Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study
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Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an 11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7–31 years participated ( n = 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.
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For a small proportion of children, early behavioral difficulties persist and represent the start of a pathway to mental health challenges.
“While such difficulties usually resolve naturally across the transition into the pre-school years [86], for a small proportion of children, difficulties persist and represent the start of a pathway to mental health challenges [4, 11, 15, 16, 24, 44, 71].”
From Optimizing parenting and child outcomes following parent–child interaction therapy – toddler: a randomized controlled trial (2024) · cites this paper as [71]
The Discussion reports that about 31% of participants with mental health problems at baseline had corresponding problems six years later, and that childhood or adolescent symptoms predicted later mental health. It does not establish that behavioral difficulties beginning before preschool persist in a small proportion of children; its findings concern mental health problems in children and adolescents more broadly. Page numbers are unavailable in our copy. (LLM, conf=0.84)
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Ravens-Sieberer, U., Erhart, M., Devine, J., Gilbert, M., Reiss, F., Barkmann, C., Siegel, N. A., Simon, A. M., Hurrelmann, K., Schlack, R., et al. (2022) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2022.06.022 · Cited by 401 · see citing works
Self-citationRavens-Sieberer, U., Kaman, A., Otto, C., Adedeji, A., Napp, A.-K., Becker, M., Blanck-Stellmacher, U., Löffler, C., Schlack, R., Hölling, H., et al. (2021) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-021-03291-3 · Cited by 227 · see citing works
Self-citationNagata, J. M., Al-Shoaibi, A. A. A., Leong, A. W., Zamora, G., Testa, A., Ganson, K. T., & Baker, F. C. (2024) · BMC Public Health · doi:10.1186/s12889-024-20102-x · Cited by 103 · see citing works
Kohlhoff, J., Wallace, N., Cibralic, S., Morgan, S., Briggs, N. E., McMahon, C., Hawkins, E., Druskin, L., Owen, C., Lieneman, C., et al. (2024) · BMC Psychology · doi:10.1186/s40359-024-02171-0 · Cited by 11 · see citing works
“While such difficulties usually resolve naturally across the transition into the pre-school years [86], for a small proportion of children, difficulties persist and represent the start of a pathway to mental health challenges [4, 11, 15, 16, 24, 44, 71].”
- Authors
- Otto, C., Reiss, F., Voss, C., Wüstner, A., Meyrose, A.-K., Hölling, H., & Ravens-Sieberer, U.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Helmut Schmidt University (DE)
- Robert Koch Institute (DE)
- ORCID
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2020-09-12
- Volume
- 30
- Issue
- 10
- Pages
- 1559-1577
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC8505294
- OpenAlex
- W3086032504
- Cited by
- 235
- References
- 94
- Citations by year
- 2026: 31 · 2025: 64 · 2024: 54 · 2023: 45 · 2022: 30 · 2021: 9 · 2020: 1
- FWCI
- 8.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Publication server of the Robert Koch Institute (Robert Kock Institute) (submittedVersion, cc-by)
- Funders
- Robert Koch Institut
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- mental health, well-being, longitudinal follow-up, child psychopathology, adolescents, young adults, health status, gender differences, age differences, mental health service utilization, health promotion, prevention, KiGGS
- MeSH terms
- Adolescent, Mental Disorders, Child, Female, Follow-Up Studies, Germany, Health Surveys, Humans, Male, Mental Health, Prospective Studies, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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