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Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants

  • Katrina A. S. Davis (a1), Jonathan R. I. Coleman (a1), Mark Adams (a2), Naomi Allen (a3), Gerome Breen (a4), Breda Cullen (a5), Chris Dickens (a6), Elaine Fox (a7), Nick Graham (a8), Jo Holliday (a3), Louise M. Howard (a9), Ann John (a10), William Lee (a11), Rose McCabe (a12), Andrew McIntosh (a2), Robert Pearsall (a8), Daniel J. Smith (a8), Cathie Sudlow (a13), Joey Ward (a8), Stan Zammit (a14) and Matthew Hotopf (a15)...
  • Please note a correction has been issued for this article.
Abstract
Background

UK Biobank is a well-characterised cohort of over 500 000 participants that offers unique opportunities to investigate multiple diseases and risk factors.

Aims

An online mental health questionnaire completed by UK Biobank participants was expected to expand the potential for research into mental disorders.

Method

An expert working group designed the questionnaire, using established measures where possible, and consulting with a patient group regarding acceptability. Case definitions were defined using operational criteria for lifetime depression, mania, anxiety disorder, psychotic-like experiences and self-harm, as well as current post-traumatic stress and alcohol use disorders.

Results

157 366 completed online questionnaires were available by August 2017. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status than the general population across a range of indicators. Thirty-five per cent (55 750) of participants had at least one defined syndrome, of which lifetime depression was the most common at 24% (37 434). There was extensive comorbidity among the syndromes. Mental disorders were associated with high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.

Conclusions

The questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed owing to selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.

Declaration of interest

G.B. received grants from the National Institute for Health Research during the study; and support from Illumina Ltd. and the European Commission outside the submitted work. B.C. received grants from the Scottish Executive Chief Scientist Office and from The Dr Mortimer and Theresa Sackler Foundation during the study. C.S. received grants from the Medical Research Council and Wellcome Trust during the study, and is the Chief Scientist for UK Biobank. M.H. received grants from the Innovative Medicines Initiative via the RADAR-CNS programme and personal fees as an expert witness outside the submitted work.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Matthew Hotopf, NIHR Biomedical Research Centre, PO Box 005, De Crespigny Park, Denmark Hill, London, UK. Email: matthew.hotopf@kcl.ac.uk
References
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1Sudlow, C, Gallacher, J, Allen, N, Beral, V, Burton, P, Danesh, J, et al. UK Biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med 2015; 12(3): e1001779.
2Weissman, MM, Brown, AS, Talati, A. Translational epidemiology in psychiatry: linking population to clinical and basic sciences. Arch Gen Psychiatry 2011; 68(6): 600–8.
3Bell, V. Open science in mental health research. Lancet Psychiatry 2017: doi:10.1016/S2215-0366(17)30244-4.
4Prince, M, Patel, V, Saxena, S, Maj, M, Maselko, J, Phillips, MR, et al. No health without mental health. Lancet 2007; 370(9590): 859–77.
5Newton, JN, Briggs, ADM, Murray, CJL, Dicker, D, Foreman, KJ, Wang, H, et al. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386(10010): 2257–74.
6Barnett, K, Mercer, SW, Norbury, M, Watt, G, Wyke, S, Guthrie, B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012; 380(9836): 3743.
7Cohen, BE, Edmondson, D, Kronish, IM. State of the art review: depression, stress, anxiety, and cardiovascular disease. Am J Hypertens 2015; 28(11): 1295–302.
8Chang, C-K, Hayes, RD, Broadbent, MTM, Hotopf, M, Davies, E, Møller, H, et al. A cohort study on mental disorders, stage of cancer at diagnosis and subsequent survival. BMJ Open 2014; 4(1): e004295.
9Smith, DJ, Nicholl, BI, Cullen, B, Martin, D, Ul-Haq, Z, Evans, J, et al. Prevalence and characteristics of probable major depression and bipolar disorder within UK Biobank: cross-sectional study of 172,751 participants. PLoS One 2013; 8(11): e75362.
10Kessler, RC, Amminger, GP, Aguilar-Gaxiola, S, Alonso, J, Lee, S, Ustun, TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry 2007; 20(4): 359–64.
11Newson, RS, Karlsson, H, Tiemeier, H. Epidemiological fallacies of modern psychiatric research. Nord J Psychiatry 2011; 65(4): 226–37.
12Davis, KA, Sudlow, CL, Hotopf, M. Can mental health diagnoses in administrative data be used for research? A systematic review of the accuracy of routinely collected diagnoses. BMC Psychiatry 2016; 16(1): 263.
13Pitman, A, Osborn, DPJ, King, MB. The use of internet-mediated cross-sectional studies in mental health research. BJPsych Adv 2015; 21(3): 175–84.
14Bridges, S. Health Survey for England 2014: Mental Health Problems. In HSE 2014 (ed Health and Social Care Information Centre). Office of National Statistics, 2015.
15Kessler, RC, Andrews, G, Mroczek, D, Ustun, B, Wittchen, HU. The World Health Organization composite international diagnostic interview short-form (CIDI-SF). Int J Methods Psychiatr Res 1998; 7(4): 171–85.
16Robotham, D, Wykes, T, Rose, D, Doughty, L, Strange, S, Neale, J, et al. Service user and carer priorities in a Biomedical Research Centre for mental health. J Ment Health 2016; 25(3): 185–8.
17Wesnes, KA, Brooker, H, Ballard, C, McCambridge, L, Stenton, R, Corbett, A. Utility, reliability, sensitivity and validity of an online test system designed to monitor changes in cognitive function in clinical trials. Int J Geriatr Psychiatry 2017: doi:10.1002/gps.4659.
18Cerimele, JM, Chwastiak, LA, Dodson, S, Katon, WJ. The prevalence of bipolar disorder in general primary care samples: a systematic review. Gen Hosp Psychiatry 2014; 36(1): 1925.
19Carvalho, AF, Takwoingi, Y, Sales, PMG, Soczynska, JK, Köhler, CA, Freitas, TH, et al. Screening for bipolar spectrum disorders: a comprehensive meta-analysis of accuracy studies. J Affect Disord 2015; 172: 337–46.
20Joint Health Surveys Unit. Health Survey for England 2014: Volume 2 Methods and Documentation (http://content.digital.nhs.uk/catalogue/PUB19295). In HSE 2014 (eds Craig, R, Fuller, E, Mindell, J). Office of National Statistics, 2015.
21Streiner, DL, Patten, SB, Anthony, JC, Cairney, J. Has ‘lifetime prevalence’ reached the end of its life? An examination of the concept. Int J Methods Psychiatr Res 2009; 18(4): 221–8.
22Kessler, RC, Birnbaum, HG, Shahly, V, Bromet, E, Hwang, I, McLaughlin, KA, et al. Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depress Anxiety 2010; 27(4): 351–64.
23Fry, A, Littlejohns, TJ, Sudlow, C, Doherty, N, Adamska, L, Sprosen, T, et al. Comparison of sociodemographic and health-related characteristics of UK Biobank participants with the general population. Am J Epidemiol 2017: doi:10.1093/aje/kwx246.
24Knudsen, AK, Hotopf, M, Skogen, JC, Øverland, S, Mykletun, A. The health status of nonparticipants in a population-based health study: The Hordaland Health Study. Am J Epidemiol 2010; 172(11): 1306–14.
25Atherton, K, Fuller, E, Shepherd, P, Strachan, DP, Power, C. Loss and representativeness in a biomedical survey at age 45 years: 1958 British birth cohort. J Epidemiol Community Health 2008; 62(3): 216–23.
26Martin, J, Tilling, K, Hubbard, L, Stergiakouli, E, Thapar, A, Davey Smith, G, et al. Association of genetic risk for schizophrenia with nonparticipation over time in a population-based cohort study. Am J Epidemiol 2016; 183(12): 1149–58.
27Macfarlane, GJ, Beasley, M, Smith, BH, Jones, GT, Macfarlane, TV. Can large surveys conducted on highly selected populations provide valid information on the epidemiology of common health conditions? An analysis of UK Biobank data on musculoskeletal pain. Br J Pain 2015; 9(4): 203–12.
28Hernan, MA, Hernandez-Diaz, S, Robins, JM. A structural approach to selection bias. Epidemiology 2004; 15(5): 615–25.
29Sperrin, M, Candlish, J, Badrick, E, Renehan, A, Buchan, I. Collider bias is only a partial explanation for the obesity paradox. Epidemiology 2016; 27(4): 525–30.
30Lilienfeld, SO, Treadway, MT. Clashing diagnostic approaches: DSM-ICD Versus RDoC. Annu Rev Clin Psychol 2016; 12(1): 435–63.
31National Institute for Health and Clinical Excellence. Depression in Adults: Recognition and Management. NICE Clinical Guideline CG90. NICE, 2009 (updated 2016).
32National Institute for Health and Clinical Excellence. Generalised Anxiety Disorder and Panic Disorder in Adults: Management. NICE Clinical Guideline CG113. NICE, 2011.
33American Psychiatric Association. Highlights of Changes from DSM-IV-TR to DSM-5: psychiatry.org, 2013.
34Nevin, RL. Low validity of self-report in identifying recent mental health diagnosis among US service members completing Pre-Deployment Health Assessment (PreDHA) and deployed to Afghanistan, 2007: a retrospective cohort study. BMC Public Health 2009; 9(1): 376.
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Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants

  • Katrina A. S. Davis (a1), Jonathan R. I. Coleman (a1), Mark Adams (a2), Naomi Allen (a3), Gerome Breen (a4), Breda Cullen (a5), Chris Dickens (a6), Elaine Fox (a7), Nick Graham (a8), Jo Holliday (a3), Louise M. Howard (a9), Ann John (a10), William Lee (a11), Rose McCabe (a12), Andrew McIntosh (a2), Robert Pearsall (a8), Daniel J. Smith (a8), Cathie Sudlow (a13), Joey Ward (a8), Stan Zammit (a14) and Matthew Hotopf (a15)...
  • Please note a correction has been issued for this article.
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