Changes in millennial adolescent mental health and health-related behaviours over 10 years: a population cohort comparison study
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Abstract
BACKGROUND: There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015. METHODS: Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5627, born 1991-92) and Millennium Cohort Study (MCS, N = 11 318, born 2000-02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples. RESULTS: Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7-8.9% to 9.7-17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2-40.1% to 1.6-27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (<8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts. CONCLUSIONS: Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge.
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Effectively addressing multiple lifestyle factors in young people presents a promising approach towards tackling the rates of mental illness across the population.
“effectively addressing multiple lifestyle factors in young people presents a promising approach towards tackling the rates of mental illness across the population 6,7,83,84 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [7]
The Discussion (page not supplied) says that understanding links between adolescents’ health-related behaviours and mental health could identify targets for interventions to prevent rising mental health problems. It does not establish that addressing multiple lifestyle factors is effective or would reduce mental illness rates across the population; it cautions that these links may be complex and change over time. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMetabolic diseases and obesity have been linked to the recent rise of mental illness in young people.
“have been linked to the recent rise of mental illness in young people 7 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [7]
The Discussion (page not provided) says increasing weight and perceived overweight status might help explain rising mental health difficulties in adolescents. It does not address metabolic diseases as a factor in that rise. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Patalay, P., & Gage, S. H.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Patalay, Praveetha
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-02-27
- Volume
- 48
- Issue
- 5
- Pages
- 1650-1664
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2951404944
- Cited by
- 335
- References
- 33
- Citations by year
- 2026: 26 · 2025: 55 · 2024: 63 · 2023: 57 · 2022: 50 · 2021: 44 · 2020: 31 · 2019: 9
- FWCI
- 39.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Epidemiology (publishedVersion)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- UK Medical Research Council
- Wellcome (102215/2/13/2)
- University of Bristol
- 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 › Adolescent Health and Behaviors
- Keywords
- adolescent mental health, depressive symptoms, self-harm, substance use, adolescent sexual activity, sleep duration, body mass index, weight perception, conduct problems, peer problems, antisocial behavior, health behavior, cohort comparison, Avon Longitudinal Study of Parents and Children, Millennium Cohort Study, temporal trends, adolescent obesity
- MeSH terms
- Adolescent, Adolescent Behavior, Depression, Female, United Kingdom, Humans, Male, Mental Health, Risk Factors, Smoking, Cohort Studies, Health Behavior, Body Mass Index, Logistic Models, Substance-Related Disorders, Overweight
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