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. We examined the correlates of suicidality in a nationally representative sample of US adolescents with bipolar disorder (BD) and major depressive disorder (MDD), (Dimick et al, 2025). Findings showed there was a higher prevalence of suicide attempts and ideation in adolescents with BD and MDD and emphasized the established link between suicide risk and mood disorders and how understanding underlying mechanisms and providing targeted interventions can be useful in these populations. Further, we examined the prevalence and correlates of cannabis use (CU) and cannabis use disorder (CUD) in the NCS-A representative sample with- and without mood disorders (Sultan et al, 2025). There was an increased lifetime prevalence of CU and CUD in adolescents with MDD and BD, and CU was most prevalent in adolescents with MDD while CUD was most prevalent in adolescents with BD. The authors suggest that future cannabis research should be tailored to adolescents with mood disorders to help with interventions and treatment options for risk reduction. With collaborators from Canada and Brazil, we analyzed data collected by the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and reviewed data sources used by GBD on mental health conditions across nationally representative data sources (Casella et al, 2025). We found that substantial gaps in prevalence data exist globally and that many disorders and groups, including children and low-income populations, remain underrepresented. These findings highlight the need for a unified global effort to improve mental health data collection. Maintaining our ongoing collaboration with the Child Mind Institute (CMI) team through the Child and Adolescent Mental Health Initiative and investigators from Greece, authors report on the development of comprehensive research tools to assess the current state and needs of child and mental health in Greece. The first is a program developed through a community-based mixed methods approach for an open-access quantitative and qualitative resource that can be used to assess needs and priorities for child and mental health care (Koumoula et al, 2024). Geographically distributed samples of caregivers, children/adolescents, schoolteachers, and health professionals were surveyed using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Additionally, this collaboration performed a systematic review of literature on prevalence estimates, assessment instruments, and interventions in child and adolescent mental health in Greece (Koumoula et al, 2024) which resulted in an interactive online resource of up-to-date resources to be used for practice and policy. Finally, we utilized data from a United States nationally representative sample from the Population Assessment of Tobacco and Health (PATH) study, including N=32,320 adults and N=13,651 adolescents, to examine the links between self-reported lifetime tobacco product use and substance and mental health problems (Conway et al, 2025). We found significant unidirectional and bidirectional associations between specific product use and mental health and substance problems in both age groups. Particularly for adolescents, results pointed to mental health problems as risk factors for incident tobacco use and findings suggested that mental health problems during adolescence may be a pathway to nicotine use and future research should be targeted across more defined age groups and nicotine exposures. Public Health Impact: Our research group continues to be at the forefront of coordinating the evidence base on epidemiology including prevalence, correlates and consequences of child and youth mental health through extensive collaborations with leaders in the field. The focus on developmental risk factors in the manifestations of emotional and behavioral conditions, which the NCS-A made possible, are critical for identifying targets for intervention and prevention of psychiatric disorders. Our studies of physical-mental comorbidity and sleep in adolescents and adults complement our family study research 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. The continued collaboration with CMI will further our opportunity to conduct research aimed at influences on mental health and substance problems among youth, which may have life-long positive benefit. Our growing collaborations with other research across the world will also facilitate our ability to identify the common global influences on mental illness as well as individual-level susceptibility on youth physical and mental health. Future Plans: We plan to continue our activity initiated with CMI that is now extending to broader efforts to track youth mental health through our collaborations between CMI and HBN, and parallel Brazilian, Canadian, and Swiss studies 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. Our team is also collaborating with the leaders of a recent nationwide study of youth in Canada, the CHSCY Canadian Health Survey of Children and Youth of more than 40,000 youth ages 7-21 across Canada. Now the data have been collected, we will consult on the priorities, analyses and interpretations of the findings. We also plan to interrogate data from the PATH Study for associations between tobacco-product use (including e-cigarettes) and mental health problems. Across these rich data resources, we expect to continue publishing studies related to: 1) the intersection between physical and mental health; 2) the relationship 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 components. More broadly, our epidemiology team is becoming increasingly involved in secondary data analysis of several large studies of youth including the ABCD study, PNC, Brazilian Cohort Study and several smaller studies on youth with mood disorders. With our unique research team and resources, we are making important contributions to the harmonization of epidemiologic data on youth mental health not only in the US but across the world.