Skip to main content Accesibility Help
×
×
Home

Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders

  • J. Ormel (a1), D. Raven (a1), F. van Oort (a2), C. A. Hartman (a1), S. A. Reijneveld (a3), R. Veenstra (a4), W. A. M. Vollebergh (a5), J. Buitelaar (a6), F. C. Verhulst (a2) and A. J. Oldehinkel (a1)...
Abstract
Background

With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders.

Method

We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths.

Results

Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5–10% of the sample, experiencing 34–55% of all severe lifetime disorders.

Conclusions

At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5–10% of the adolescent population.

Copyright
Corresponding author
* Address for correspondence: J. Ormel, Ph.D., University Medical Center Groningen, CC 72, PO Box 30.001, 9700 RB Groningen, The Netherlands. (Email: j.ormel@umcg.nl)
References
Hide All
Achenbach, TM, Dumenci, L, Rescorla, LA (2003). DSM-oriented and empirically based approaches to constructing scales from the same item pools. Journal of Clinical Child and Adolescent Psychology 32, 328340.
Achenbach, TM, Rescorla, LA (2006). The Achenbach System of Empirically Based Assessment. In Forensic Uses of Clinical Assessment Instruments (ed. Archer, R. P.), pp. 229262. Lawrence Erlbaum Associates Publishers: Mahwah, NJ.
Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, de Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lépine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, M, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martínez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacín, C, Romera, B, Taub, N, Vollebergh, WAM (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica 109, 2127.
Andrews, G, Henderson, S, Hall, W (2001). Prevalence, comorbidity, disability and service utilisation. Overview of the Australian National Mental Health Survey. British Journal of Psychiatry 178, 145153.
Angold, A, Costello, EJ, Erkanli, A (1999). Comorbidity. Journal of Child Psychology and Psychiatry 40, 5787.
Angold, A, Costello, EJ, Worthman, CM (1998). Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychological Medicine 28, 5161.
APA (1995). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Primary Care Version. American Psychiatric Association: Washington, DC.
Bijl, RV, Ravelli, A (2000). Current and residual functional disability associated with psychopathology: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Psychological Medicine 30, 657668.
Bijl, RV, Ravelli, A, van Zessen, G (1998). Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 33, 587595.
Brugha, TS, Jenkins, R, Taub, N, Meltzer, H, Bebbington, PE (2001). A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychological Medicine 31, 10011013.
Caspi, A, Houts, R, Belsky, DW, Goldman-Mellor, S, Harrington, HL, Israel, S, Meier, MH, Ramrakha, S, Shalev, I, Poulton, R, Moffit, TE (2013). The p factor: one general psychopathology factor in the structure of psychiatric disorders. Clinical Psychological Science. Published online 14 August 2013 . doi:10.1177/2167702613497473.
Copeland, W, Shanahan, L, Costello, EJ, Angold, A (2011). Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains study. Journal of the American Academy of Child and Adolescent Psychiatry 50, 252261.
Copeland, WE, Shanahan, L, Costello, EJ, Angold, A (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry 66, 764772.
Costello, EJ, Angold, A, Burns, BJ, Stangl, DK, Tweed, DL, Erkanli, A, Worthman, CM (1996). The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry 53, 11291136.
Costello, EJ, Angold, A, Keeler, GP (1999). Adolescent outcomes of childhood disorders: the consequences of severity and impairment. Journal of the American Academy of Child and Adolescent Psychiatry 38, 121128.
Costello, EJ, Egger, HL, Angold, A (2005 a). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics of North America 14, 631648.
Costello, EJ, Egger, H, Angold, A (2005 b). 10-Year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child and Adolescent Psychiatry 44, 972986.
de Graaf, R, Ten Have, M, van Gool, C, van Dorsselaer, S (2012). Prevalence of mental disorders, and trends from 1996 to 2009. Results from NEMESIS-2. Tijdschrift voor Psychiatrie 54, 2738.
de Winter, AF, Oldehinkel, AJ, Veenstra, R, Brunnekreef, JA, Verhulst, FC, Ormel, J (2005). Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents. European Journal of Epidemiology 20, 173181.
Eaton, WW, Kessler, RC, Wittchen, HU, Magee, WJ (1994). Panic and panic disorder in the United States. American Journal of Psychiatry 151, 413420.
Edelbrock, C, Costello, AJ, Dulcan, MK, Kalas, R, Conover, NC (1985). Age differences in the reliability of the psychiatric interview of the child. Child Development 56, 265275.
Eder, W, Ege, MJ, von Mutius, E (2006). The asthma epidemic. New England Journal of Medicine 355, 22262235.
Ferdinand, RF, Verhulst, FC, Wiznitzer, M (1995). Continuity and change of self-reported problem behaviors from adolescence into young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry 34, 680690.
Fergusson, DM, Horwood, LJ (2001). The Christchurch Health and Development Study: review of findings on child and adolescent mental health. Australian and New Zealand Journal of Psychiatry 35, 287296.
Ford, T, Goodman, R, Meltzer, H (2003). The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry 42, 12031211.
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. International Journal of Methods in Psychiatric Research 15, 167180.
Hossain, P, Kawar, B, El Nahas, M (2007). Obesity and diabetes in the developing world – a growing challenge. New England Journal of Medicine 356, 213215.
Huisman, M, Oldehinkel, AJ, Winter, AD, Minderaa, RB, Bildt, AD, Huizink, AC, Verhulst, FC, Ormel, J (2008). Cohort profile: The Dutch ‘TRacking Adolescents’ Individual Lives’ Survey’; TRAILS. International Journal of Epidemiology 37, 12271235.
Jacobi, F, Wittchen, H-, Hölting, C, Höfler, M, Pfister, H, Müller, N, Lieb, R (2004). Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychological Medicine 34, 597611.
Jenkins, R, Lewis, G, Bebbington, P, Brugha, T, Farrell, M, Gill, B, Meltzer, H (1997). The National Psychiatric Morbidity Surveys of Great Britain: initial findings from the Household Survey. Psychological Medicine 27, 775789.
Kessler, RC, Abelson, J, Demler, O, Escobar, JI, Gibbon, M, Guyer, ME, Howes, MJ, Jin, R, Vega, WA, Walters, EE, Wang, P, Zaslavsky, A, Zheng, H (2004). Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI). International Journal of Methods in Psychiatric Research 13, 122139.
Kessler, RC, Avenevoli, S, Costello, EJ, Georgiades, K, Green, JG, Gruber, MJ, He, JP, Koretz, D, McLaughlin, KA, Petukhova, M, Sampson, NA, Zaslavsky, AM, Merikangas, KR (2012 a). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry 69, 372380.
Kessler, RC, Avenevoli, S, Costello, J, Green, JG, Gruber, MJ, McLaughlin, KA, Petukhova, M, Sampson, NA, Zaslavsky, AM, Merikangas, KR (2012 b). Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry 69, 381389.
Kessler, RC, Avenevoli, S, Green, J, Gruber, MJ, Guyer, M, He, Y, Jin, R, Kaufman, J, Sampson, NA, Zaslavsky, AM, Merikangas, KR (2009). National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI diagnoses with clinical reassessments. Journal of the American Academy of Child and Adolescent Psychiatry 48, 386399.
Kessler, RC, Avenevoli, S, McLaughlin, KA, Green, JG, Lakoma, MD, Petukhova, M, Pine, DS, Sampson, NA, Zaslavsky, AM, Merikangas, KR (2012 c). Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Psychological Medicine 42, 19972010.
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005 a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005 b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.
Kessler, RC, Cox, BJ, Green, JG, Ormel, J, McLaughlin, KA, Merikangas, KR, Petukhova, M, Pine, DS, Russo, LJ, Swendsen, J, Wittchen, HU, Zaslavsky, AM (2011). The effects of latent variables in the development of comorbidity among common mental disorders. Depression and Anxiety 28, 2939.
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 819.
Kessler, RC, Merikangas, KR, Berglund, P, Eaton, WW, Koretz, DS, Walters, EE (2003). Mild disorders should not be eliminated from the DSM-V. Archives of General Psychiatry 60, 11171122.
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.
Kim-Cohen, J, Caspi, A, Moffitt, TE, Harrington, H, Milne, BJ, Poulton, R (2003). Prior juvenile diagnoses in adults with mental disorder – developmental follow-back of a prospective–longitudinal cohort. Archives of General Psychiatry 60, 709717.
Kotov, R, Ruggero, CJ, Krueger, RF, Watson, D, Yuan, Q, Zimmerman, M (2011). New dimensions in the quantitative classification of mental illness. Archives of General Psychiatry 68, 10031011.
Krueger, RF, Markon, KE (2011). A dimensional-spectrum model of psychopathology: progress and opportunities. Archives of General Psychiatry 68, 1011.
Lahey, BB (2009). Public health significance of neuroticism. American Psychologist 64, 241256.
Lahey, BB, Applegate, B, Hakes, JK, Zald, DH, Hariri, AR, Rathouz, PJ (2012). Is there a general factor of prevalent psychopathology during adulthood? Journal of Abnormal Psychology 121, 971977.
Maughan, B, Collishaw, S, Meltzer, H, Goodman, R (2008). Recent trends in UK child and adolescent mental health. Social Psychiatry and Psychiatric Epidemiology 43, 305310.
McGee, R, Feehan, M, Williams, S, Anderson, J (1992). DSM-III disorders from age 11 to age 15 years. Journal of the American Academy of Child and Adolescent Psychiatry 31, 5059.
Merikangas, KR, He, JP, Burstein, M, Swanson, SA, Avenevoli, S, Cui, L, Benjet, C, Georgiades, K, Swendsen, J (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 49, 980989.
Moffitt, TE, Arseneault, L, Belsky, D, Dickson, N, Hancox, RJ, Harrington, H, Houts, R, Poulton, R, Roberts, BW, Ross, S, Sears, MR, Thomson, WM, Caspi, A (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences USA 108, 26932698.
Moffitt, TE, Caspi, A, Taylor, A, Kokaua, J, Milne, BJ, Polanczyk, G, Poulton, R (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine 40, 899909.
Murray, CJL, Lopez, AD (1996). The Global Burden of Disease. Harvard University Press: Boston.
Nederhof, E, Jörg, F, Raven, D, Veenstra, R, Verhulst, FC, Ormel, J, Oldehinkel, AJ (2012). Benefits of extensive recruitment effort persist during follow-ups and are consistent across age group and survey method. The TRAILS study. BMC Medical Research Methodology 12, 93.
Newman, DL, Moffitt, TE, Caspi, A, Magdol, L, Silva, PA (1996). Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology 64, 552562.
Oldehinkel, AJ, Hartman, CA, de Winter, AF, Veenstra, R, Ormel, J (2004). Temperament profiles associated with internalizing and externalizing problems in preadolescence. Development and Psychopathology 16, 421440.
Ormel, J, Jeronimus, BF, Kotov, R, Riese, H, Bos, EH, Hankin, B, Rosmalen, JGM, Oldehinkel, AJ (2013). Neuroticism and common mental disorders: meaning and utility of a complex relationship. Clinical Psychology Review 33, 686697.
Ormel, J, Oldehinkel, AJ, Sijtsema, J, van Oort, F, Raven, D, Veenstra, R, Vollebergh, WAM, Verhulst, FC (2012). The TRacking Adolescents’ Individual Lives Survey (TRAILS): design, current status, and selected findings. Journal of the American Academy of Child and Adolescent Psychiatry 51, 10201036.
Ormel, J, Petukhova, M, Chatterji, S, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Bromet, EJ, Burger, H, Demyttenaere, K, de Girolamo, G, Haro, JM, Hwang, I, Karam, E, Kawakami, N, Lepine, JP, Medina-Mora, ME, Posada-Villa, J, Sampson, N, Scott, K, Ustun, TB, Von Korff, M, Williams, DR, Zhang, M, Kessler, RC (2008). Disability and treatment of specific mental and physical disorders across the world. British Journal of Psychiatry 192, 368375.
Quinton, D, Gulliver, L, Rutter, M (1995). A 15–20 year follow-up of adult psychiatric patients. Psychiatric disorder and social functioning. British Journal of Psychiatry 167, 315323.
Reijneveld, SA, Veenstra, R, de Winter, AF, Verhulst, FC, Ormel, J, de Meer, G (2010). Area deprivation affects behavioral problems of young adolescents in mixed urban and rural areas: the TRAILS study. Journal of Adolescent Health 46, 189196.
Rutter, M (1995). Relationships between mental disorders in childhood and adulthood. Acta Psychiatrica Scandinavica 91, 7385.
Rutter, M (2005). How the environment affects mental health. British Journal of Psychiatry 186, 46.
Rutter, M, Maughan, B (1997). Psychosocial adversities in childhood and adult psychopathology. Journal of Personality Disorders 11, 418.
Shanahan, L, Copeland, W, Costello, EJ, Angold, A (2008). Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents. Journal of Child Psychology and Psychiatry 49, 3442.
Simon, GE, Von Korff, M (1995). Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiologic Reviews 17, 221227.
ten Have, M, Nuyen, J, Beekman, A, de Graaf, R (2013). Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems. Psychological Medicine 43, 22032213.
Uher, R, Rutter, M (2012). Basing psychiatric classification on scientific foundation: problems and prospects. International Review of Psychiatry 24, 591605.
van den Akker, M, Buntinx, F, Metsemakers, JF, Roos, S, Knottnerus, JA (1998). Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. Journal of Clinical Epidemiology 51, 367375.
van der Jagt-Jelsma, W, de Vries-Schot, M, de Jong, R, Verhulst, FC, Ormel, J, Veenstra, R, Swinkels, S, Buitelaar, J (2011). The relationship between parental religiosity and mental health of pre-adolescents in a community sample: the TRAILS study. European Child and Adolescent Psychiatry 20, 253260.
Veenstra, R, Lindenberg, S, Oldehinkel, AJ, De Winter, AF, Ormel, J (2006). Temperament, environment, and antisocial behavior in a population sample of preadolescent boys and girls. International Journal of Behavioral Development 30, 422432.
Verboom, CE, Sijtsema, JJ, Verhulst, FC, Penninx, BWJH, Ormel, J (2014). Longitudinal associations between depressive problems, academic performance, and social functioning in adolescent boys and girls. Developmental Psychology 50, 247257.
Verhulst, FC, van der Ende, J, Ferdinand, RF, Kasius, MC (1997). The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. Archives of General Psychiatry 54, 329336.
Vollebergh, WAM, Iedema, J, Bijl, RV, de Graaf, R, Smit, F, Ormel, J (2001). The structure and stability of common mental disorders: the NEMESIS Study. Archives of General Psychiatry 58, 597603.
Wing, JK, Mann, SA, Leff, JP, Nixon, JM (1978). The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine 8, 203217.
Wittchen, H-U, Nelson, CB, Lachner, G (1998). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine 28, 109126.
Yach, D, Hawkes, C, Gould, CL, Hofman, KJ (2004). The global burden of chronic diseases: overcoming impediments to prevention and control. Journal of the American Medical Association 291, 26162622.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Ormel Supplementary Material
Tables S1-S4

 Word (145 KB)
145 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed