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Article ; Online: Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies

Amal R. Khanolkar / Praveetha Patalay

The Lancet Regional Health. Europe, Vol 6, Iss , Pp 100106- (2021)

2021

Abstract: Aim: To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from ...

Abstract	Aim: To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort. Methods: Data were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Socioeconomic indicators included childhood and adulthood social class and educational level. Risk for i. having healthy BMI and mental ill-health, ii. overweight and good mental health, and iii. overweight and mental ill-health was analysed using multinomial logistic regression. Findings: Socioeconomic disadvantage was consistently associated with greater risk for overweight-mental ill-health comorbidity at all ages (RRR 1.43, 2.04, 2.38, 1.64 and 1.71 at ages 10, 16, 23, 34 and 42 respectively for unskilled/skilled vs. professional/managerial class). The observed inequalities in co-morbidity were greater than those observed for either condition alone (overweight; RRR 1.39 and 1.25, mental ill-health; 1.36 and 1.22 at ages 16 and 42 respectively, for unskilled/skilled vs. professional/managerial class). In adulthood, both childhood and adulthood socioeconomic disadvantage were independently associated with comorbid overweight-mental ill-health, with a clear inverse gradient between educational level and risk for comorbidity. For instance, for the no education group (compared to university education) the RRR is 6.11 (95% CI 4.31-8.65) at age 34 and 4.42 (3.28-5.96) at age 42. There were no differences observed in the extent of inequalities by sex and differences between cohorts were limited. Interpretation: While socioeconomic disadvantage in childhood and adulthood are consistently and independently associated with greater risk for mental ill-health and being overweight separately, these associations are even larger ...
Keywords	Socioeconomic inequalities ; Socioeconomic position ; Comorbidity ; Obesity ; Mental health ; Depression ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Measurement invariance of the strengths and difficulties questionnaire across socioeconomic status and ethnicity from ages 3 to 17 years

Umar Toseeb / Olakunle Oginni / Richard Rowe / Praveetha Patalay

PLoS ONE, Vol 17, Iss 12, p e

A population cohort study.

2022 Volume 0278385

Abstract: Mental health inequalities along ethnic and socioeconomic groupings are well documented. The extent to which these observed inequalities are genuine or reflect measurement differences is unclear. In the current study we sought to investigate this in a ... ...

Abstract	Mental health inequalities along ethnic and socioeconomic groupings are well documented. The extent to which these observed inequalities are genuine or reflect measurement differences is unclear. In the current study we sought to investigate this in a large population-based sample of children and adolescents in the United Kingdom. The main objective of the study was to establish whether the parent-report Strengths and Difficulties Questionnaire (SDQ) was invariant across ethnicity and socioeconomic status groupings at six time points from 3 to 17 years (maximum N = 17,274). First, we fitted a series of confirmatory factor analysis models to the data and confirmed that the five-factor structure (emotional problems; peer problems; conduct problems; hyperactivity/inattention; and prosocial behaviour) had acceptable fit at ages 5, 7, 11, and 14 years. Next, we tested configural, metric, and scalar invariance at these time points and demonstrated scalar invariance across household income, parent highest education, and ethnicity categories. The five-factor structure did not fit well at ages 3 and 17 years; therefore invariance was not tested at these ages. These findings suggest the parent-report SDQ can be used to measure socioeconomic and ethnic inequalities in mental health from ages 5-14 years but more consideration is required outside these ages.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lifecourse investigation of the cumulative impact of adversity on cognitive function in old age and the mediating role of mental health

Jonathan M Schott / Marcus Richards / Praveetha Patalay / Yiwen Liu / Jean Stafford

BMJ Open, Vol 13, Iss

longitudinal birth cohort study

2023 Volume 11

Abstract: Objective To investigate the accumulation of adversities (duration of exposure to any, economic, psychosocial) across the lifecourse (birth to 63 years) on cognitive function in older age, and the mediating role of mental health.Design National birth ... ...

Abstract	Objective To investigate the accumulation of adversities (duration of exposure to any, economic, psychosocial) across the lifecourse (birth to 63 years) on cognitive function in older age, and the mediating role of mental health.Design National birth cohort study.Setting Great Britain.Participants 5362 singleton births within marriage in England, Wales and Scotland born within 1 week of March 1946, of which 2131 completed at least 1 cognitive assessment.Main outcome measures Cognitive assessments included the Addenbrooke’s Cognitive Examination-III, as a measure of cognitive state, processing speed (timed-letter search task), and verbal memory (word learning task) at 69 years. Scores were standardised to the analytical sample. Mental health at 60–64 years was assessed using the 28-item General Health Questionnaire, with scores standardised to the analytical sample.Results After adjusting for sex, increased duration of exposure to any adversity was associated with decreased performance on cognitive state (β=−0.39; 95% CI −0.59 to –0.20) and verbal memory (β=−0.45; 95% CI −0.63 to –0.27) at 69 years, although these effects were attenuated after adjusting for further covariates (childhood cognition and emotional problems, educational attainment). Analyses by type of adversity revealed stronger associations from economic adversity to verbal memory (β=−0.54; 95% CI −0.70 to –0.39), with a small effect remaining even after adjusting for all covariates (β=−0.18; 95% CI −0.32 to –0.03), and weaker associations from psychosocial adversity. Causal mediation analyses found that mental health mediated all associations between duration of exposure to adversity (any, economic, psychosocial) and cognitive function, with around 15% of the total effect of economic adversity on verbal memory attributable to mental health.Conclusions Improving mental health among older adults has the potential to reduce cognitive impairments, as well as mitigate against some of the effect of lifecourse accumulation of adversity on cognitive ...
Keywords	Medicine ; R
Subject code	150
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Socio-economic inequalities in adolescent mental health in the UK

Matthew Hazell / Emma Thornton / Hassan Haghparast-Bidgoli / Praveetha Patalay

SSM - Mental Health, Vol 2, Iss , Pp 100176- (2022)

Multiple socio-economic indicators and reporter effects

2022

Abstract: There are socio-economic inequalities in the experience of mental ill-health. However, less is known about the extent of inequalities by different indicators of socio-economic position (SEP). This is relevant for insights into the mechanisms by which ... ...

Abstract	There are socio-economic inequalities in the experience of mental ill-health. However, less is known about the extent of inequalities by different indicators of socio-economic position (SEP). This is relevant for insights into the mechanisms by which these inequalities arise. For young people's mental health there is an additional layer of complexity provided by the widespread use of proxy reporters. Using data from the UK Millennium Cohort Study (N = 10,969), we investigated the extent to which five SEP indicators (parent education, household income, household wealth, parent occupational status, and relative neighbourhood deprivation) predict adolescent internalising mental health (at ages 14 and 17 years) and how this varies as a function of reporter. Both parent report and adolescent self-report were considered. Regression models demonstrated that whilst greater disadvantage in all five SEP indicators were associated with greater parent-reported adolescent mental health symptoms, only income, wealth, and occupational status were associated with self-reported mental health symptoms at ages 14 and 17 years. The magnitude of these effects was greater for parent-reported than self-reported adolescent internalising symptoms: SEP indicators jointly predicted 4.73% and 4.06% of the variance in parent-reported symptoms at ages 14 and 17 compared to 0.58% and 0.60% of the variance in self-reported internalising mental health. Household income predicted the most variance in parent reported adolescent internalising symptoms (2.95% variance at age 14 & 2.64% at age 17) and wealth the most for self-reported internalising symptoms (0.42% variance at age 14 & 0.36% at age 17). Interestingly, the gradient and variance explained of parent-reported adolescent mental health across SEP indicators mirrors that of parent's own mental health (for example, income explained 4.89% variance at the age 14 sweep). Our findings highlight that the relevance of different SEP indicators to adolescent internalising mental health ...
Keywords	Inequalities ; Adolescence ; Mental health ; Internalising ; Socioeconomic ; Measurement ; Mental healing ; RZ400-408 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The gender gap in adolescent mental health

Olympia L K Campbell / David Bann / Praveetha Patalay

SSM: Population Health, Vol 13, Iss , Pp 100742- (2021)

A cross-national investigation of 566,829 adolescents across 73 countries

2021

Abstract: Mental ill-health is a leading cause of disease burden worldwide. While women suffer from greater levels of mental health disorders, it remains unclear whether this gender gap differs systematically across regions and/or countries, or across the ... ...

Abstract	Mental ill-health is a leading cause of disease burden worldwide. While women suffer from greater levels of mental health disorders, it remains unclear whether this gender gap differs systematically across regions and/or countries, or across the different dimensions of mental health. We analysed 2018 data from 566,829 adolescents across 73 countries for 4 mental health outcomes: psychological distress, life satisfaction, eudaemonia, and hedonia. We examine average gender differences and distributions for each of these outcomes as well as country-level associations between each outcome and purported determinants at the country level: wealth (GDP per capita), inequality (Gini index), and societal indicators of gender inequality (GII, GGGI, and GSNI). We report four main results: 1) The gender gap in mental health in adolescence is largely ubiquitous cross-culturally, with girls having worse average mental health; 2) There is considerable cross-national heterogeneity in the size of the gender gap, with the direction reversed in a minority of countries; 3) Higher GDP per capita is associated with worse average mental health and a larger gender gap across all mental health outcomes; and 4) more gender equal countries have larger gender gaps across all mental health outcomes. Taken together, our findings suggest that while the gender gap appears largely ubiquitous, its size differs considerably by region, country, and dimension of mental health. Findings point to the hitherto unrealised complex nature of gender disparities in mental health and possible incongruence between expectations and reality in high gender equal countries.
Keywords	Public aspects of medicine ; RA1-1270 ; Social sciences (General) ; H1-99
Subject code	331
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adverse childhood experiences and multiple mental health outcomes through adulthood

Dawid Gondek / Praveetha Patalay / Rebecca E. Lacey

SSM - Mental Health, Vol 1, Iss , Pp 100013- (2021)

A prospective birth cohort study

2021

Abstract: Objective: Exposure to adverse childhood experiences (ACEs) is associated with a broad range of mental health-related outcomes. Previous studies tended to use retrospectively reported ACEs, measure mental health outcomes at a one time point in adulthood ... ...

Abstract	Objective: Exposure to adverse childhood experiences (ACEs) is associated with a broad range of mental health-related outcomes. Previous studies tended to use retrospectively reported ACEs, measure mental health outcomes at a one time point in adulthood and focus on individual outcomes. Hence, this study aimed to examine the association between prospectively and retrospectively measured ACEs and a wide range of mental health-related outcomes, spanning ages 16 to55, using a prospective birth cohort, representative of those born around 1958 in Great Britain. Methods: The study used the 1958 National Child Development Study (n = 7980). Adverse childhood experiences were measured both prospectively and retrospectively, and combined into ACE scores. The associations between the ACE scores and mental health were quantified with linear regression for continuous and robust Poisson regression for binary outcomes. Results: We found a dose-response association between prospectively and retrospectively reported ACEs and all studied mental health-related outcomes, after accounting for multiple covariates. Among those with 2+ (vs 0) prospective ACEs, the risk of clinically significant psychological distress was up to 2.14 times higher, and of seeing a mental health specialist up to 2.85 times higher. Conclusions: Our findings reiterate the need for early-life interventions to reduce inequalities in mental health.
Keywords	Adverse childhood experiences ; Mental health ; Psychological distress ; National child development study ; Mental healing ; RZ400-408 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A systematic literature review of existing conceptualisation and measurement of mental health literacy in adolescent research

Rosie Mansfield / Praveetha Patalay / Neil Humphrey

BMC Public Health, Vol 20, Iss 1, Pp 1-

current challenges and inconsistencies

2020 Volume 14

Abstract: Abstract Background With an increased political interest in school-based mental health education, the dominant understanding and measurement of mental health literacy (MHL) in adolescent research should be critically appraised. This systematic literature ...

Abstract	Abstract Background With an increased political interest in school-based mental health education, the dominant understanding and measurement of mental health literacy (MHL) in adolescent research should be critically appraised. This systematic literature review aimed to investigate the conceptualisation and measurement of MHL in adolescent research and the extent of methodological homogeneity in the field for meta-analyses. Methods Databases (PsycINFO, EMBASE, MEDLINE, ASSIA and ERIC) and grey literature were searched (1997–2017). Included articles used the term ‘mental health literacy’ and presented self-report data for at least one MHL domain with an adolescent sample (10–19 years). Definitions, methodological and contextual data were extracted and synthesised. Results Ninety-one articles were identified. There was evidence of conceptual confusion, methodological inconsistency and a lack of measures developed and psychometrically tested with adolescents. The most commonly assessed domains were mental illness stigma and help-seeking beliefs; however, frequency of assessment varied by definition usage and study design. Recognition and knowledge of mental illnesses were assessed more frequently than help-seeking knowledge. A mental-ill health approach continues to dominate the field, with few articles assessing knowledge of mental health promotion. Conclusions MHL research with adolescent samples is increasing. Results suggest that a better understanding of what MHL means for this population is needed in order to develop reliable, valid and feasible adolescent measures, and explore mechanisms for change in improving adolescent mental health. We recommend a move away from ‘mental disorder literacy’ and towards critical ‘mental health literacy’. Future MHL research should apply integrated, culturally sensitive models of health literacy that account for life stage and acknowledge the interaction between individuals’ ability and social and contextual demands.
Keywords	Adolescent ; Mental health literacy ; Systematic literature review ; Conceptualisation ; Measurement ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The association between early life mental health and alcohol use behaviours in adulthood

Ke Ning / Dawid Gondek / Praveetha Patalay / George B Ploubidis

PLoS ONE, Vol 15, Iss 2, p e

A systematic review.

2020 Volume 0228667

Abstract: This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of ... ...

Abstract	This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.
Keywords	Medicine ; R ; Science ; Q
Subject code	150 ; 306
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The impact of the COVID-19 pandemic on adolescent mental health

Rosie Mansfield / Joao Santos / Jessica Deighton / Daniel Hayes / Tjasa Velikonja / Jan R. Boehnke / Praveetha Patalay

Royal Society Open Science, Vol 9, Iss

a natural experiment

2022 Volume 4

Abstract: Despite widespread concern about the impact of COVID-19 on adolescent mental health, there remains limited empirical evidence that can causally attribute changes to the pandemic. The current study aimed to overcome existing methodological limitations by ... ...

Abstract	Despite widespread concern about the impact of COVID-19 on adolescent mental health, there remains limited empirical evidence that can causally attribute changes to the pandemic. The current study aimed to overcome existing methodological limitations by exploiting a serendipitously occurring natural experiment within two ongoing, multi-phase cluster randomized controlled trials. Depressive symptoms (primary outcome), externalizing difficulties and life satisfaction (secondary outcomes) were assessed at baseline (phase 1 [pre-COVID-19 group]: September – October 2018, phase 2 [COVID-19 group]: September – October 2019) and 1-year follow-up (pre-COVID-19 group: January – March 2020, COVID-19 group: February – April 2021). Participants in phase 1 (N = 6419) acted as controls. In phase 2, participants (N = 5031) were exposed to the COVID-19 pandemic between the baseline and follow-up assessments providing a natural experimental design. The primary analysis used a random intercept linear multivariable regression model with phase (exposure to the COVID-19 pandemic) included as the key predictor while controlling for baseline scores and individual and school-level covariates. Depressive symptoms were higher and life satisfaction scores lower in the group exposed to the COVID-19 pandemic. Had the COVID-19 pandemic not occurred, we estimate that there would be 6% fewer adolescents with high depressive symptoms. No effect of exposure to the pandemic on externalizing difficulties was found. Exploratory analyses to examine subgroup differences in impacts suggest that the negative impact of the COVID-19 pandemic on adolescent mental health may have been greater for females than males. Given the widespread concern over rising adolescent mental health difficulties prior to the pandemic, this paper quantifies the additional impacts of the pandemic. A properly resourced, multi-level, multi-sector public health approach for improving adolescent mental health is necessary. Following in-principle acceptance, the approved Stage 1 ...
Keywords	COVID-19 pandemic ; adolescence ; mental health ; depression ; externalizing ; wellbeing ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	The Royal Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Structure and Connectivity of Depressive Symptom Networks Corresponding to Early Treatment Response

Eoin McElroy / Elisa Napoleone / Miranda Wolpert / Praveetha Patalay

EClinicalMedicine, Vol 8, Iss , Pp 29-

2019 Volume 36

Abstract: Background: There are suggestions that denser network connectivity (i.e., the strength of associations between individual symptoms) may be a prognostic indicator of poor treatment response in depression. We sought to examine this aspect of depressive ... ...

Abstract	Background: There are suggestions that denser network connectivity (i.e., the strength of associations between individual symptoms) may be a prognostic indicator of poor treatment response in depression. We sought to examine this aspect of depressive symptom networks in the context of early responses to treatment in adolescents. Methods: Routine psychiatric data were obtained for child/adolescent service users who underwent at least three treatment sessions in publicly funded services in England between 2011 and 2015 (N = 3017, 78% female; mean age [SD] = 14.43 years [1.75]). Depressive symptoms were assessed using the Revised Children's Anxiety and Depression Scale at presentation, and again after three treatment sessions. Treatment response was determined using the Reliable Change Index. Network analysis was used to compare the depressive symptom structure and connectivity of sub-samples who, after three treatment sessions had: 1) positively responded (n = 566), 2) not reliably changed (n = 2277), and 3) reliably deteriorated (n = 174), using matched samples to control for baseline severity. Findings: Overall connectivity (i.e., the summed total of weighted connections) was significantly weaker for the positive treatment response group at baseline (compared with unchanged and deteriorated groups), however, this group saw the largest increase in connectivity over the course of treatment. With regard to the overall importance of specific symptoms within the networks, fatigue was highest in strength for the unchanged and deteriorated groups, whereas low mood was highest in strength for the improved group. Interpretation: This study demonstrates that adolescents who respond early to treatment for depression are characterised by symptom networks that are less densely connected initially, yet increase in connectivity over the course of treatment. This may be indicative of ‘positive spirals’ whereby improvement in one symptom triggers improvements in other symptoms, thereby increasing symptom–symptom associations ...
Keywords	Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2019-02-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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