Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study

Abstract

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.

Keywords: Children and adolescents; Health care use; Health-related quality of life; Longitudinal analyses; Nation-wide survey; Young adults.

Fig. 1

Measuring points of the BELLA study

Fig. 2

Numbers of invited and participating children and adolescents in the BELLA study

Fig. 3

Gender-specific course of self-reported general health (according to the general health item; GHI) from age 11 to age 29 (1 = ‘poor’ / ‘fair’, 2 = ‘good’, 3 = ‘very good’ and 4 = ‘excellent’ general health)

Fig. 4

Gender-specific course of parent-reported general health (according to the general health item; GHI) from age 3 to age 19 (1 = ‘poor’ / ‘fair’, 2 = ‘good’, 3 = ‘very good’ and 4 = ‘excellent’ general health)

Fig. 5

Gender-specific course of self-reported health-related quality of life (according to the KIDSCREEN-10 index) from age 11 to age 19

Fig. 6

Gender-specific course of parent-reported health-related quality of life (according to the KIDSCREEN-10 index) from age 6 to age 19

Fig. 7

Long-term effects of self-reported mental health problems and of the impact of mental health problems (according to the Strengths and Difficulties Questionnaire (SDQ) and its impact supplement) at baseline on health-related outcomes (according to the SF-36) at 6-year and 11-year follow-ups. B = unstandardized regression coefficient; *p < 0.05, **p < 0.01, ***p < 0.001; dashed lines indicate non-significant effects, continuous arrows indicate significant effects; η² indicates effect sizes; for the impact of mental health problems, groups borderline and abnormal were compared each to the group normal

Fig. 8

Long-term effects of parent-reported mental health problems and of the impact of mental health problems (according to the Strengths and Difficulties Questionnaire (SDQ) and its impact supplement) at baseline on health-related outcomes (according to the SF-36) at 6-year and 11-year follow-ups. B = unstandardized regression coefficient; *p < 0.05, **p < 0.01, ***p < 0.001; dashed lines indicate non-significant effects, continuous arrows indicate significant effects; η² indicates effect sizes; for the impact of mental health problems, groups borderline and abnormal were compared each to the group normal