title: School environment and mental health in early adolescence - a longitudinal study in Sweden (KUPOL).
abstract: Longitudinal studies indicate strong associations between school proficiency and indicators of mental health throughout adulthood, but the mechanisms of such associations are not fully elucidated. The Kupol study is a prospective cohort study in Sweden set up in order to: (i) describe the association of school pedagogic and social environment and its specific dimensions with the risk of mental ill-health and psychiatric disorders in adolescence; (ii) evaluate the direct effects of school pedagogic and social environment on mental health and the effects mediated by the individual's academic achievements; and (iii) assess if school pedagogic and social environment are associated with mental ill-health through epigenetic mechanisms, in particular those involving genes regulating the response to stress.
  
  
  
  The Kupol cohort at baseline consists of 3959 children attending the 7th grade of compulsory school (13-14 years old) in 8 regions of central Sweden in the school years 2013-2014 or 2014-2015. Three follow-up surveys in subsequent years are planned. Teachers' and students' perceptions of the culture, climate and ethos of their schools, and students' mental ill-health are assessed at the whole school level by annual questionnaire surveys. In order to conduct epigenetic analyses saliva specimens are collected from a nested sample of students at inception and two years later. Further, class-, family- and child-level information is collected at baseline and during each year of follow-up. Self-reported information is being complemented with register data via record-linkages to national and regional health and administrative registers.
  
  
  
  The topic being investigated is new, and the sample constitutes the largest adolescent cohort in Sweden involved in an ad hoc study. Epigenetic analyses centered on environmental cues to stress response are a thoroughly new approach. Finally a notable feature is the multi-informant and multi-method data collection, with surveys at the school, class, family, and student level. Collaboration and data access: interested investigators should contact the coordinating centre. Additional information is available on the study's website, http://kupolstudien.se/ .
authors.affiliation: Department of Public Health Sciences, Centre for Epidemiology and Community Medicine (CES), Stockholm County's Health Care District (SLSO), Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 17177, Stockholm, Sweden. rosaria.galanti@ki.se.
authors.forename: Maria Rosaria
authors.identifier: 0000-0002-7805-280X
authors.initials: MR
authors.lastname: Galanti
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Hultin
authors.affiliation: Department of Public Health Sciences, Centre for Epidemiology and Community Medicine (CES), Stockholm County's Health Care District (SLSO), Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 17177, Stockholm, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Dalman
authors.affiliation: Department of Public Health Sciences, Centre for Epidemiology and Community Medicine (CES), Stockholm County's Health Care District (SLSO), Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 17177, Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Engström
authors.affiliation: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors.forename: Laura
authors.initials: L
authors.lastname: Ferrer-Wreder
authors.affiliation: Department of Public Health Sciences, Centre for Epidemiology and Community Medicine (CES), Stockholm County's Health Care District (SLSO), Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 17177, Stockholm, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Forsell
authors.affiliation: Department of Education, Uppsala University, Stockholm, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Karlberg
authors.affiliation: Center for Molecular Medicine, Karolinska Institutet, University Hospital Sweden, Stockholm, Sweden.
authors.forename: Catharina
authors.initials: C
authors.lastname: Lavebratt
authors.affiliation: Department of Public Health Sciences, Centre for Epidemiology and Community Medicine (CES), Stockholm County's Health Care District (SLSO), Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 17177, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Magnusson
authors.affiliation: The Swedish Agency for Health Technology Assessment and Assessment of the Social Services, SBU, Stockholm, Sweden.
authors.forename: Knut
authors.initials: K
authors.lastname: Sundell
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Melody
authors.initials: M
authors.lastname: Almroth
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Elena
authors.initials: E
authors.lastname: Raffetti
mesh_terms: D000293:Adolescent; D004522:Educational Status; D015340:Epidemiologic Research Design; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011446:Prospective Studies; D000070777:School Teachers / Q000523:psychology; D012574:Schools; D057566:Self Report; D012931:Social Environment; D013315:Stress, Psychological / Q000235:genetics; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Adolescence; Mental health; School environment