Population-Based Epidemiologic Research

National Institute Of Mental Health

Investigators

Linked publications, trials & patents

Abstract

We continue to leverage the National Comorbidity Survey (NCS-A) for its rich information on risk factors to expand the scientific knowledge base that can be used to inform prevention efforts. In collaboration with a colleague at UCSF we published a study documenting associations between various indicators of social capital and mental disorder among US adolescents (Hirota et al., 2021). We found consistent and pervasive associations between mental disorder and adolescent reports of friendship quality, family cohesion, and school bonding, while caregiver reports of community social capital were less consistent. These results are consistent with the importance of peer relationships, family environment, and school as influences on adolescents' health and functioning. We continue to work with data from the NCS-A, the National Comorbidity Survey Replication, and the National Epidemiologic Study on Alcohol and Related Conditions (NESARC), to study comorbidity of medical and mental health conditions. We found associations between headache and mental disorders among US adolescents (Hommer et al., 2020). In particular, migraine was strongly associated with the presence of mood/anxiety disorders, although it was also associated with substance use and behavior disorders, and adolescents with migraine were more likely to have multiple types of mental disorder. We also published a study investigating the links between Irritable Bowel Syndrome (IBS), and mental health and sleep among US adults (Grover et al., 2021). We found that IBS was associated with anxiety, mood, and behavior disorders, but not with substance use disorders. Finally, we published an article investigating the contributions of childhood maltreatment and mood disorder to medical comorbidities among US adults from NESARC (Stapp et al., 2020). We found that both mood disorders and childhood maltreatment contributed to medical conditions among adults, with magnitudes similar to major risk factors such as obesity and smoking, underscoring the importance of early-life exposures in shaping health and highlight the need for trauma-informed medical care. We also collaborated on a publication using data from a community-based sample of twins and siblings in Australia that investigated the structure of symptom networks in youth with, and at high risk for, bipolar disorder (BD). We found that among those with recent-onset BD and those with greater risk of BD, the symptoms of anergia and psychomotor speed were influential in the symptom structure (Scott et al., 2021). These findings are consistent with work from our mMARCH and Family Study programs that documents the importance of behavioral activation and activity as a core domain of BD. A substantial proportion of our work this year was devoted to responding to the COVID-19 pandemic. Along with researchers at the Child Mind Institute, with whom we collaborate on publications from the Healthy Brain Network (HBN) study, as well as another Branch at NIMH, we established the CRISIS Consortium. Our first task was to develop and validate a survey to measure the mental, physical, and behavioral health impacts of the pandemic. We achieved this by creating the Coronavirus Health Impact Survey (CRISIS; www.crisissurvey.org), which has subsequently been used in numerous research studies and translated into multiple languages. We published a study documenting the reliability and validity features of the CRISIS, which demonstrated the relevance of various domains measured on the CRISIS as contributors to mood/anxiety symptoms during the pandemic (Nikolaidis et al., 2020). Subsequent to its development and validation, the CRISIS was administered to parents of youth participants in the HBN at 2 time points during the pandemic. These data will serve as a valuable scientific resource, as the HBN participants were extremely well-characterized prior to the pandemic with regard to mental health, physical/psychological development, cognitive function, physical health, sleep and activity, and other key domains. We are working on several projects that leverage this rich prior data in combination with CRISIS data to study important questions regarding the effects of the COVID-19 pandemic on youth mental and behavioral health. We recently advocated for such approaches, which link data across multiple platforms and systems, to serve the mental health field by using more complex study designs and analytic techniques to predict changes in population mental health in response to events such as the COVID-19 pandemic (Atkinson et al., 2020). In this commentary, we compared the field of population mental health research with that of infectious disease epidemiology and argued that more advanced ways of approaching data and research are needed to adequately deliver mental health interventions and services to the population. Transdiagnostic samples of youth with extensive measurement across a large variety of domains, such as the HBN, are necessary to develop better early interventions and improve diagnosis and treatment of mental health conditions. We recently contributed to a publication describing the inception of a new cohort study, the Neurobiology Youth Follow-up Study, which will collect such information longitudinally among youth seeking care at an early intervention clinical service in Sydney, Australia (Nichles et al., 2021). The longitudinal design will make this study a rich and beneficial resource for numerous scientific questions relevant to our own research programs as well as others across the world. Finally, we collaborated with colleagues at NIMH on a validation study of the ASQ suicide screening tool among pediatric inpatients (Horowitz et al, 2020). Our validation study showed that the ASQ provides effective screening of pediatric medical/surgical inpatients for suicide risk that is also feasible and acceptable. Public Health Impact: The investigation of risk factors during development, which the NCS-A makes possible, is extremely important in mental health because many cases of psychiatric disorder first arise during or prior to young adulthood and because brain development is implicated in the etiology of many psychiatric disorders. Our studies of physical-mental comorbidity and sleep in adolescents and adults complement our family study work on the importance of physiological systems and behavioral rhythms in mental health and contribute to scientific understanding of psychiatric disorder etiology and opportunities for prevention. Our work to understand the core clinical domains underlying BD complements our other research programs and will ultimately aid in treatment and prevention by informing disorder etiology. Our recently established CRISIS Consortium and continued collaboration with HBN will further our opportunity to conduct research aimed at reducing the adverse consequences of the COVID-19 pandemic and other influences on mental health problems among youth, which may have life-long positive benefit. Future Plans: We plan to continue our activity in the CRISIS Consortium and the HBN study with intensive analysis of collected data on clinical features, risk factors, and impairment. We are also helping to design and implement a prospective follow-up of select HBN participants that will provide longitudinal information on patterns of symptoms, behaviors, and risk across time during development. We also expect to continue publishing population-based studies related the themes of: 1) the intersection between physical and mental health, 2) the relation between health behaviors such as sleep and activity and psychiatric disorders, 3) the influence of environmental and social exposures among children and youth; 4) associations between sleep, physical activity and mood disorders; and 5) subtypes of depression, mania and their core component