Skip to main content
×
×
Home

Adolescent affective symptoms and mortality

  • Gemma Archer (a1), Diana Kuh (a1), Matthew Hotopf (a2), Mai Stafford (a1) and Marcus Richards (a1)...
Abstract
Background

Little is known about the relationship between adolescent affective problems (anxiety and depression) and mortality.

Aims

To examine whether adolescent affective symptoms are associated with premature mortality, and to assess whether this relationship is independent of other developmental factors.

Method

Data (n = 3884) was from Britain's oldest birth cohort study – the National Survey of Health and Development. Adolescent affective symptoms were rated by teachers at ages 13 and 15 years: scores were summed and classified into three categories: mild or no, moderate and severe symptoms (1st–50th, 51st–90th and 91st–100th percentiles, respectively). Mortality data were obtained from national registry data up to age 68 years. Potential confounders were parental social class, childhood cognition and illness, and adolescent externalising behaviour.

Results

Over the 53-year follow-up period, 12.2% (n = 472) of study members died. Severe adolescent affective symptoms were associated with an increased rate of mortality compared with those with mild or no symptoms (gender adjusted hazard ratio 1.76, 95% CI 1.33–2.33). This association was only partially attenuated after adjustment for potential confounders (fully adjusted hazard ratio 1.61, 95% CI 1.20–2.15). There was suggestive evidence of an association across multiple causes of death. Moderate symptoms were not associated with mortality.

Conclusions

Severe adolescent affective symptoms are associated with an increased rate of premature mortality over a 53-year follow-up period, independent of potential confounders. These findings underscore the importance of early mental health interventions.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Adolescent affective symptoms and mortality
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Adolescent affective symptoms and mortality
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Adolescent affective symptoms and mortality
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence: Gemma Archer, PhD, MRC Unit for Lifelong Health and Ageing at UCL, University College London, 33 Bedford Place, London, WC1B 5JU, UK. Email: g.archer@ucl.ac.uk
References
Hide All
1Lacey, RE, Kumari, M, McMunn, A. Parental separation in childhood and adult inflammation: the importance of material and psychosocial pathways. Psychoneuroendocrinology 2013; 38: 2476–84.
2Richards, M, Abbott, RA. Childhood Mental Health and Life Chances in Post-war Britain: Insights from Three National Birth Cohort Studies. Centre for Mental Health, 2009.
3Breslau, N, Peterson, EL, Schultz, LR, Chilcoat, HD, Andreski, P. Major depression and stages of smoking: a longitudinal investigation. Arch Gen Psychiatry 1998; 55: 161–6.
4Fuller-Thomson, E, Filippelli, J, Lue-Crisostomo, CA. Gender-specific association between childhood adversities and smoking in adulthood: findings from a population-based study. Public Health 2013; 127: 449–60.
5Knüppel, A, Shipley, MJ, Llewellyn, CH, Brunner, EJ. Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study. Sci Rep 2017; 7: 6287.
6Colman, I, Wadsworth, MEJ, Croudace, TJ, Jones, PB. Forty-year psychiatric outcomes following assessment for internalizing disorder in adolescence. Am J Psychiatry 2007; 164: 126–33.
7Doll, R, Peto, R, Boreham, J, Sutherland, I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519.
8Kant, AK, Leitzmann, MF, Park, Y, Hollenbeck, A, Schatzkin, A. Patterns of recommended dietary behaviors predict subsequent risk of mortality in a large cohort of men and women in the United States. J Nutr 2009; 139: 1374–80.
9Mykletun, A, Bjerkeset, O, Dewey, M, Prince, M, Overland, S, Stewart, R. Anxiety, depression, and cause-specific mortality: the HUNT study. Psychosom Med 2007; 69: 323–31.
10Paffenbarger, RS Jr, Hyde, RT, Wing, AL, Lee, I-M, Jung, DL, Kampert, JB. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328: 538–45.
11Lee, WE, Wadsworth, MEJ, Hotopf, M. The protective role of trait anxiety: a longitudinal cohort study. Psychol Med 2006; 36: 345–51.
12Jokela, M, Ferrie, J, Kivimäki, M. Childhood problem behaviors and death by midlife: the British National Child Development Study. J Am Acad Child Adolesc Psychiatry 2009; 48: 1924.
13Kuh, D, Wong, A, Shah, I, Moore, A, Popham, M, Curran, P, et al. The MRC National Survey of Health and Development reaches age 70: maintaining participation at older ages in a birth cohort study. Eur J Epidemiol 2016; 31: 1135–47.
14Stafford, M, Black, S, Shah, I, Hardy, R, Pierce, M, Richards, M, et al. Using a birth cohort to study ageing: representativeness and response rates in the National Survey of Health and Development. Eur J Ageing 2013; 10: 145–57.
15Wadsworth, ME, Mann, SL, Rodgers, B, Kuh, DJ, Hilder, WS, Yusuf, EJ. Loss and representativeness in a 43 year follow up of a national birth cohort. J Epidemiol Community Health 1992; 46: 300–4.
16World Health Organization. ICD-9-CM: International Classification of Diseases, 9th Revision: Clinical Modification. World Health Organization, 1998.
17World Health Organization. ICD-10: International statistical classification of diseases and related health problems. World Health Organization, 2004.
18Rutter, M. A children's behaviour questionnaire for completion by teachers: preliminary findings. J Child Psychol Psychiatry 1967; 8: 111.
19Colman, I, Ploubidis, GB, Wadsworth, ME, Jones, PB, Croudace, TJ. A longitudinal typology of symptoms of depression and anxiety over the life course. Biol Psychiatry 2007; 62: 1265–71.
20Xu, MK, Jones, PB, Barnett, JH, Gaysina, D, Kuh, D, Croudace, TJ, et al. Adolescent self-organization predicts midlife memory in a prospective birth cohort study. Psychol Aging 2013; 28: 958–68.
21Merikangas, KR, Nakamura, EF, Kessler, RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci 2009; 11: 720.
22Kuh, D, Richards, M, Hardy, R, Butterworth, S, Wadsworth, ME. Childhood cognitive ability and deaths up until middle age: a post-war birth cohort study. Int J Epidemiol 2004; 33: 408–13.
23Maughan, B, Stafford, M, Shah, I, Kuh, D. Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort. Psychol Med 2014; 44: 1077.
24Kuh, D, Hardy, R, Langenberg, C, Richards, M, Wadsworth, ME. Mortality in adults aged 26–54 years related to socioeconomic conditions in childhood and adulthood: post war birth cohort study. BMJ 2002; 325: 1076–80.
25Richards, M, Shipley, B, Fuhrer, R, Wadsworth, ME. Cognitive ability in childhood and cognitive decline in mid-life: longitudinal birth cohort study. BMJ 2004; 328: 552.
26Jones, P, Murray, R, Jones, P, Rodgers, B, Marmot, M. Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet 1994; 344: 1398–402.
27Henderson, M, Hotopf, M, Shah, I, Hayes, RD, Kuh, D. Psychiatric disorder in early adulthood and risk of premature mortality in the 1946 British birth cohort. BMC Psychiatry 2011; 11: 37.
28Carpenter, J, Kenward, M. Multiple Imputation and its Application. John Wiley & Sons, 2012.
29Little, RJ, Rubin, DB. Statistical Analysis with Missing Data. John Wiley & Sons, 2014.
30Stott, D. The Social-Adjustment of Children: Manual to the Bristol Social-Adjustment Guides. University of London Press, 1963.
31Centers for Disease Control and Prevention (CDC). Ten Leading Causes of Death and Injury. CDC, 2015 (https://www.cdc.gov/injury/wisqars/LeadingCauses.html).
32Harrington, R, Fudge, H, Rutter, M, Pickles, A, Hill, J. Adult outcomes of childhood and adolescent depression: I. Psychiatric status. Arch Gen Psychiatry 1990; 47: 465–73.
33Joukamaa, M, Heliövaara, M, Knekt, P, Aromaa, A, Raitasalo, R, Lehtinen, V. Mental disorders and cause-specific mortality. Br J Psychiatry 2001; 179: 498502.
34Miloyan, B, Fried, E. A reassessment of the relationship between depression and all-cause mortality in 3,604,005 participants from 293 studies. World Psychiatry 2017; 16: 219–20.
35Tsuang, MT, Woolson, RF. Excess mortality in schizophrenia and affective disorders: do suicides and accidental deaths solely account for this excess? Arch Gen Psychiatry 1978; 35: 1181–5.
36Goodman, R. Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 2000; 177: 534–9.
37Khan, L. Missed Opportunities: A Review of the Recent Evidence into Children and Young People's Mental Health. Centre for Mental Health, 2016.
Recommend this journal

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

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
UNKNOWN
Supplementary materials

Archer et al. supplementary material 1
Archer et al. supplementary material

 Unknown (145 KB)
145 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 53
Total number of PDF views: 197 *
Loading metrics...

Abstract views

Total abstract views: 941 *
Loading metrics...

* Views captured on Cambridge Core between 28th May 2018 - 22nd June 2018. This data will be updated every 24 hours.

Adolescent affective symptoms and mortality

  • Gemma Archer (a1), Diana Kuh (a1), Matthew Hotopf (a2), Mai Stafford (a1) and Marcus Richards (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *