupy lowe job posi ions a wo k, which a e no demanding on
he a ained educa ional le el, such as elemen a y occupa ions,
plan and machine ope a o s and assemble s, c a and ela ed
ade wo ke s, skilled ag icul u al, o es y, and ishe y wo ke s.
Mo eo e , Milne e al. s a e ha imp o ing employmen
oppo uni ies could educe nea ly hal o he ad e se e ec s o
low educa ion on men al heal h o young people (21).
Mo e e ec i e in e en ions would be eached i he e
we e close links be ween heal h li e acy and beha io change
amewo ks (22). The e o e, i is necessa y o inc ease he heal h
li e acy in younge age. Sukys e al. wa n ha heal h li e acy
among young uni e si y s uden s is insu icien (23). Indi iduals
mus unde s and and use in o ma ion ega ding how o bene i
om heal hca e se ices and main ain a heal hy li e. The inc ease
in heal h li e acy migh inc ease he pa icipa ion o indi iduals
in p omo ing heal hy beha io s. All beha io s ha can a ec
heal h mus be unde con ol (24). Men al heal h li e acy can
be inc eased wi h speci ic in e en ions, which p o ided in he
p ima y ca e o in mains eam o online media (13,25,26).
Low le els o heal h li e acy migh be a p oblem in wo k
en i onmen , as people wi h lowe heal h li e acy a e a highe
isk o sp eading he illness and o longe pe iod needed o
ea men (15,17,19,22). Longe ea men exp essed by a longe
sick lea e du a ion ep esen s a se ious economic bu den no
only o company, bu also, in he o m o los p oduc i i y, o
socie y as well. Sick lea e, associa ed wi h men al illness as well as
any o he ypes o illness, ep esen s long- e m expendi u es o
he s a e, especially in economies whe e he heal hca e sys em is
inanced om he s a e money. Young people who ha e a men al
illness o diso de a e no only cu en economic bu den, bu also
a u u e one. The sick lea e du a ion a ies depending on he
ype o disease. Some diseases a e ea able whe eas o he s a e
incu able o ha e las ing consequences ha esul s in o inancial
dependence on amily membe s o s a e aid. These ac s we e
he mo i a ion o ou esea ch aiming o ind ou whe he he
occupa ional ypes o young people a ec he leng h o hei
incapaci y o wo k due o men al illnesses acqui ed h ough he
use o addic i e subs ances o o he isk ac o s.
In his s udy, sick lea e leng h is compa ed in ega d o he
ypes o men al disease and he wo k/occupa ional ca ego ies
in he case o he Czech Republic. Men al diseases a e di ided
in o wo g oups: men al diseases ela ed o subs ance use (legal
and illegal d ugs) and men al diseases ela ed o o he ac o s
(demen ia, beha io al synd omes associa ed wi h physiological
dis u bances and physical ac o , beha io al and emo ional
diso de s, e c.). The di e ence in he leng h o sick lea e be ween
occupa ional ca ego ies is supposed, as hose ca ego ies a e
di e en ia ed by he le el o heal h li e acy. Limi ed heal h
li e acy in luences how people ca e abou hei heal h and hei
F on ie s in Public Heal h | www. on ie sin.o g 2June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
heal h p e en ion. The di e ences in he leng h o sick lea e a e
expec ed in he case o men al illnesses caused by addic ions, as
addic ed people a e mo e likely o be in wo king ca ego ies ha
does no need any u he le el o educa ion.
METHODS
This s udy aims o examine he di e ences in he leng h o sick
lea es ela ed o alcoholic and non-alcoholic men al diso de s
and diseases, which is de ined acco ding o In e na ional
S a is ical Classi ica ion o Diseases and Rela ed Heal h P oblems
(ICD-10) as diagnoses F00–F99 (27). In he analysis, da abase
o sick lea es om 2017, co e ing he sick lea es in he Czech
Republic, was used. This da abase includes da a on sick lea e
s a ing om i s day o wo king absence o las day o sick
lea e. In he Czech Republic, pe sons pa icipa ing in he sickness
insu ance a e en i led o sickness cash bene i (dá ka nemoci
o nemocenské) when hey a e empo a ily incapable o wo k
o in qua an ine s a ing om he 14 h day o hei sick lea e.
People who a e eligible o sickness bene i s a e hose who a e
employed o sel -employed o a leas , he ones who pay sickness
insu ance con ibu ion. I mon hly income is highe o equals o
EUR 117.11, i is compulso y by law o pa icipa e in sickness
insu ance. Sickness bene i is gi en by employe om i s o 14 h
day o sick lea e; i he sick lea e is longe han 14 days, hen
sickness bene i is gi en o employee by sickness insu ance. Sel -
employed people a e gi en sickness bene i s a ing om 15 h day
o hei sickness. The e a e he limi s based on which he sickness
bene i is calcula ed. Sickness bene i is calcula ed as 60% o daily
income o he i s 30 days o sickness; 66% o daily income
o he nex 30 days; and 72% o daily income o he days ha
exceeds 61.
In ou analysis, we conside all pe iod o sick lea e ( om
s a ing day o he las day). The diagnose issued on pa ien ’s
ansc ip ion is de e mined based on he examina ion o men al
heal h specialis . Analyzed da a we e p o ided by he Czech
Social Secu i y Adminis a ion as a pa o esea ch p ojec A-
86-19: “Economic Quan i ica ion o Social Cos s o he Use
o Alcohol, Tobacco and Illici D ugs in he Czech Republic,”
app o ed by he E hical Commi ee o he Gene al Uni e si y
Hospi al in P ague. The main aim o his p ojec was o quan i y
he social cos s ela ed o d ug abuse. To u he analyze he
subs ance use p oblem in he Czech Republic, in his a icle, we
dis inguish be ween sick lea e leng h ela ed o subs ance use and
ela ed o o he causes.
As men al diseases a e dange ous mos ly in younge people,
because young people p esen po en ial u u e economic bu den,
we analyzed only sick lea es o people aged up o 29 yea s (6).
Eu os a de ines young adul s as people aged 15–29 yea s (28).
Da abase o sick lea e p o ides de ailed in o ma ion abou each
case o sick lea e such as demog aphic ac o s, diagnosis ela ed
o sick lea e, and ca ego y o pa ien s’ wo k. In his da abase,
he e a e only sick lea e co e ing employees, sel -employed
people, and people paying he social insu ance, and da a on
unemployed people a e missing.
E e y case o sick lea e is he e o e de ined by pa ien ’s:
TABLE 1 | The in e na ional s anda d classi ica ion o occupa ions (31).
N◦Wo k ca ego y
0 A med o ces occupa ions
1 Manage s
2 P o essionals
3 Technicians and associa e p o essionals
4 Cle ical suppo wo ke s
5 Se ices and sales wo ke s
6 Skilled ag icul u al, o es y and ishe y wo ke s
7 C a and ela ed ades wo ke s
8 Plan and machine ope a o s and assemble s
9 Elemen a y occupa ions
•age—calcula ed as he di e ence be ween yea 2017 and he
yea o bi h,
•sex—male, emale,
•diagnosis—co esponding code o diagnosis (acco ding o
ICD−10); i is he diagnosis ha ela e o sick lea e,
•leng h o sick lea e—calcula ed as he di e ence be ween he
end da e and s a da e o sick lea e,
•occupa ions ca ego y— he e a e 10 wo king ca ego ies
(acco ding o wo k classi ica ion CZ–ISCO),
•ID—nume ical code,
•NUTS 3 o employe —NUTS 3 code o place o wo k,
•NUTS 3 o doc o —NUTS 3 code o place o doc o ,
•NUTS 3 o pa ien —NUTS 3 code o place whe e pa ien li es.
The e a e 10 wo k ca ego ies de ined by he CZ-ISCO
classi ica ion o occupa ions (29). Fi s wo king ca ego y p esen s
manage s. Tha posi ion usually equi es highe educa ion. On
he con a y, he las ( he nin h) ca ego y p esen s elemen a y
occupa ions. All occupa ional ca ego ies a e p esen ed in Table 1.
I is supposed ha he wo k ca ego y ha dly ela es o
educa ion, whe eas he le el o educa ion a ained o a la ge
ex en a ec s employabili y and he ype o wo k pe o med.
Nex , compa ed o people wi h lowe educa ion, i is supposed
ha people wi h highe educa ion will ake ca e o hei
heal h mo e wi h emphasis on be e p e en ion. In gene al,
heal h li e acy is highe in people wi h highe educa ion.
On he con a y, people wi h lowe educa ion migh ha e
mo e social p oblems ela ed o addic ion o any kind o
psychical issue, e c. Mo eo e , as lowe educa ed people
a e supposed o ha e lowe heal h li e acy, hei sick lea e
migh be longe ; he e o e, his s udy aims o de e mine he
di e ences in he leng h o sick lea e ac oss di e en wo k ypes
as ollows:
•di e ences in he leng h o sick lea e wi hin di e en men al
diagnose g oup (g oups F10–F19 o g oups F00–F09, F20–
F99).
•di e ences in he leng h o ime ela ed o sick lea e
a ibu able o diagnoses de ined as F10–F19 wi hin di e en
wo k ca ego ies.
•di e ences in he sick lea e leng h a ibu able o diagnoses
de ined as F00–F09, F20–F99 wi hin di e en wo k ca ego ies.
F on ie s in Public Heal h | www. on ie sin.o g 3June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
•pai wise di e ences in case o sick lea e ela ed o F00–
F09, F20–F99.
In gene al, o examine his kind o ela ionship, he
ANOVA, analysis o a iance, is used. Howe e , acco ding
o Shapi o–Wilk es , he assump ion o no mali y was
iola ed. The e o e, K uskal–Wallis and independen samples
Mann–Whi ney U es we e pe o med o examine he
exis ence o di e ences in he du a ion o sick lea e as bo h
a e a non-pa ame ic al e na i es o ANOVA (30,31). The
du a ion o sick lea e, conside ed as dependen a iable,
is no om he no mal dis ibu ion, since he majo i y
o sick lea es ook sho e pe iod o ime. The e o e, he
dis ibu ion is skewed o he igh . B own–Fo sy he (B–F)
was used o es an assump ion o equal a iances ha was
no iola ed.
Acco ding o ou assump ions, he es ed hypo heses a e
as ollows:
•H1: The e is he di e ence in he leng h o sick lea e
compa ing men al diagnoses caused by subs ances (diagnoses
F10–F19 acco ding o ICD−10) and men al diagnoses caused
by o he issues (F00–F09, F20–F99 acco ding o ICD−10).
•H2: Compa ing di e en wo king ca ego ies, he e is he
di e ence in median o leng h o sick lea es ela ed o
subs ance use (F10–F19).
•H3: Compa ing di e en wo king ca ego ies, he e is he
di e ence in median o leng h o sick lea es ela ed o o he
issues (F00–F09, F20–F99).
•H4: Sample 1 and Sample 2 dis ibu ions a e he same.
The design and ealiza ion o he s udy we e app o ed by he
e hics commi ee o he Gene al Uni e si y Hospi al in P ague
as indi idual esea ch ( e . 915/20 S–IV).
RESULTS
Fi s , we di ided all cases o sick lea e ela ed o men al diso de
in o wo g oups, and hen, we examined he di e ences wi hin
bo h g oups by using independen samples Mann–Whi ney U
es . The Mann–Whi ney U es was selec ed as he dependen
a iable (leng h o sick lea e) is no om no mal dis ibu ion,
and we compa e only wo g oups. Those g oups a e as ollows:
•men al diso de s/diagnoses ela ed o he consump ion o
subs ance (alcohol, obacco, illegal d ugs), he e o e he
diagnoses—de ined by ICD−10 as F10–F19;
•men al diso de s/diagnoses ela ed o o he causes—de ined
by ICD−10 as F00–F09 and F20–F99.
The i s pa o analy ical p ocesses consis s o de e mining
desc ip i e s a is ics o he a iable leng h o sick lea e,
p esen ed in Table 1 in ela ion o i s hypo hesis:
H1: The e is a di e ence in he leng h o sick lea e compa ing
men al diagnoses caused by subs ances (diagnoses F10–F19
acco ding o ICD–10) and men al diagnoses caused by o he issues
(F00–F09, F20–F99 acco ding o ICD–10).
The p- alue was es ima ed a 0.0001; he e o e, we ejec
he null hypo hesis in a o o he al e na i e hypo hesis a
TABLE 2 | Independen -samples Mann–Whi ney U es Summa y: he leng h o
sick lea e ela ed o men al diso de caused by d ugs (alcohol, obacco, illici
d ugs) and o he condi ions, in he s udy sample o young adul s aged 15–29
yea s, he Czech Republic, 2017.
Type Value
To al N5,981
Mann-Whi ney U 1015174,000
Wilcoxon W 16508135,000
Tes s a is ic 1015174,000
S anda d e o 33925,690
S anda dized es s a is ic −4,120
Asymp o ic Sig. (2-sided es ) <0.001
TABLE 3 | K uskal–Wallis es esul s: he leng h o sick lea e ela ed o men al
illnesses caused by d ugs (alcohol, obacco, illici d ugs), in he s udy sample o
young adul s aged 15–29 yea s, he Czech Republic, 2017.
Wo k ca ego y NRank sum Mean ank
F10–F19: he leng h o
sick lea e by wo k
ca ego ies
0 12 3258.5 271.54
1 5 1173.5 234.70
2 5 1168.5 233.70
3 26 4941.0 190.04
4 20 4067.0 203.35
5 91 19626.0 215.67
6 5 589.5 117.90
7 167 35652.5 213.49
8 35 6884.5 196.70
9 49 8959.0 182.84
K uskal–Wallis es
de ails
H s a is ic 10.47
X²app oxima ion 10.47
DF 9
p- alue 0.3136
he 5% signi icance le el. Acco ding o p- alue, he e a e
he di e ences in dis ibu ion o he leng h be ween men al
diagnoses a ibu able o subs ance use (F10–F19) and o he
ypes o men al diseases (F00–F09, F20–F99). As s a ed in
Table 2, leng h o sick lea e ela ed o men al disease F10–F19
di e s om he leng h o sick lea e ela ed o men al disease
F00–F09, F20–F99.
Men al diso de s ca ego y: F10–F19 (N=415) has a la ge
mean ank 3, 327, 8 han men al diso de ca ego y ela ed o
o he causes (N=5 566) wi h mean ank (2 965,89) and hus
ends o ake la ge alues. A s a is ically signi ican di e ence
was ound (U =1,015,174, p<0.001).
Nex , we pe o med K uskal–Wallis H es o es he
second hypo hesis:
H2: Compa ing di e en wo king ca ego ies, he e is a di e ence
in he median o leng h o sick lea es ela ed o subs ance use (F10–
F19).
F on ie s in Public Heal h | www. on ie sin.o g 4June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
As p esen ed in Table 3, he p- alue was es ima ed a 0.3136;
he e o e, we do no ejec he null hypo hesis in a o o he
al e na i e hypo hesis a he 5% signi icance le el. Acco ding o
p- alue, he e a e no di e ences in he median o he leng h
be ween sepa a e wo king ca ego ies.
As opposed o ou assump ion H2, in he case o men al
illnesses a ibu able o excessi e use o alcohol, illegal d ugs,
o smoking, he e a e no di e ences in he du a ion o sick
lea e. Ou assump ion o a longe du a ion o sick lea e
in case o people wi h lowe le el o educa ion has no
been con i med.
TABLE 4 | K uskal–Wallis es esul s: he leng h o sick lea e ela ed o men al
illnesses caused by o he condi ions, in he s udy sample o young adul s aged
15–29 yea s, he Czech Republic, 2017.
Wo k ca ego y NRank sum Mean ank
F00–F09,
F20–F99: he
leng h o sick lea e
(in days) by wo k
ca ego ies
0 397 1052902.0 2652.15
1 79 252820.0 3200.25
2 80 216649.0 2708.11
3 562 1582469.5 2815.78
4 555 1588038.0 2861.33
5 1,327 3780646.5 2849.02
6 37 96767.0 2615.32
7 1,556 4350593.0 2796.01
8 455 1168787.0 2568.76
9 518 1403289.0 2709.05
K uskal-Wallis es
de ails
H s a is ic 21.62
X²app oxima ion 21.62
DF 9
p- alue 0.0101
H3: Compa ing di e en wo king ca ego ies, he e is a di e ence
in median o leng h o sick lea es ela ed o o he issues (F00–
F09, F20–F99).
Acco ding o esul s in Table 4, he p- alue was es ima ed a
0.0101; he e o e, we ejec he null hypo hesis in a o o he
al e na i e hypo hesis a he 5% signi icance le el. Acco ding o
p- alue, he e a e he di e ences in median o he leng h be ween
men al diagnoses a ibu able o o he issues (F00–F09, F20–
F99).
In he case o men al illnesses F00–F09, F20–F99, we ound
he di e ences in he leng h o sick lea e wi hin di e en wo k
ca ego ies. As he e a e di e ences wi hin he ype o men al
disease ( ela ed o subs ance use o no ela ed o subs ance use)
and di e ences among occupa ional g oups, we compa ed he
a e age leng h o sick lea e be ween men and women in ega d o
ICD−10 g oups, shown in Table 5. The e o e, Table 5 shows he
a e age leng h o sick lea e in ega d o men al disease in ega d
o ICD−10 classi ica ion and gende . As i may be seen, in he
case o men, he g ea e a e age leng h o sick lea e is ela ed o
in ellec ual disabili y (g oup F70–F79), amoun ed a 85.63. On
he con a y, beha io al synd omes associa ed wi h physiological
dis u bances and physical ac o s a e ela ed o sick lea e wi h
he sho es a e age du a ion amoun ed a 20.17 days on a e age.
In he case o women, he longes a e age sick lea e is ela ed
o o ganic, including symp oma ic, men al diso de s (F00–F09)
amoun ed a 53.11 days on a e age. Neu o ic, s ess- ela ed, and
soma o o m diso de s (F40–F49), amoun ed a 30.89 days on
a e age, a e ela ed o sho es du a ion o sick lea e.
H4: Sample 1 and Sample 2 dis ibu ions a e he same.
Based on he cu en esul s, i is e iden ha he e a e
di e ences in leng h o sick lea e be ween di e en occupa ional
ca ego y in bo h Sample 1 and Sample 2. The esul s a e p esen ed
in Table 6.
In ou u he analysis, we es ed he null hypo hesis ha he
Sample 1 and Sample 2 dis ibu ions a e he same, whe eas hose
samples p esen he wo k ca ego y. K uskal–Wallis es p o ided
e y s ong e idence o a di e ence (p<0.001) be ween he
mean anks o a leas one pai o g oups. The e was e y s ong
TABLE 5 | Desc ip i e s a is ics: he a e age leng h o sick lea e in he s udy sample o young adul s aged 15–29 yea s, acco ding o In e na ional S a is ical
Classi ica ion o Diseases and Rela ed Heal h P oblems, e sion 10, he Czech Republic, 2017.
ICD−10 ICD−10 desc ip ion A e age leng h o sick lea e
Men Women
F40–F49 Neu o ic, s ess- ela ed and soma o o m diso de s 26.87 30.89
F30–F39 Mood [a ec i e] diso de s 35.32 37.37
F20–F29 Schizoph enia, schizo ypal and delusional diso de s 68.30 52.59
F60–F69 Diso de s o adul pe sonali y and beha io 44.64 51.38
F10–F19 Men al and beha io al diso de s due o psychoac i e subs ance use 44.86 43.30
F50–F59 Beha io al synd omes associa ed wi h physiological dis u bances and physical ac o s 20.17 44.57
F00–F09 O ganic, including symp oma ic, men al diso de s 36.79 53.11
F70–F79 In ellec ual disabili y 85.63 36.63
F90–F99 Beha io al and emo ional diso de s wi h onse usually occu ing in childhood and adolescence, unspeci ied
men al diso de
45.19 38.36
F80–F89 Diso de s o psychological de elopmen 66.20 38.50
The bold alues indica es ha ou o all diagnoses, only men al illnesses a e conside ed in his a icle.
F on ie s in Public Heal h | www. on ie sin.o g 5June 2022 | Volume 10 | A icle 882707

Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
TABLE 6 | Pai wise compa isons: he a e age leng h o sick lea e in he s udy sample o young adul s aged 15–29 yea s, acco ding o In e na ional S a is ical
Classi ica ion o Diseases and Rela ed Heal h P oblems, e sion 10, he Czech Republic, 2017.
Sample 1–Sample 2 Sig. Adj. Sig.a
Plan and machine ope a o s and assemble s–P o essionals 0.986 1.000
Plan and machine ope a o s and assemble s–Elemen a y occupa ions 0.281 1.000
Plan and machine ope a o s and assemble s–A med o ces occupa ions 0.392 1.000
Plan and machine ope a o s and assemble s–Technicians and associa e p o essionals 0.082 1.000
Plan and machine ope a o s and assemble s–C a and ela ed ades wo ke s 0.066 1.000
Plan and machine ope a o s and assemble s–Se ices and sales wo ke s 0.013 0.580
Plan and machine ope a o s and assemble s–Cle ical suppo wo ke s <0.001 0.000
Plan and machine ope a o s and assemble s–Skilled ag icul u al, o es y, and ishe y wo ke s 0.289 1.000
Plan and machine ope a o s and assemble s–Manage s <0.001 0.000
A med o ces occupa ions–P o essionals 0.853 1.000
A med o ces occupa ions–Elemen a y occupa ions 0.960 1.000
A med o ces occupa ions–Technicians and associa e p o essionals 0.577 1.000
A med o ces occupa ions–C a and ela ed ades wo ke s 0.463 1.000
A med o ces occupa ions–Cle ical suppo wo ke s 0.025 1.000
A med o ces occupa ions–Se ices and sales wo ke s 0.059 1.000
A med o ces occupa ions–Skilled ag icul u al, o es y and ishe y wo ke s 0.546 1.000
P o essionals–Manage s 0.096 1.000
Elemen a y occupa ions–Manage s <0.001 0.000
P o essionals–Elemen a y occupa ions 0.872 1.000
P o essionals–C a and ela ed ades wo ke s 0.884 1.000
P o essionals–Technicians and associa e p o essionals 0.858 1.000
P o essionals–Cle ical suppo wo ke s 0.581 1.000
P o essionals–Se ices and sales wo ke s 0.654 1.000
P o essionals–Skilled ag icul u al, o es y and ishe y wo ke s 0.794 1.000
Elemen a y occupa ions–Technicians and associa e p o essionals 0.358 1.000
Elemen a y occupa ions–Se ices and sales wo ke s 0.028 1.000
Elemen a y occupa ions–Cle ical suppo wo ke s 0.025 1.000
Elemen a y occupa ions–Skilled ag icul u al, o es y and ishe y wo ke s 0.555 1.000
A med o ces occupa ions–Manage s 0.015 0.693
Elemen a y occupa ions–C a and ela ed ades wo ke s 0.233 1.000
C a and ela ed ades wo ke s–Cle ical suppo wo ke s 0.065 0.089
C a and ela ed ades wo ke s–Se ices and sales wo ke s 0.162 1.000
Technicians and associa e p o essionals–C a and ela ed ades wo ke s 0.925 1.000
Technicians and associa e p o essionals–Se ices and sales wo ke s 0.406 1.000
Technicians and associa e p o essionals–Skilled ag icul u al, o es y and ishe y wo ke s 0.776 1.000
Technicians and associa e p o essionals–Manage s 0.040 1.000
C a and ela ed ades wo ke s–Manage s 0.026 0.765
Technicians and associa e p o essionals–Cle ical suppo wo ke s 0.495 1.000
C a and ela ed ades wo ke s–Skilled ag icul u al, o es y and ishe y wo ke s 0.793 1.000
Cle ical suppo wo ke s–Se ices and sales wo ke s 0.776 1.000
Cle ical suppo wo ke s–Skilled ag icul u al, o es y and ishe y wo ke s 0.832 1.000
Se ices and sales wo ke s–Skilled ag icul u al, o es y and ishe y wo ke s 0.762 1.000
Se ices and sales wo ke s–Manage s 0.105 1.000
Cle ical suppo wo ke s–Manage s 0.092 1.000
Skilled ag icul u al, o es y and ishe y wo ke s–Manage s 0.842 1.000
The bold alues indica es he mos signi ican alues.
e idence (p<0.001, adjus ed using he Bon e oni co ec ion
o mul iple es s) o a di e ence be ween plan and machine
ope a o s and assemble s s. cle ical suppo wo ke s, plan and
machine ope a o s and assemble s s. manage s, and elemen a y
occupa ions s. manage s. The e was no e idence o a di e ence
be ween he o he pai s.
F on ie s in Public Heal h | www. on ie sin.o g 6June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
DISCUSSION
Men al illnesses p esen se ious heal h issues accompanied by
a ious symp oms ha nega i ely a ec a pe son’s beha io ,
emo ional s a e, hough s, and cogni i e abili ies. Many non-
communicable diseases, leading o high social bu dens, a e
associa ed wi h obesi y, ela ed pa hologies, diabe es, high
choles e ol, ca dio ascula p oblems, men al diseases, e c. (32).
Men al illnesses ake many o ms, om mild dep ession, anxie y
o se e e dep ession, and psychosis. Robe s & G imes, Hewle
e al., and Pa el e al. s a e ha men al illnesses can ha e a sho
e m bu also a ch onic o m and a ec he en i e popula ion o
coun ies. The di e en ia ion o age and gende o hese mild
as well as se ious ch onic men al diseases is p o en (33–35).
As s a ed in he p e ious s udies o Song e al. and McDaid
e al., he impo ance o sol ing he p oblem o men al illness
o he popula ion a ises om heal h and economic aspec s.
Conside ing heal h, men al illnesses a e o en associa ed wi h
a highe incidence o au oimmune diseases and wo sen he
ea men o hese diseases o como bidi ies (36,37). People wi h
se e e men al illness li e on a e age 20 yea s sho e , and gene al
men al heal h p oblems sho en li e expec ancy by up o 7.5 yea s
(32,33). F om an economic poin o iew, imp o ing men al
heal h has a posi i e impac on employmen and p oduc i i y
o he economy, i educes social expendi u es, because heal hy
people ha e a highe abili y and p econdi ions o wo k e icien ly.
Psychia ic pa ien s ha e a g ea e isk o p ema u e all-cause
mo ali y han he gene al popula ion. Epidemiological s udies
show ha he li e expec ancy o pa ien s wi h majo psychia ic
diso de s is educed by 7 o 24 yea s. Indeed, he ca dio ascula
disease (CVD) isk bu also ha o he ela ed como bidi ies
o diabe es, s oke, and obesi y has p o en o be signi ican ly
inc eased in a mul i ude o psychia ic condi ions, including
dep ession, schizoph enia, bipola diso de (BD), and anxie y
diso de (34,36).
Young people ace s ess ul si ua ions ha in luence hei
men al heal h. Mi chell e al. and Bi n e al. con i med ha
young adul s a e a high isk o de eloping men al disease
and beha io al diso de s as psychic o young people is no
ully o med (2,3). This migh educe hei abili y o wo k
and he e o e be wholly economically ac i e and con ibu e
o na ional GDP. Men al diso de in younge people migh
nega i ely in luence hei abili y o ind wo k, o gain good social
s a us, and o become economically independen . I any kind o
disease sp ead ou in younge age, he economic bu den o his
pe son is highe as he yea s li ing wi h disabili y inc ease. In
he case o men al illness, i is necessa y o dis inguish whe he
he illness has b oken ou as a esul o subs ance abuse o is
a di e en ype o disease; he e o e, men al diso de s migh be
di ided in o wo g oups: men al diseases a ibu able o subs ance
use (F10–F19) and men al diseases no a ibu able o subs ance
use (F00–F09, F20–F99).
Gene ally, men al diso de s occu in people who ha e long-
e m p oblems caused by social and psychological ac o s,
e c. Acco ding o Liu e al., Wi ink and Oos e ha en, and
Duplaga, he g ea p oblem is people wi h limi ed heal h
li e acy, mos ly people wi h lowe educa ion (14,15,17).
I is necessa y o c ea e app op ia e policy ha deals wi h
he p oblem o social inequali y, di e en ypes o access o
educa ion and disad an aged condi ions in which a young
pe son migh g ow up. People wi h highe educa ion (such as
manage s, p o essionals, echnicians, and associa e p o essionals)
a e supposed o ha e be e access o heal h ca e as hey
p esumably ca e abou hei heal h and p e en ion mo e. This
was con i med in ou pai wise analysis which shows ha he e a e
di e ences be ween manage s (supposed o be highe educa ed,
o ca e mo e abou hei heal hca e) and plan and machine
ope a o s and assemble s (supposed o be opposi e o manage s).
On he con a y, people who ha e only p ima y educa ion
o a e no educa ed a all do no usually ca e abou hei
heal h as much as educa ed people. The social s a us o lowe
educa ed people migh be wo se and hei heal h li e acy is lowe
oo. The e o e, as s a ed by Duplaga, Ca od-A al, and Zheng
e al., heal hca e o people, who do no ca e abou hei heal h,
p e en ion, and heal hie li e, migh be mo e complica ed, longe ,
and mo e expensi e (17–19). As he heal h sys em o Czech
Republic is based on Bisma ck model o heal h ca e, longe heal h
p oblems ela ed o longe sick lea e will inc ease he expenses
o s a e. Acco ding o many p e ious s udies, i is supposed ha
he leng h o sick lea e will be in luenced by he social s a us and
ela ed wo k ca ego y (6,8,9).
Fi s , we examined he di e ences in he leng h o sick lea e
in people wi h addic ion, he e o e people wi h sick lea e ela ed
o diagnoses F10–F19. This assump ion was no con i med as he
leng h o sick lea e was highe in people wi h men al diso de
a ibu able o o he issues such as demen ia in Alzheime ’s
disease, schizoph enia, and bipola e ec i e diso de , e c. As i
is seen in Table 5, in case o bo h women and men, he a e age
leng h o sick lea e ela ed o men al diseases caused by subs ance
use is he i h longes . In case o women, i is 43.3 days on a e age
and in case o men, i is 44.86 days on a e age.
P e ious s udies con i m a ela ionship be ween lowe
educa ion and a highe incidence o men al diseases (37–
39). We supposed ha people in occupa ional ca ego ies 9
(elemen a y occupa ions), 8 (plan and machine ope a o s
and assemble s), 7 (c a and ela ed ades wo ke s), and
6 (skilled ag icul u al, o es y, and ishe y wo ke s) ha e
p esumably lowe educa ion and will be mo e endange ed
by men al diseases ela ed o addic ion. Thus, we examined
he exis ence o di e ence in median in he leng h o sick
lea e. Howe e , his assump ion was no con i med. The e o e,
we do no ha e enough e idence o con i m ha leng h o
sick lea e, in people who ha e men al disease a ibu able
o subs ance use, a ies om one occupa ional ca ego y
o ano he .
Conside ing men al diso de s o beha io al issues ha a e
no ela ed o subs ance use (F00–F09 and F20–F99), ou las
assump ion was ha he e is a di e ence in leng h o sick lea e
among di e en occupa ional ca ego ies. To make he analysis
mo e de ailed, we did he pai wise compa ison o ge o know
exac ly wha kind o occupa ional ca ego ies a e s a is ically
signi ican om o he g oups.
F on ie s in Public Heal h | www. on ie sin.o g 7June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
The e a e many ac o s ha in luence he ou b eak o men al
disease and associa ed sick lea e. Ca od-A al s a es ha he e
a e di e ences in mo bidi y ela ed o men al diseases among
men and women (18). I is con i med by ou indings, which
show ha he a e age numbe o days o sickness lea e ela ed o
men al illness is highe o men compa ed o women. This is he
impo an in o ma ion o he policymake s. Fu he mo e, based
on ou esul s, conside ing only he men al diso de s ela ed o
subs ances, he e is no di e ence in wo king ca ego ies among
young people wi h di e en le els o educa ion. This may esul
om he ac ha people who ha e some kinds o men al diso de
a ibu able o addic ion a e p esen ed in all wo king ca ego ies,
o leng h o hei sick lea e is simila (40,41). Thus, he addic ion
does no seem o be ela ed o di e en occupa ional ca ego ies.
As ou s udy shows, i is impo an o examine he di e ences
in mo bidi y a ibu able o men al diseases and beha io al
diso de s. I is impo an o iden i y and moni o ac o s ha
can be a majo cause o an ou b eak o men al illness, especially
in people wi h lowe educa ion. These people a e mo e a isk
o disease’s ou b eak because hei heal h li e acy is lowe . The
employmen o a pa icula pe son can be he esul o se e al
ac o s. Thus, he key ac o in employmen is he educa ional
le el and ype (42,43).
Fu he mo e, nowadays, people a e wo king unde p essu e,
a wo k because o highe demands o employe s (19). The
sociocul u al en i onmen , poli ical egula ions, and public
heal h s a egies a y conside ably among coun ies (44).
The e o e, when se ing heal h policies, i is necessa y o pe o m
he analyses ha de ine ulne able g oups o he popula ion
in mo e de ail aking in o accoun also he di e ences in he
occupa ional g oups. In he case o men al illnesses ha a e
no associa ed wi h he use o alcohol, obacco, o illici d ugs,
he e a e no di e ences in he du a ion o sick lea e be ween
people in indi idual occupa ional ca ego ies. On he con a y,
he di e ence is e iden in people wi h se e al men al diagnoses
ha a e no a ibu able o subs ance use. Limi a ion o his
s udy is he impossibili y o compa ison o o he coun ies
as ou analysis is based on he da a wi h speci ic s uc u e.
Da a access o such a da a in o he coun ies may be limi ed
by legisla ion. As he social sys em o coun ies migh be
di e en , his kind o da a migh exis in di e en s uc u es
o migh no exis a all. Fu he analysis migh be p o ided
wi h he main aim o show which occupa ions a e di e en om
he o he s.
DATA AVAILABILITY STATEMENT
The da a analyzed in his s udy is subjec o he ollowing
licenses/ es ic ions: This esea ch was suppo ed by he In e nal
G an Agency o FaME Tomas Ba a Uni e si y in Zlin:
RVO/2022. Reques s o access hese da ase s should be di ec ed
o ga[email p o ec ed].
ETHICS STATEMENT
E hical e iew and app o al was no equi ed o he s udy
on human pa icipan s in acco dance wi h he local legisla ion
and ins i u ional equi emen s. W i en in o med consen
om he pa icipan s was no equi ed o pa icipa e in his
s udy in acco dance wi h he na ional legisla ion and he
ins i u ional equi emen s.
AUTHOR CONTRIBUTIONS
BG: concep ualiza ion, alida ion, in es iga ion, and p ojec
adminis a ion. MT: me hodology, o mal analysis, and esou ces
and da a cu a ion. BG and MT: w i ing—o iginal d a
p epa a ion and w i ing— e iew and edi ing. All au ho s
con ibu ed o he a icle and app o ed he submi ed e sion.
FUNDING
This wo k was suppo ed by In e nal G an Agency o FaME
Tomas Ba a Uni e si y in Zlin: RO/2022: Use o co po a e social
esponsibili y in he hospi alisa ion sec o in he Czech Republic
and he Slo ak Republic o inc ease e iciency and sus ainabili y
o he heal h sys ems and he Slo ak Resea ch and De elopmen
Agency: Con ac No. APVV-17-0360: Mul idimensional analysis
o signi ican de e minan s o public p ocu emen e iciency wi h
emphasis on he applica ion o Heal h Technology Assessmen in
he p ocu emen p epa a ion phase.
REFERENCES
1. McMahon G, C ea en A-M, Gallaghe S. S ess ul li e e en s and adolescen
well-being: he ole o pa en and pee ela ionships. S ess Heal h. (2020)
36:299–310. doi: 10.1002/smi.2923
2. Mi chell C, McMillan B, Hagan T. Men al heal h help-seeking beha iou s in
young adul s. B J Gen P ac . (2017) 67:8–9. doi: 10.3399/bjgp17X688453
3. Bi n RM, Roebe BJ, Pollak SD. Ea ly childhood s ess exposu e,
ewa d pa hways, and adul decision making. PNAS. (2017) 114:13549–
54. doi: 10.1073/pnas.1708791114
4. James SL, Aba e D, Aba e KH, Abay SM, Abba a i C, Abbasi N, e al. Global,
egional, and na ional incidence, p e alence, and yea s li ed wi h disabili y
o 354 diseases and inju ies o 195 coun ies and e i o ies, 1990–2017:
a sys ema ic analysis o he Global Bu den o Disease S udy 2017. Lance .
(2018) 392:1789–858. doi: 10.1016/S0140-6736(18)32279-7
5. Chand a PS, Chand P. Towa ds a new e a o men al heal h. Lance . (2018)
392:1495–7. doi: 10.1016/S0140-6736(18)32272-4
6. Ma he L, Na usy e J, Ropponen A, Be gs öm G, Blom V, Helgadó i B, e
al. Sick lea e due o men al diso de s, mo bidi y and mo ali y: a p ospec i e
s udy o disco dan win pai s. Soc Psychia y Psychia Epidemiol. (2020)
55:25–32. doi: 10.1007/s00127-019-01715-9
7. Salomonsson S, Hedman-Lage lö E, Ös L-G. Sickness absence: a sys ema ic
e iew and me a-analysis o psychological ea men s o indi iduals on
sick lea e due o common men al diso de s. Psychol Med. (2018) 48:1954–
65. doi: 10.1017/S0033291718000065
8. Ma he L, Blom V, Be gs öm G, S edbe g P. Ad e se ou comes o sick lea e
due o men al diso de s: a p ospec i e s udy o disco dan win pai s. Scand J
Public Heal h. (2019) 47:127–36. doi: 10.1177/1403494817735755
9. Lidwall U, Bill S, Palme E, Olsson Bohlin C. Men al diso de
sick lea e in Sweden: a popula ion s udy. Wo k. (2018) 59:259–
72. doi: 10.3233/WOR-172672
10. Lima F, Sims S, O’Donnell M. Ha m ul d inking is associa ed wi h men al
heal h condi ions and o he isk beha iou s in Aus alian young people. Aus
N Z J Public Heal h. (2020) 44:201–7. doi: 10.1111/1753-6405.12978
F on ie s in Public Heal h | www. on ie sin.o g 8June 2022 | Volume 10 | A icle 882707
Ga u o a and Ta hanico a Men al Illnesses o Young Adul s
11. Ami i S, Behnezhad S. Alcohol consump ion and sick lea e: a me a-analysis. J
Addic Dis. (2020) 38:100–12. doi: 10.1080/10550887.2020.1724606
12. Malla A, Shah J, Iye S, Boksa P, Joobe R, Ande sson N, e al. You h men al
heal h should be a op p io i y o heal h ca e in Canada. Can J Psychia y.
(2018) 63:216–22. doi: 10.1177/0706743718758968
13. Tay JL, Tay YF, Klainin-Yobas P. Men al heal h li e acy le els. A ch Psychia
Nu s. (2018) 32:757–63. doi: 10.1016/j.apnu.2018.04.007
14. Liu H, Zeng H, Shen Y, Zhang F, Sha ma M, Lai W, e al. Assessmen ools
o heal h li e acy among he gene al popula ion: a sys ema ic e iew. In J
En i on Res Public Heal h. (2018) 15:1711. doi: 10.3390/ije ph15081711
15. Wi ink H, Oos e ha en J. Pa ien educa ion and heal h li e acy. Musculoskele
Sci P ac . (2018) 38:120–7. doi: 10.1016/j.msksp.2018.06.004
16. Flea y SA, Joseph P, Pappagianopoulos JE. Adolescen heal h li e acy
and heal h beha io s: a sys ema ic e iew. J Adolesc. (2018) 62:116–
27. doi: 10.1016/j.adolescence.2017.11.010
17. Duplaga M. De e minan s and consequences o limi ed heal h
li e acy in polish socie y. In J En i on Res Public Heal h. (2020)
17:642. doi: 10.3390/ije ph17020642
18. Ca od-A al FJ. Social de e minan s o men al heal h. In: Bäh e -Kohle S,
Ca od-A al FJ, edi o s. Global Men al Heal h : P e en ion and P omo ion.
Cham: Sp inge In e na ional Publishing (2017) p. 33–46.
19. Zheng M, Jin H, Shi N, Duan C, Wang D, Yu X, e al. The ela ionship
be ween heal h li e acy and quali y o li e: a sys ema ic e iew and me a-
analysis. Heal h Qual Li e Ou comes. (2018) 16:201. doi: 10.1186/s12955-018-
1031-7
20. B öde J, Okan O, Baue U, Schlupp S, Pinhei o P. Ad ancing pe spec i es
on heal h li e acy in childhood and you h. Heal h P omo In . (2020) 35:575–
85. doi: 10.1093/heap o/daz041
21. Milne A, Blakely T, Disney G, Ka anagh AM, LaMon agne AD, Ai ken Z. Do
employmen ac o s educe he e ec o low educa ion on men al heal h? A
causal media ion analysis using a na ional panel s udy. In J Epidemiol. (2018)
47:1423–31. doi: 10.1093/ije/dyy128
22. Wal e s R, Leslie SJ, Polson R, Cusack T, Go ely T. Es ablishing he e icacy o
in e en ions o imp o e heal h li e acy and heal h beha iou s: a sys ema ic
e iew. BMC Public Heal h. (2020) 20:1040. doi: 10.1186/s12889-020-08991-0
23. Sukys S, Cesnai iene VJ, Ossowsky ZM. Is heal h educa ion a
uni e si y associa ed wi h s uden s’ heal h li e acy? E idence om
c oss-sec ional s udy applying HLS-EU-Q. BioMed Res In . (2017)
2017:e8516843. doi: 10.1155/2017/8516843
24. Uysal N, Ceylan E, Koç A. Heal h li e acy le el and in luencing ac o s
in uni e si y s uden s. Heal h Soc Ca e Communi y. (2020) 28:505–
11. doi: 10.1111/hsc.12883
25. Ku che S, Wei Y, Coniglio C. Men al heal h li e acy: pas , p esen , and u u e.
Can J Psychia y. (2016) 61:154–8. doi: 10.1177/0706743715616609
26. Fu nham A, Swami V. Men al heal h li e acy: a e iew o wha i is and why i
ma e s. In Pe spec Psychol. (2018) 7:240–57. doi: 10.1037/ipp0000094
27. Wo ld Heal h O ganiza ion. ICD-10. A ailable online a : h ps://icd.who.in /
b owse10/2010/en (accessed May 3, 2021).
28. Eu opean Commission, Eu os a . Being Young in Eu ope Today: 2015
Edi ion. Publica ions O ice (2015). A ailable online a : h ps://da a.eu opa.eu/
(accessed May 7, 2021). doi: 10.2785/59267
29. Czech S a is ical O ice. Classi ica ion o Occupa ions ISCO (CZ-ISCO).
A ailable online a : h ps://www.czso.cz/csu/czso/klasi ikace_zames nani_-
cz_isco- (accessed May 3, 2021).
30. Hen iques C, Ma os A, Mal a M, Ba kiene E, Djeki´
c I, Ta cea
M, e al. Ma ke ing mo i a ions in luencing ood choice in 16
coun ies: segmen a ion and clus e analysis. Insigh s Reg De . (2022)
4:10–25. doi: 10.9770/IRD.2022.4.1(1)
31. Leon AC. 3.12 - Desc ip i e and in e en ial s a is ics. In: Bellack AS, He sen
M, edi o s. Comp ehensi e Clinical Psychology. Ox o d: Pe gamon (1998).
p. 243–85. A ailable online a : h ps://www.sciencedi ec .com/science/a icle/
pii/B0080427073002649 (accessed May 3, 2021).
32. Gau hie TD, Hawley ME. Chap e 5 - s a is ical me hods. In: Mu phy BL,
Mo ison RD, edi o s. In oduc ion o En i onmen al Fo ensics. 3 d ed. San
Diego, CA: Academic P ess (2015). p. 99–148. A ailable online a : h ps://
www.sciencedi ec .com/science/a icle/pii/B978012404696200005
33. Re u n on In es men —Men al Heal h P omo ion and Men al Illness
P e en ion. A ailable online a : h p:// ead.chcm.ubc.ca/2011/10/04/ e u n-
on-in es men -men al-heal h-p omo ion-and-men al-illness-p e en ion/
(accessed May 18, 2021).
34. Hewle S, Amble N, Almeida C, Cliss A, Hammond A, Ki chen K, e al.
Sel -managemen o a igue in heuma oid a h i is: a andomised con olled
ial o g oup cogni i e-beha iou al he apy. Ann Rheum Dis. (2011) 70:1060–
7. doi: 10.1136/a d.2010.144691
35. Pa el V, Saxena S, F ankish H, Boyce N. Sus ainable de elopmen and
global men al heal h—a Lance Commission. Lance . (2016) 387:1143–
5. doi: 10.1016/S0140-6736(16)00208-7
36. McDaid D, Hewle E, Pa k A-L. Unde s anding E ec i e App oaches
o P omo ing Men al Heal h and P e en ing Men al Illness. (2017).
A ailable online a : h ps://www.oecd-ilib a y.o g/con en /pape /bc364 b2-
en (accessed Janua y 21, 2022).
37. Song H, Fang F, Tomasson G, A nbe g FK, Ma aix-Cols D, Fe nández de.
la C uz L, e al. Associa ion o s ess- ela ed diso de s wi h subsequen
au oimmune disease. JAMA. (2018) 319:2388. doi: 10.1001/jama.2018.
7028
38. Hiles SA, Ré ész D, Lame s F, Gil ay E, Penninx BWJH. Bidi ec ional
p ospec i e associa ions o me abolic synd ome componen s wi h
dep ession, anxie y, and an idep essan use. Dep ess Anxie y. (2016)
33:754–64. doi: 10.1002/da.22512
39. Mo ei a FP, Jansen K, Ca doso T de A, Mondin TC, Magalhães
PV da S, Kapczinski F, e al. Me abolic synd ome in subjec s wi h
bipola diso de and majo dep essi e diso de in a cu en dep essi e
episode: popula ion-based s udy: me abolic synd ome in cu en dep essi e
episode. J Psychia Res. (2017) 92:119–23. doi: 10.1016/j.jpsychi es.2017.
03.025
40. Rolo a G, Ga u o a B, Pe uzelka B. Explo ing heal h li e acy in indi iduals
wi h alcohol addic ion: a mixed me hods clinical s udy. In J En i on Res
Public Heal h. (2020) 17:6728. doi: 10.3390/ije ph17186728
41. Rolo a G, Ga u o a B, Pe uzelka B. Heal h li e acy, sel -pe cei ed
heal h, and subs ance use beha io among young people wi h alcohol
and subs ance use diso de s. In J En i on Res Public Heal h. (2021)
18:4337. doi: 10.3390/ije ph18084337
42. Šlepecký M, Cla k DM, Še a o á I, P aško J. Za ko á, Popelko á M, e al.
The ole o e ec i e ea men o men al illness in he igh agains po e y.
Ceskoslo enská Psychol. (2019) 63:67–79.
43. Ahmad S, Iqbal T. The ole o managemen commi men in adop ion
o occupa ional heal h and sa e y a highe educa ion ins i u ions.
En ep eneu ship Sus ain Issues. (2022) 9:103–17. doi: 10.9770/jesi.2022.9.3(7)
44. Vancamp o D, S ubbs B, Mi chell AJ, He MD, Wampe s M, Wa d PB,
e al. Risk o me abolic synd ome and i s componen s in people wi h
schizoph enia and ela ed psycho ic diso de s, bipola diso de and majo
dep essi e diso de : a sys ema ic e iew and me a-analysis. Wo ld Psychia y.
(2015) 14:339–47. doi: 10.1002/wps.20252
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