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Enduring Mental Health: Prevalence and Prediction

View Article: PubMed Central - PubMed

ABSTRACT

We review epidemiological evidence indicating that most people will develop a diagnosable mental disorder, suggesting that only a minority experience enduring mental health. This minority has received little empirical study, leaving the prevalence and predictors of enduring mental health unknown. We turn to the population-representative Dunedin cohort, followed from birth to midlife, to compare people never-diagnosed with mental disorder (N = 171; 17% prevalence) to those diagnosed at 1–2 study waves, the cohort mode (N = 409). Surprisingly, compared to this modal group, never-diagnosed Study members were not born into unusually well-to-do families, nor did their enduring mental health follow markedly sound physical health, or unusually high intelligence. Instead, they tended to have an advantageous temperament/personality style, and negligible family history of mental disorder. As adults, they report superior educational and occupational attainment, greater life satisfaction, and higher-quality relationships. Our findings draw attention to “enduring mental health” as a revealing psychological phenotype and suggest it deserves further study.

No MeSH data available.


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Mental disorder diagnoses in the Dunedin Cohort (N = 988). Panel A: Number of waves in which Dunedin Study members met criteria for a DSM diagnosis. The 6 waves represent ages 11–15, 18, 21, 26, 32, and 38. The red bar represents Study members with enduring mental health (those diagnosed at 0 waves). The light blue bars represent Study members with typical mental health histories (those diagnosed at 1–2 waves). The dark blue bars represent Study members diagnosed at 3 + waves. Panel B: Distribution of DSM diagnoses across assessment waves. Each thin horizontal line represents an individual Study member’s mental health history. Blue indicates that the Study member met criteria for a past-year DSM -defined psychiatric disorder during this assessment. Red indicates that the Study member did not meet criteria for a past-year DSM-defined psychiatric disorder during this assessment. Panel B shows that the largest proportion of Study members met diagnostic criteria at 1–2 waves, but that neither these individuals nor those diagnosed at 3 + waves were characterized by any particular developmental pattern (e.g., adolescent-limited course of disorder or late-onset forms of disorder).
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fig2: Mental disorder diagnoses in the Dunedin Cohort (N = 988). Panel A: Number of waves in which Dunedin Study members met criteria for a DSM diagnosis. The 6 waves represent ages 11–15, 18, 21, 26, 32, and 38. The red bar represents Study members with enduring mental health (those diagnosed at 0 waves). The light blue bars represent Study members with typical mental health histories (those diagnosed at 1–2 waves). The dark blue bars represent Study members diagnosed at 3 + waves. Panel B: Distribution of DSM diagnoses across assessment waves. Each thin horizontal line represents an individual Study member’s mental health history. Blue indicates that the Study member met criteria for a past-year DSM -defined psychiatric disorder during this assessment. Red indicates that the Study member did not meet criteria for a past-year DSM-defined psychiatric disorder during this assessment. Panel B shows that the largest proportion of Study members met diagnostic criteria at 1–2 waves, but that neither these individuals nor those diagnosed at 3 + waves were characterized by any particular developmental pattern (e.g., adolescent-limited course of disorder or late-onset forms of disorder).

Mentions: Figure 2a displays the number of waves (from 0 to 6) in which Study members met criteria for one or more mental disorders. On average, cohort members met criteria for a mental disorder on 2.3 of the six assessment waves, but there was a great deal of variation. The most common mental health history in the cohort appeared to be one characterized by a relatively brief, episodic course of disorder, in which Study members met diagnostic criteria for a disorder at only 1 or 2 assessment waves (N = 409). We also included in this group 9 Study members who were not diagnosed with a mental disorder by Dunedin Study staff, but reported receiving a psychiatric diagnosis while using mental health services in the gaps between assessment waves.1 Study members who experienced enduring mental health (i.e., met diagnostic criteria at 0 waves), in contrast, were a distinct minority, comprising only 17.3% of the cohort (N = 171).2 The remainder of the cohort were Study members who had met criteria for one or more mental disorder diagnoses at 3 + waves (N = 408). It is important to note that Study members were not classified as having enduring mental health simply because they participated in fewer waves: On average, Study members with enduring mental health had complete data on 5.7 (out of 6) waves, whereas Study members who met diagnostic criteria at 1–2 waves had complete data on 5.8 waves, and Study members who met diagnostic criteria at 3–6 waves had complete data on 5.8 waves.


Enduring Mental Health: Prevalence and Prediction
Mental disorder diagnoses in the Dunedin Cohort (N = 988). Panel A: Number of waves in which Dunedin Study members met criteria for a DSM diagnosis. The 6 waves represent ages 11–15, 18, 21, 26, 32, and 38. The red bar represents Study members with enduring mental health (those diagnosed at 0 waves). The light blue bars represent Study members with typical mental health histories (those diagnosed at 1–2 waves). The dark blue bars represent Study members diagnosed at 3 + waves. Panel B: Distribution of DSM diagnoses across assessment waves. Each thin horizontal line represents an individual Study member’s mental health history. Blue indicates that the Study member met criteria for a past-year DSM -defined psychiatric disorder during this assessment. Red indicates that the Study member did not meet criteria for a past-year DSM-defined psychiatric disorder during this assessment. Panel B shows that the largest proportion of Study members met diagnostic criteria at 1–2 waves, but that neither these individuals nor those diagnosed at 3 + waves were characterized by any particular developmental pattern (e.g., adolescent-limited course of disorder or late-onset forms of disorder).
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Related In: Results  -  Collection

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fig2: Mental disorder diagnoses in the Dunedin Cohort (N = 988). Panel A: Number of waves in which Dunedin Study members met criteria for a DSM diagnosis. The 6 waves represent ages 11–15, 18, 21, 26, 32, and 38. The red bar represents Study members with enduring mental health (those diagnosed at 0 waves). The light blue bars represent Study members with typical mental health histories (those diagnosed at 1–2 waves). The dark blue bars represent Study members diagnosed at 3 + waves. Panel B: Distribution of DSM diagnoses across assessment waves. Each thin horizontal line represents an individual Study member’s mental health history. Blue indicates that the Study member met criteria for a past-year DSM -defined psychiatric disorder during this assessment. Red indicates that the Study member did not meet criteria for a past-year DSM-defined psychiatric disorder during this assessment. Panel B shows that the largest proportion of Study members met diagnostic criteria at 1–2 waves, but that neither these individuals nor those diagnosed at 3 + waves were characterized by any particular developmental pattern (e.g., adolescent-limited course of disorder or late-onset forms of disorder).
Mentions: Figure 2a displays the number of waves (from 0 to 6) in which Study members met criteria for one or more mental disorders. On average, cohort members met criteria for a mental disorder on 2.3 of the six assessment waves, but there was a great deal of variation. The most common mental health history in the cohort appeared to be one characterized by a relatively brief, episodic course of disorder, in which Study members met diagnostic criteria for a disorder at only 1 or 2 assessment waves (N = 409). We also included in this group 9 Study members who were not diagnosed with a mental disorder by Dunedin Study staff, but reported receiving a psychiatric diagnosis while using mental health services in the gaps between assessment waves.1 Study members who experienced enduring mental health (i.e., met diagnostic criteria at 0 waves), in contrast, were a distinct minority, comprising only 17.3% of the cohort (N = 171).2 The remainder of the cohort were Study members who had met criteria for one or more mental disorder diagnoses at 3 + waves (N = 408). It is important to note that Study members were not classified as having enduring mental health simply because they participated in fewer waves: On average, Study members with enduring mental health had complete data on 5.7 (out of 6) waves, whereas Study members who met diagnostic criteria at 1–2 waves had complete data on 5.8 waves, and Study members who met diagnostic criteria at 3–6 waves had complete data on 5.8 waves.

View Article: PubMed Central - PubMed

ABSTRACT

We review epidemiological evidence indicating that most people will develop a diagnosable mental disorder, suggesting that only a minority experience enduring mental health. This minority has received little empirical study, leaving the prevalence and predictors of enduring mental health unknown. We turn to the population-representative Dunedin cohort, followed from birth to midlife, to compare people never-diagnosed with mental disorder (N = 171; 17% prevalence) to those diagnosed at 1–2 study waves, the cohort mode (N = 409). Surprisingly, compared to this modal group, never-diagnosed Study members were not born into unusually well-to-do families, nor did their enduring mental health follow markedly sound physical health, or unusually high intelligence. Instead, they tended to have an advantageous temperament/personality style, and negligible family history of mental disorder. As adults, they report superior educational and occupational attainment, greater life satisfaction, and higher-quality relationships. Our findings draw attention to “enduring mental health” as a revealing psychological phenotype and suggest it deserves further study.

No MeSH data available.


Related in: MedlinePlus