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Underwood JFG, Madley-Dowd P, Dardani C, Hull L, Kwong ASF, Pearson RM, Hall J, Rai D. Childhood trauma as a mediator between autistic traits and depression: evidence from the ALSPAC birth cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.12.24310340. [PMID: 39040168 PMCID: PMC11261931 DOI: 10.1101/2024.07.12.24310340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Background Autism and autistic traits have been associated with greater risk of childhood trauma and adulthood psychopathology. However, the role that childhood trauma plays in the association between autism, autistic traits and depression in adulthood is poorly understood. Methods We used a UK-based birth cohort with phenotype and genotype data on autism, autistic traits, childhood trauma and depression in up to 9,659 individuals prospectively followed up from birth until age 28 years. Using mixed-effects growth-curve models, we assessed trajectories of depression symptoms over time according to the presence or absence of autism/ autistic traits and explored whether these differed by trauma exposure. We further investigated the association between autism/ autistic traits and depression in adulthood using confounder-adjusted logistic regression models and undertook mediation analyses to investigate the relationship with childhood trauma. Results All autism variables demonstrated increased depressive symptom trajectories between ages 10-28 years. Social communication difficulties (SCDs) were the most strongly associated with a depression diagnosis in adulthood (age 24 OR= 2.15; 95%CIs: 1.22-3.76). Trauma and autistic traits combined to further increase depression symptom scores. Mediation analyses provided evidence for direct pathways between autistic traits and increased risk of depression alongside indirect pathways through increased risk of trauma. Conclusions Autism/ autistic traits increase the odds of experiencing childhood trauma and of being diagnosed with depression at age 18 and 24. Depressive symptom trajectories emergent in childhood persist into adulthood. The combined effect of SCDs and childhood trauma is greater than the individual exposures, suggesting worse depression symptomatology following trauma in individuals with SCDs.
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Affiliation(s)
- Jack F G Underwood
- Neuroscience and Mental Health Innovation Institute, Cardiff University, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Paul Madley-Dowd
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University of Bristol, United Kingdom
| | - Christina Dardani
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Bristol, United Kingdom
| | - Laura Hull
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Alex S F Kwong
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Bristol, United Kingdom
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Rebecca M Pearson
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University of Bristol, United Kingdom
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jeremy Hall
- Neuroscience and Mental Health Innovation Institute, Cardiff University, United Kingdom
| | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University of Bristol, United Kingdom
- Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, United Kingdom
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Evanski JM, Zundel CG, Baglot SL, Desai S, Gowatch LC, Ely SL, Sadik N, Lundahl LH, Hill MN, Marusak HA. The First "Hit" to the Endocannabinoid System? Associations Between Prenatal Cannabis Exposure and Frontolimbic White Matter Pathways in Children. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:11-18. [PMID: 38021250 PMCID: PMC10654001 DOI: 10.1016/j.bpsgos.2023.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cannabis is the most used federally illicit substance among pregnant people in the United States. However, emerging preclinical data show that a significant portion of cannabis constituents, such as Δ9-tetrahydrocannabinol and its bioactive metabolites, readily cross the placenta and accumulate in the fetal brain, disrupting neurodevelopment. Recent research using the Adolescent Brain Cognitive Development (ABCD) Study cohort has linked prenatal cannabis exposure (PCE) to greater neurobehavioral problems and lower total gray and white matter volume in children. Here, we examined the impact of PCE on frontolimbic white matter pathways that are critical for cognitive- and emotion-related functioning, show a high density of cannabinoid receptors, and are susceptible to cannabis exposure during other periods of rapid neurodevelopment (e.g., adolescence). Methods This study included 11,530 children (mean ± SD age = 118.99 ± 7.49 months; 47% female) from the ABCD Study cohort. Linear mixed-effects models were used to examine the effects of caregiver-reported PCE on fractional anisotropy of 10 frontolimbic pathways (5 per hemisphere). Results PCE was associated with lower fractional anisotropy of the right (β = -0.005, p < .001) and left (β = -0.003, p = .007) fornix, and these results remained significant after adjusting for a variety of covariates, multiple comparisons, fractional anisotropy of all fibers, and using a quality-control cohort only. Conclusions In sum, we demonstrated small, yet reliable, effects of PCE on white matter integrity during childhood, particularly in the fornix, which plays a crucial role in emotion- and memory-related processes. Future studies are needed to understand the impacts of small changes in brain structure or function on neurodevelopment and risk of neurobehavioral problems.
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Affiliation(s)
- Julia M. Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Clara G. Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Samantha L. Baglot
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education University of Calgary, Calgary, Alberta, Canada
| | - Shreya Desai
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Leah C. Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Samantha L. Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Nareen Sadik
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Leslie H. Lundahl
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Matthew N. Hill
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education University of Calgary, Calgary, Alberta, Canada
| | - Hilary A. Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education University of Calgary, Calgary, Alberta, Canada
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, Michigan
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan
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Kilpi F, Howe LD. Early-life socioeconomic circumstances and the comorbidity of depression and overweight in adolescence and young adulthood: A prospective study. SSM Popul Health 2023; 24:101494. [PMID: 37674980 PMCID: PMC10477755 DOI: 10.1016/j.ssmph.2023.101494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023] Open
Abstract
Depression and overweight both often emerge early in life and have been found to be associated, but few studies examine depression-overweight comorbidity and its social patterning early in the life course. Drawing on data from 4,948 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort from the UK (2,798 female, 2,150 male), we investigated how different aspects of early-life socioeconomic circumstances are associated with depression-overweight comorbidity from adolescence to young adulthood exploring any differences by age and sex. We estimated how parental education, social class and financial difficulties reported in pregnancy were associated with depression and overweight, and their comorbidity at approximately the ages 17 and 24 in males and females. The results from multinomial logistic regression models showed that all three socioeconomic markers were associated with depression-overweight comorbidity and results were similar across age. Lower parental education (relative risk ratio (RRR) and 95% confidence interval (CI) of low education v high education: 3.61 (2.30-5.67) in females and 1.54 (1.14-2.07) in males) and social class (class IV/V v class I: 5.67 (2.48-12.94) in females and 3.11 (0.70-13.91) in males) had strong associations with comorbidity at age 17 relative to having neither depression or overweight. Financial difficulties were also a risk factor in females, with less clear results in males. These findings highlight how early socioeconomic circumstances are linked with the accumulation of mental and physical health problems already in adolescence, which has implications for life-long health inequalities.
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Affiliation(s)
- Fanny Kilpi
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura D. Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Carey EG, Ridler I, Ford TJ, Stringaris A. Editorial Perspective: When is a 'small effect' actually large and impactful? J Child Psychol Psychiatry 2023; 64:1643-1647. [PMID: 37226639 DOI: 10.1111/jcpp.13817] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 05/26/2023]
Abstract
Reporting of effect sizes is standard practice in psychology and psychiatry research. However, interpretation of these effect sizes can be meaningless or misleading - in particular, the evaluation of specific effect sizes as 'small', 'medium' and 'large' can be inaccurate depending on the research context. A real-world example of this is research into the mental health of children and young people during the COVID-19 pandemic. Evidence suggests that clinicians and services are struggling with increased demand, yet population studies looking at the difference in mental health before and during the pandemic report effect sizes that are deemed 'small'. In this short review, we utilise simulations to demonstrate that a relatively small shift in mean scores on mental health measures can indicate a large shift in the number of cases of anxiety and depression when scaled up to an entire population. This shows that 'small' effect sizes can in some contexts be large and impactful.
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Affiliation(s)
- Emma Grace Carey
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Isobel Ridler
- Division of Psychiatry, University College London, London, UK
| | - Tamsin Jane Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Argyris Stringaris
- Division of Psychiatry, University College London, London, UK
- First Dept of Psychiatry, National and Kapodistrian University of Athens, Greece
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Iles-Caven Y, Gregory S, Northstone K, Golding J, Nowicki S. The beneficial role of personality in preserving well-being during the pandemic: A longitudinal population study. J Affect Disord 2023; 331:229-237. [PMID: 36965624 PMCID: PMC10035805 DOI: 10.1016/j.jad.2023.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/10/2023] [Accepted: 03/18/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic resulted in increased rates of mental health problems. We examined the possible role of the personality characteristic, Locus of Control (LOC), in moderating pandemic-induced stress. METHODS The UK-based Avon Longitudinal Study of Parents & Children (ALSPAC), 7021 adults (mean ages: women 57.6 (SD = 4.48); partners 60.5 (SD = 5.36)) responded to a 2020 questionnaire which included a generalised measure of LOC. Between March 2020-January 2021, questionnaires focussed on the pandemic were administered, which included measures of mental health. Over 60 % of respondents completed questionnaires at three timepoints of interest. RESULTS In those with an internal LOC higher rates of positive well-being and reduced likelihood of anxiety and depression were shown compared to those who were external, e.g. after adjustment for socioeconomic/demographic factors mean differences in well-being score for internal compared with external women was +2.01 (95%CI +1.02,+2.10) p = 0.0001; for their partners +2.52 (95%CI +1.22,+3.82) p = 0.0002. External women were more likely than internals to have depression (adjusted OR 3.41 [95%CI 1.77,6.57] p < 0.0005. LIMITATIONS Attrition is a problem in this 30-year-old longitudinal cohort. Those still participating are more likely to have higher education and SES levels, be female and have an internal LOC. This population suffers from a lack of ethnic diversity. CONCLUSIONS Having an internal LOC positively moderated the effects of pandemic-induced stress on the frequency of anxiety and depression in middle-age. Programmes geared to raise internality and coping strategies may have long-term benefits on well-being in stressful situations, especially for women and frontline health professionals.
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Affiliation(s)
- Yasmin Iles-Caven
- Population Health Sciences, Bristol Medical School, University of Bristol, UK.
| | - Steven Gregory
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Jean Golding
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Zhao M, Ford T, Panayiotou M, Karl A. Developmental pathways of depressive symptoms via parenting, self-evaluation and peer relationships in young people from 3 to 17 years old: evidence from ALSPAC. Soc Psychiatry Psychiatr Epidemiol 2023; 58:907-917. [PMID: 36708401 PMCID: PMC10241697 DOI: 10.1007/s00127-022-02416-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/21/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Self-evaluation and interpersonal factors are theoretically and empirically linked to depression in young people. An improved understanding of the multifactorial developmental pathways that explain how these factors predict depression could inform intervention strategies. METHODS Using structural equation modeling, this study explored whether self-evaluation and interpersonal factors were associated with adolescent depressive symptoms in a population-based sample (n = 11,921; Avon Longitudinal Study of Parents and Children, ALSPAC), across four development stages: early and late childhood plus early and middle adolescence from 3 to 17 years old. RESULTS Early good parenting practices predicted self-esteem, fewer peer difficulties, good friendships and fewer depressive symptoms in late childhood development outcomes. Higher self-esteem and less negative self-concept mediated the effect of early good parenting practice on reduced depressive symptoms in middle adolescence. The hypothesized erosion pathway from depressive symptoms in late childhood via higher levels of negative self-concept in early adolescence to depressive symptoms in middle adolescence was also confirmed. Additionally, peer difficulties played a mediation role in developing depressive symptoms. Contrary to the hypothesis, poor friendships predicted fewer depressive symptoms. The analysis supported a developmental pathway in which good parenting practices in early childhood led to fewer peer difficulties in late childhood and to less negative self-concept in early adolescence, which in turn predicted fewer depressive symptoms in middle adolescence. CONCLUSION The social-developmental origin of youth depressive symptoms was supported via the effect of peer relationships in late childhood on self-evaluation in early adolescence.
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Bowman K, Cadman T, Goncalves Soares A, Robinson O, Hughes A, Heron J, Segal AB, Huerta MC, Howe LD. Mediators of the association between childhood body mass index and educational attainment: Analysis of a UK prospective cohort study. Pediatr Obes 2023; 18:e13014. [PMID: 36823984 PMCID: PMC10909521 DOI: 10.1111/ijpo.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Higher body mass index (BMI) in childhood is associated with lower academic achievement. OBJECTIVE To explore potential pathways linking childhood BMI with educational attainment. METHODS Using data from the Avon Longitudinal Study of Parents and Children prospective cohort study (N = 6949), we assessed the association between BMI z-scores at 11.7 years and educational attainment at 16 (General Certificate of Secondary Education [GCSE] results). Depressive symptoms, externalizing behaviours, bullying and school enjoyment were considered as potential mediators. Mediators were examined individually and jointly using sequential causal mediation. RESULTS Higher BMI z-scores were associated with lower GCSE scores (females β = -3.47 95% CI -5.54, -1.41 males β = -4.33 95% CI -6.73, -1.94). Together, bullying, externalizing symptoms, depressive symptoms and school enjoyment mediated 41.9% of this association in females, and 23.3% in males. In males, evidence for mediation was weak (confidence intervals for all indirect effects spanned the null). In both females and males, most of the mediation was driven by externalizing symptoms. CONCLUSIONS The detrimental effect of higher BMI on educational attainment appears to be partly explained by externalizing behaviours, particularly in females. Interventions to support behavioural problems may help the academic achievement of children with a higher body weight.
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Affiliation(s)
- Kirsty Bowman
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesUniversity of BristolBristolUK
| | - Tim Cadman
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Ana Goncalves Soares
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesUniversity of BristolBristolUK
| | - Oliver Robinson
- MRC Centre for Environment and HealthSchool of Public Health, Imperial College LondonLondonUK
| | - Amanda Hughes
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesUniversity of BristolBristolUK
| | - Jon Heron
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesUniversity of BristolBristolUK
| | - Alexa Blair Segal
- Centre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Maria Carmen Huerta
- Centre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Laura D. Howe
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesUniversity of BristolBristolUK
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Forbes G, Kent R, Charman T, Baird G, Pickles A, Simonoff E. How do autistic people fare in adult life and can we predict it from childhood? Autism Res 2023; 16:458-473. [PMID: 36519265 PMCID: PMC10947100 DOI: 10.1002/aur.2868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/26/2022] [Indexed: 12/23/2022]
Abstract
This study describes social, mental health, and quality of life outcomes in early adulthood, and examines childhood predictors in the Special Needs and Autism Project (SNAP), a longitudinal population-based cohort. Young autistic adults face variable but often substantial challenges across many areas of life. Prediction of outcomes is important to set expectations and could lead to the development of targeted early intervention. Autistic children were enrolled at age 12 and parents reported outcomes 11 years later when their children were age 23 (n = 121). Thirty six percent of autistic adults were in competitive employment or education and 54% had frequent contact with friends. Only 5% of autistic adults were living independently, and 37% required overnight care. Moderate or severe anxiety and depression symptoms were found for 11% and 12% of young adults, respectively. Subjective quality of life was similar to UK averages except for social relationships. Using childhood IQ, autism traits and adaptive functioning meaningful predictions can be made of living situation, employment and education and physical health. Prediction was poor for friendships, mental health outcomes and other aspects of quality of life. Our results suggest that although young autistic adults face challenges across normative, social outcomes, they may be faring better in regard to mental health or quality of life. Childhood IQ, autism traits and adaptive functioning are most useful for predicting outcomes. After accounting for these factors, childhood measurements of behavioral and emotional problems and language offered little improvement in prediction of adult outcomes.
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Affiliation(s)
- Gordon Forbes
- Department of Biostatistics and Health Informatics London, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Rachel Kent
- Department of Child and Adolescent Psychiatry, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Tony Charman
- Department of Psychology, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | | | - Andrew Pickles
- Department of Biostatistics and Health Informatics London, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- NIHR Maudsley Biomedical Research Centre at South LondonMaudsley NHS Foundation Trust and King's CollegeLondonUK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- NIHR Maudsley Biomedical Research Centre at South LondonMaudsley NHS Foundation Trust and King's CollegeLondonUK
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Shanaube K, Gachie T, Hoddinott G, Schaap A, Floyd S, Mainga T, Bond V, Hayes R, Fidler S, Ayles H. Depressive symptoms and HIV risk behaviours among adolescents enrolled in the HPTN071 (PopART) trial in Zambia and South Africa. PLoS One 2022; 17:e0278291. [PMID: 36454874 PMCID: PMC9714741 DOI: 10.1371/journal.pone.0278291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mental health is a critical and neglected public health problem for adolescents in sub-Saharan Africa. In this paper we aim to determine the prevalence of depressive symptoms and the association with HIV risk behaviours in adolescents aged 15-19 years in Zambia and SA. METHODS We conducted a cross-sectional survey from August-November 2017 in seven control communities of HPTN 071 (PopART) trial (a community-randomised trial of universal HIV testing and treatment), enrolling approximately 1400 eligible adolescents. HIV-status was self-reported. Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ), with a positive screen if adolescents scored ≥12. We fitted a logistic regression model to identify correlates of depressive symptoms with subgroup analyses among those who self-reported ever having had sex, by gender and country. RESULTS Out of 6997 households approached, 6057 (86.6%) were enumerated. 2546 adolescents were enumerated of whom 2120 (83.3%) consented to participate and were administered the SMFQ. The prevalence of depressive symptoms was 584/2120 (27.6%) [95%CI: 25.7%-29.5%]. Adolescents in SA were less likely to experience depressive symptoms (Adjusted Odds Ratio [AOR] = 0.63 (95% CI: 0.50, 0.79), p-value<0.0001). Female adolescents (AOR = 1.46 (95% CI: 1.19, 1.81), p-value<0.0001); those who reported ever having sex and being forced into sex (AOR = 1.80 (95% CI: 1.45, 2.23), p-value<0.001) and AOR = 1.67 (95% CI: 0.99, 2.84); p-value = 0.057 respectively) were more likely to experience depressive symptoms. Among 850 (40.1%) adolescents who self-reported to ever having had sex; those who used alcohol/drugs during their last sexual encounter were more likely to experience depressive symptoms (AOR = 2.18 (95% CI: 1.37, 3.47); p-value = 0.001), whereas those who reported using a condom were less likely to experience depressive symptoms (AOR = 0.74 (95% CI: 0.55, 1.00); p-value = 0.053). CONCLUSION The prevalence of depressive symptoms among adolescents ranged from 25-30% and was associated with increased HIV-risk behaviour.
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Affiliation(s)
| | - Thomas Gachie
- Zambart, Lusaka, Zambia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Albertus Schaap
- Zambart, Lusaka, Zambia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sian Floyd
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Virginia Bond
- Zambart, Lusaka, Zambia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard Hayes
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sarah Fidler
- Department of infectious disease, Imperial College, London, Imperial College NIHR BRC, United Kingdom
| | - Helen Ayles
- Zambart, Lusaka, Zambia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Edmondson-Stait AJ, Shen X, Adams MJ, Barbu MC, Jones HJ, Miron VE, Allardyce J, Boardman JP, Lawrie SM, McIntosh AM, Khandaker GM, Kwong AS, Whalley HC. Early-life inflammatory markers and subsequent psychotic and depressive episodes between 10 to 28 years of age. Brain Behav Immun Health 2022; 26:100528. [PMID: 36277463 PMCID: PMC9582583 DOI: 10.1016/j.bbih.2022.100528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Inflammation is implicated in depression and psychosis, including association of childhood inflammatory markers on the subsequent risk of developing symptoms. However, it is unknown whether early-life inflammatory markers are associated with the number of depressive and psychotic symptoms from childhood to adulthood. Using the prospective Avon Longitudinal Study of Children and Parents birth cohort (N = up-to 6401), we have examined longitudinal associations of early-life inflammation [exposures: interleukin-6 (IL-6), C-reactive protein (CRP) levels at age 9y; IL-6 and CRP DNA-methylation (DNAm) scores at birth and age 7y; and IL-6 and CRP polygenic risk scores (PRSs)] with the number of depressive episodes and psychotic experiences (PEs) between ages 10-28 years. Psychiatric outcomes were assessed using the Short Mood and Feelings Questionnaire and Psychotic Like Symptoms Questionnaires, respectively. Exposure-outcome associations were tested using negative binomial models, which were adjusted for metabolic and sociodemographic factors. Serum IL-6 levels at age 9y were associated with the total number of depressive episodes between 10 and 28y in the base model (n = 4835; β = 0.066; 95%CI:0.020-0.113; pFDR = 0.041) which was weaker when adjusting for metabolic and sociodemographic factors. Weak associations were observed between inflammatory markers (serum IL-6 and CRP DNAm scores) and total number of PEs. Other inflammatory markers were not associated with depression or PEs. Early-life inflammatory markers are associated with the burden of depressive episodes and of PEs subsequently from childhood to adulthood. These findings support a potential role of early-life inflammation in the aetiology of depression and psychosis and highlight inflammation as a potential target for treatment and prevention.
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Affiliation(s)
- Amelia J. Edmondson-Stait
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Xueyi Shen
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Mark J. Adams
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Miruna C. Barbu
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Hannah J. Jones
- National Institute for Health Research Bristol Biomedical Research Centre, At University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Veronique E. Miron
- Medical Research Council Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, UK
| | | | - James P. Boardman
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Medical Research Council Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, UK
| | | | | | - Golam M. Khandaker
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Alex S.F. Kwong
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
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Ladd BA, Maheux AJ, Roberts SR, Choukas-Bradley S. Black adolescents' appearance concerns, depressive symptoms, and self-objectification: Exploring the roles of gender and ethnic-racial identity commitment. Body Image 2022; 43:314-325. [PMID: 36242995 DOI: 10.1016/j.bodyim.2022.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022]
Abstract
There is a dearth of research examining Black adolescents' body image, with even less work examining gender differences or the influence of ethnic-racial identity (ERI) commitment. It is critical to understand how culturally relevant aspects of appearance-beyond commonly measured ideals such as thinness and muscularity-are particularly relevant to Black adolescents. The present study of Black youth (n = 252; 55% girls, 45% boys, ages 13-18, Mage = 15.5) explored the roles of gender and ERI commitment in the associations between skin tone, hair, and facial satisfaction and appearance esteem, depressive symptomatology, and self-objectification. With a few exceptions, satisfaction with skin tone, hair, and face were significantly associated with higher appearance esteem and lower self-objectification and depressive symptoms, even when controlling for weight and muscle tone satisfaction. Findings were similar across genders, with some associations stronger among Black girls relative to boys. Among youth with higher ERI commitment, associations were stronger between skin tone, hair, and facial satisfaction and some indicators of wellbeing. Findings elucidate the role of culturally relevant appearance concerns of Black adolescents and the potential benefits of ERI commitment. This work can inform culturally sensitive research practices and therapeutic interventions related to Black youth's body image experiences.
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Affiliation(s)
- Brianna A Ladd
- University of Maryland, Department of Counseling, Higher Education, and Special Education, 3119 Benjamin Building, College Park, MD 20742, the United States of America.
| | - Anne J Maheux
- University of Pittsburgh, Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, the United States of America
| | - Savannah R Roberts
- University of Pittsburgh, Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, the United States of America
| | - Sophia Choukas-Bradley
- University of Pittsburgh, Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, the United States of America
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12
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Culpin I, Heuvelman H, Rai D, Pearson RM, Joinson C, Heron J, Evans J, Kwong ASF. Father absence and trajectories of offspring mental health across adolescence and young adulthood: Findings from a UK-birth cohort. J Affect Disord 2022; 314:150-159. [PMID: 35842065 PMCID: PMC10666570 DOI: 10.1016/j.jad.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/30/2022] [Accepted: 07/09/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND High prevalence of parental separation and resulting biological father absence raises important questions regarding its impact on offspring mental health across the life course. We specifically examined whether these relationships vary by sex and the timing of exposure to father absence (early or middle childhood). METHODS This study is based on up to 8409 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants provided self-reports of depression (Clinical Interview Schedule-Revised) at age 24 years and depressive symptoms (Short Mood and Feelings Questionnaire) between the ages of 10 and 24 years. Biological father absence in childhood was assessed through maternal questionnaires at regular intervals from birth to 10 years. We estimated the association between biological father absence and trajectories of depressive symptoms using multilevel growth-curve modelling. RESULTS Early but not middle childhood father absence was strongly associated with increased odds of offspring depression and greater depressive symptoms at age 24 years. Early childhood father absence was associated with higher trajectories of depressive symptoms during adolescence and early adulthood compared with father presence. Differences in the level of depressive symptoms between middle childhood father absent and father present groups narrowed into adulthood. LIMITATIONS This study could be biased by attrition and residual confounding. CONCLUSIONS We found evidence that father absence in childhood is persistently associated with offspring depression in adolescence and early adulthood. This relationship varies by sex and timing of father's departure, with early childhood father absence emerging as the strongest risk factor for adverse offspring mental health trajectories Further research is needed to identify mechanisms that could inform preventative interventions to reduce the risk of depression in children who experience father absence.
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
| | - Hein Heuvelman
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, United Kingdom
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
| | - Carol Joinson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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13
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Rimfeld K, Malanchini M, Arathimos R, Gidziela A, Pain O, McMillan A, Ogden R, Webster L, Packer AE, Shakeshaft NG, Schofield KL, Pingault JB, Allegrini AG, Stringaris A, von Stumm S, Lewis CM, Plomin R. The consequences of a year of the COVID-19 pandemic for the mental health of young adult twins in England and Wales. BJPsych Open 2022; 8:e129. [PMID: 35860899 PMCID: PMC9304950 DOI: 10.1192/bjo.2022.506] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/26/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected all our lives, not only through the infection itself but also through the measures taken to control the spread of the virus (e.g. lockdown). AIMS Here, we investigated how the COVID-19 pandemic and unprecedented lockdown affected the mental health of young adults in England and Wales. METHOD We compared the mental health symptoms of up to 4773 twins in their mid-20s in 2018 prior to the COVID-19 pandemic (T1) and during four-wave longitudinal data collection during the pandemic in April, July and October 2020, and in March 2021 (T2-T5) using phenotypic and genetic longitudinal designs. RESULTS The average changes in mental health were small to medium and mainly occurred from T1 to T2 (average Cohen d = 0.14). Despite the expectation of catastrophic effects of the pandemic on mental health, we did not observe trends in worsening mental health during the pandemic (T3-T5). Young people with pre-existing mental health problems were disproportionately affected at the beginning of the pandemic, but their increased problems largely subsided as the pandemic persisted. Twin analyses indicated that the aetiology of individual differences in mental health symptoms did not change during the lockdown (average heritability 33%); the average genetic correlation between T1 and T2-T5 was 0.95, indicating that genetic effects before the pandemic were substantially correlated with genetic effects up to a year later. CONCLUSIONS We conclude that on average the mental health of young adults in England and Wales has been remarkably resilient to the effects of the pandemic and associated lockdown.
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Affiliation(s)
- Kaili Rimfeld
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Psychology, Royal Holloway University of London, London, UK
| | - Margherita Malanchini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Department of Psychology, Queen Mary University of London, UK
| | - Ryan Arathimos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Agnieszka Gidziela
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Department of Psychology, Queen Mary University of London, UK
| | - Oliver Pain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Andrew McMillan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rachel Ogden
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Louise Webster
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Amy E. Packer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nicholas G. Shakeshaft
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kerry L. Schofield
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Jean-Baptiste Pingault
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, UK
| | - Andrea G. Allegrini
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, UK
| | - Argyris Stringaris
- Mood, Brain & Development Unit, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Sophie von Stumm
- Psychology in Education Research Centre, Department of Education, University of York, UK
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, and Department of Medical and Molecular Genetics, King's College London, UK
| | - Robert Plomin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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14
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Kwong ASF, Morris TT, Pearson RM, Timpson NJ, Rice F, Stergiakouli E, Tilling K. Polygenic risk for depression, anxiety and neuroticism are associated with the severity and rate of change in depressive symptoms across adolescence. J Child Psychol Psychiatry 2021; 62:1462-1474. [PMID: 33778956 DOI: 10.1111/jcpp.13422] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/21/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adolescence marks a period where depression will commonly onset. Twin studies show that genetic influences play a role in how depression develops and changes across adolescence. Recent genome-wide association studies highlight that common genetic variants - which can be combined into polygenic risk scores (PRS) - are also implicated in depression. However, the role of PRS in adolescent depression and changes in adolescent depression is not yet understood. We aimed to examine associations between PRS for five psychiatric traits and depressive symptoms measured across adolescence using cross-sectional and growth-curve models. The five PRS were as follows: depression (DEP), major depressive disorder (MDD), anxiety (ANX), neuroticism (NEU) and schizophrenia (SCZ). METHODS We used data from over 6,000 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) to examine associations between the five PRS and self-reported depressive symptoms (Short Mood and Feelings Questionnaire) over 9 occasions from 10 to 24 years. The PRS were created from well-powered genome-wide association studies conducted in adult populations. We examined cross-sectional associations between the PRS at each age and then again with longitudinal trajectories of depressive symptoms in a repeated measures framework using multilevel growth-curve analysis to examine the severity and the rate of change. RESULTS There was strong evidence that higher PRS for DEP, MDD and NEU were associated with worse depressive symptoms throughout adolescence and into young adulthood in our cross-sectional analysis, with consistent associations observed across all nine occasions. Growth-curve analyses provided stronger associations (as measured by effect sizes) and additional insights, demonstrating that individuals with higher PRS for DEP, MDD and NEU had steeper trajectories of depressive symptoms across development, all with a greater increasing rate of change during adolescence. Evidence was less consistent for the ANX and SCZ PRS in the cross-sectional analysis, yet there was some evidence for an increasing rate of change in adolescence in the growth-curve analyses with the ANX PRS. CONCLUSIONS These results show that common genetic variants as indexed by varying psychiatric PRS show patterns of specificity that influence both the severity and rate of change in depressive symptoms throughout adolescence and then into young adulthood. Longitudinal data that make use of repeated measures designs have the potential to provide greater insights how genetic factors influence the onset and persistence of adolescent depression.
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Affiliation(s)
- Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Tim T Morris
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca M Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frances Rice
- Division of Psychological Medicine & Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics & Genomics, Cardiff University, Cardiff, UK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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15
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Rimfeld K, Malanchini M, Arathimos R, Gidziela A, Pain O, McMillan A, Ogden R, Webster L, Packer AE, Shakeshaft NG, Schofield KL, Pingault JB, Allegrini AG, Stringaris A, von Stumm S, Lewis CM, Plomin R. The consequences of a year of the COVID-19 pandemic for the mental health of young adult twins in England and Wales. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.07.21264655. [PMID: 34642704 PMCID: PMC8509105 DOI: 10.1101/2021.10.07.21264655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic has impacted all our lives, not only through the infection itself, but also through the measures taken to control the virus’s spread (e.g., lockdown). Here we investigated how the COVID-19 pandemic and unprecedented lockdown affected the mental health of young adults in England and Wales. We compared the mental health symptoms of up to 4,000 twins in their mid-twenties in 2018 prior to the COVID-19 pandemic (T1) to those in a four-wave longitudinal data collection during the pandemic in April, July, and October 2020, and in March 2021 (T2-T5). The average changes in mental health were small-to-medium and mainly occurred from 2018 (T1) to March 2020 (T2, one month following the start of lockdown; average Cohen d=0.14). Despite the expectation of catastrophic effects on the pandemic on mental health of our young adults, we did not observe trends in worsening mental health during the pandemic (T3-T5). Young people with pre-existing mental health problems were adversely affected at the beginning of the pandemic, but their increased problems largely subsided as the pandemic persisted. Twin analyses indicated that the aetiology of individual differences did not change during the lockdown. The average heritability of mental health symptoms was 33% across 5 waves of assessment, and the average genetic correlation between T1 and T2-T5 was .95, indicating that genetic effects before the pandemic (T1) are substantially correlated with genetic effects up to a year later (T2-T5). We conclude that on average the mental health of young adults in England and Wales has been remarkably resilient to the effects of the pandemic and associated lockdown.
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Affiliation(s)
- Kaili Rimfeld
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Margherita Malanchini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Queen Mary University of London, London, UK
| | - Ryan Arathimos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Agnieszka Gidziela
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Queen Mary University of London, London, UK
| | - Oliver Pain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew McMillan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel Ogden
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Louise Webster
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Amy E Packer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicholas G Shakeshaft
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kerry L Schofield
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jean-Baptiste Pingault
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London
| | - Andrea G Allegrini
- Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London
| | - Argyris Stringaris
- Mood, Brain & Development Unit, Emotion and Development Branch, National Institute of Mental Health
| | - Sophie von Stumm
- Psychology in Education Research Centre, Department of Education, University of York
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
- Department of Medical and Molecular Genetics, King's College London
| | - Robert Plomin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Kwong ASF, Pearson RM, Adams MJ, Northstone K, Tilling K, Smith D, Fawns-Ritchie C, Bould H, Warne N, Zammit S, Gunnell DJ, Moran PA, Micali N, Reichenberg A, Hickman M, Rai D, Haworth S, Campbell A, Altschul D, Flaig R, McIntosh AM, Lawlor DA, Porteous D, Timpson NJ. Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry 2021; 218:334-343. [PMID: 33228822 PMCID: PMC7844173 DOI: 10.1192/bjp.2020.242] [Citation(s) in RCA: 280] [Impact Index Per Article: 93.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. AIMS To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic. METHOD Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale. RESULTS Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23-26%) compared with a pre-pandemic level of 13% (95% CI 12-14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. CONCLUSIONS These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.
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Affiliation(s)
- Alex S. F. Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | - Rebecca M. Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | | | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | - Daniel Smith
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | | | - Helen Bould
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Gloucestershire Health and Care NHS Foundation Trust, UK
| | - Naomi Warne
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Stanley Zammit
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - David J. Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute of Health Research Biomedical Research Centre, University of Bristol, UK
| | - Paul A. Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute of Health Research Biomedical Research Centre, University of Bristol, UK; and Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland; and Department of Paediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute of Health Research Biomedical Research Centre, University of Bristol, UK; and Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Simon Haworth
- 1MRC Integrative Epidemiology Unit, University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK; and Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, UK
| | - Drew Altschul
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK
| | - Robin Flaig
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK; and Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, UK
| | | | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute of Health Research Biomedical Research Centre, University of Bristol, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
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17
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Costantini I, Kwong ASF, Smith D, Lewcock M, Lawlor DA, Moran P, Tilling K, Golding J, Pearson RM. Locus of Control and Negative Cognitive Styles in Adolescence as Risk Factors for Depression Onset in Young Adulthood: Findings From a Prospective Birth Cohort Study. Front Psychol 2021; 12:599240. [PMID: 33935856 PMCID: PMC8080877 DOI: 10.3389/fpsyg.2021.599240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
Whilst previous observational studies have linked negative thought processes such as an external locus of control and holding negative cognitive styles with depression, the directionality of these associations and the potential role that these factors play in the transition to adulthood and parenthood has not yet been investigated. This study examined the association between locus of control and negative cognitive styles in adolescence and probable depression in young adulthood and whether parenthood moderated these associations. Using a UK prospective population-based birth cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between external locus of control and negative cognitive styles in adolescence with odds of depression in 4,301 young adults using logistic regression models unadjusted and adjusted for potential confounding factors. Interaction terms were employed to examine whether parenthood (i.e., having become a parent or not) moderated these associations. Over 20% of young adults in our sample were at or above the clinical threshold indicating probable depression. For each standard deviation (SD) increase in external locus of control in adolescence, there was a 19% (95% CI: 8-32%) higher odds of having probable depression in young adulthood, after adjusting for various confounding factors including baseline mood and different demographic and life events variables. Similarly, for each SD increase in negative cognitive styles in adolescence, there was a 29% (95% CI: 16-44%) higher odds of having probable depression in the adjusted model. We found little evidence that parenthood status moderated the relationship between external locus of control or negative cognitive styles in adolescence and probable depression following adjustment for confounding factors. Effect estimates were comparable when performed in the complete case dataset. These findings suggest that having an external locus of control and holding negative cognitive styles in mid- to late adolescence is associated with an increased likelihood of probable depression in young adulthood.
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Affiliation(s)
- Ilaria Costantini
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- Department of Experimental Psychology, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Alex S. F. Kwong
- Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Daniel Smith
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Melanie Lewcock
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jean Golding
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rebecca M. Pearson
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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