title: Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders.
abstract: BACKGROUND
  With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders.
  
  
  METHODS
  We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths.
  
  
  RESULTS
  Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders.
  
  
  CONCLUSIONS
  At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.
authors: University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands.
authors: J
authors: J
authors: Ormel
authors: University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands.
authors: D
authors: D
authors: Raven
authors: Department of Child and Adolescent Psychiatry and Psychology,Erasmus Medical Center,Rotterdam,The Netherlands.
authors: F
authors: F
authors: van Oort
authors: University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands.
authors: C A
authors: CA
authors: Hartman
authors: Department of Health Sciences,University of Groningen,University Medical Center Groningen, Groningen,The Netherlands.
authors: S A
authors: SA
authors: Reijneveld
authors: Department of Sociology,University of Groningen,Groningen,The Netherlands.
authors: R
authors: R
authors: Veenstra
authors: Department of Youth and Family,University of Utrecht,Utrecht,The Netherlands.
authors: W A M
authors: WA
authors: Vollebergh
authors: Department of Psychiatry,Radboud University Nijmegen,Nijmegen,The Netherlands.
authors: J
authors: J
authors: Buitelaar
authors: Department of Child and Adolescent Psychiatry and Psychology,Erasmus Medical Center,Rotterdam,The Netherlands.
authors: F C
authors: FC
authors: Verhulst
authors: University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands.
authors: A J
authors: AJ
authors: Oldehinkel
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011599:Psychopathology; D012008:Recurrence; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Age of onset; anxiety; behaviour disorders; co-morbidity; depression; psychopathology