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Association of Child and Adolescent Mental Health With Adolescent Health Behaviors in the UK Millennium Cohort

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Peer-reviewed

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Article

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Hoare, E 
Werneck, A 
Stubbs, B 
Firth, J 
Collins, S 

Abstract

Abstract Importance: There is potential for mental health status to act as a determinant of an individual’s ability to engage in healthful lifestyle behaviours. Objective: The objective of this study was to investigate the associations between parent-reported mental health problems during childhood, and self-reported mental health problems in adolescence, and health behaviours in adolescence. Design: Wave 4 and Wave 6 of the Millennium Cohort Study were utilised in this longitudinal cohort study which were collected in 2008 and 2015, respectively. Regression models were calculated for each lifestyle variable, with mental health change from 7 to 14 years as the exposure variable. Data were weighted to account for the potential clustering of region of sampling and adjusted for non-response. Setting: The Millennium Cohort Study is a UK population-representative longitudinal study of young people born during 2000-2001. Participants: This is a UK population-representative sample of young people (n=4,614). Half (52%) of the sample were female, most (77%) were born in England, and a greater proportion of the final sample had a household income reflective of the highest quintile (27%) compared to lowest quintile (8%). Most (66%) did not have mental health problems at baseline or follow-up. There were 24% who self-reported mental health problems at age 14 years, but did not have parent-reported mental health problems at 7 years. Exposure: Mental health problems at 7 years were parent-reported using Strengths and Difficulties Questionnaire. Mental health problems were self-reported at 14 years using the Short Mood and Feelings Questionnaire. Main outcome: Health behaviours at 14 years were the main outcome of interest. Sleep duration, fruit, vegetable, and soft drink consumption and social media use were self-reported using recall on a typical day. Results: The total participating sample was 4,618; 2,240 were female and 2,638 were recruited from England. Adolescents who self-reported mental health problems at 14 years were less likely to have at least 9 hours of sleep (OR=0.38, 95%CI:0.26;0.56), were less likely to consume fruit (OR=0.58, 95%CI:0.38;0.86) and reported greater use of social media (b=0.73, 95%CI:0.53;0.94), compared to individuals who did not have parent-reported mental health problems at 7 years nor self-reported at 14 years. Conclusions and Relevance: The presence of depressive symptoms at 14 years were associated to some health behaviours at 14 years. These findings are particularly important given that independent health behaviours can both deteriorate and become habitual during adolescence, and it is also a known time for the first emergence of mental health problems that continue into adulthood. Trial Registration: This study and analysis plan was registered on Australia New Zealand Clinical Trials Registry ACTRN12619001245189.

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JAMA Network Open

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Sponsorship
Medical Research Council (MC_UU_12015/7)
Medical Research Council (MR/K023187/1)
EH is funded by an Australian National Health and Medical Research Council Early Career Fellowship (1156909). JF is supported by a Blackmores Institute Fellowship. SC is supported by a Deakin University Postgraduate Scholarship. Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs is also supported by the Maudsley Charity, King’s College London and the NIHR South London Collaboration for Leadership in Applied Health Research and Care (CLAHRC) funding. This paper presents independent research. The views expressed in this publication are those of the authors and not necessarily those of the acknowledged institutions. André O. Werneck is funded by São Paulo Research Foundation (FAPESP) (FAPESP process: 2018/19183-1). The work of Kirsten Corder and Esther van Sluijs was supported by the Medical Research Council [Unit Programme number MC_UU_12015/7], and undertaken under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged [087636/Z/08/Z; ES/G007462/1; MR/K023187/1]. The MCS is led by the Centre for Longitudinal Studies through funding from the Economic and Social Research Council. Further supplemental funding has been received from a consortium of government funders, including the Department for Education, the Department of Health, the Department for Work and Pensions, the Scottish Government, the Welsh Government, the Northern Ireland Department of Employment and Learning, Northern Ireland Department of Health, Social Services and Public Safety, the Northern Ireland Department of Education, the Northern Ireland Office of the First and Deputy First Minister, the Department for Transport and the Home Office.