Enduring Mental Health in Childhood and Adolescence: Prevalence, Prediction, and Genetic Architecture

Objective: The concept of enduring mental health (EMH) describes a long-term state in which a person does not experience mental disorders. Most people encounter mental health issues at some point; this study investigated the prevalence, predictors, and genetic architecture of EMH across childhood.

Method: EMH status was based on longitudinal data from 18,884 Dutch twins assessed at ages 3, 5, 7, 10, and 12 for behavioral and emotional problems. Children were grouped into 3 categories: EMH, some instances of mental health problems, and many instances of mental health problems. Child- and parent-level factors including individual polygenic scores were tested for associations with these 3 categories. A twin model was used to assess the contribution of genetic and environmental factors to EMH.

Results: EMH was experienced by 37% of the sample. EMH was associated with parental low and middle education categories (relative risk [95% CI] = 0.77 [0.70-0.86] and 0.88 [0.82-0.95], respectively), child academic achievement (relative risk [95% CI] = 1.07 [1.03,1.12]), and child well-being (relative risk [95% CI] = 1.44 [1.35,1.54]) and was weakly associated with some polygenic scores. The twin model estimated that 54% of the variance in EMH was due to genetic factors.

Conclusion: EMH was observed in slightly more than a third of children. Individual differences in EMH were influenced by various sociodemographic factors, mental health–related variables, and genetic predispositions, suggesting that strategies to support EMH will likely require a comprehensive, multifaceted approach. Study Registration Information: Enduring Mental Health in Childhood and Adolescence: Prevalence, Prediction, and Genetic Architecture; https://osf.io/6fnwg. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science.