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A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors


Understanding individual variation in the continuity of youth mental health difficulties is critical for identifying the factors that promote recovery or chronicity. This study establishes the proportion of children showing psychopathology at 9 years, whose pathology had either remitted or persisted at 13. It describes the socio-demographic and clinical profiles of these groups, and examines the factors in 9-year-olds’ familial environments that predict longitudinal remission vs. persistence of psychopathology. The study utilised data from a prospective longitudinal study of 8568 Irish children. Child psychopathology was assessed using the Strengths and Difficulties Questionnaire (SDQ). Analysis established the rates of continuity of SDQ classifications between 9 and 13 years. Analysis also investigated the familial factors that predicted the remission vs. persistence of psychopathological symptoms, controlling for socio-demographic and child factors. Average SDQ scores improved between the ages of 9 and 13, F(1, 7292) = 276.52, p < 0.001, \(\eta _p^2\) = 0.04. Of children classified Abnormal aged 9, 41.1% remained so classified at 13, 21.4% were reclassified Borderline, and 37.6% Normal. Demographic and child risk factors for persistence of pathology were maleness (β = −1.00, p = 0.001, CI = 0.20–0.67), one-carer households (β = −0.71, p = 0.04, CI = 0.25–0.97), poor physical health (β = −0.64, p = 0.03, CI = 0.30–0.92), and low cognitive ability (β = 0.61, p = 0.002, CI = 1.26–2.70). Controlling for these factors, the only familial variable at 9 years that predicted subsequent pathological persistence was caregiver depression (β = −0.07, p = 0.03, CI = 0.87–0.99). The analysis highlights substantial rates of psychopathological discontinuity in a community sample and identifies the children most at risk of chronic mental health problems. These results will inform the targeting of early interventions and distribution of clinical resources.

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This research was funded by the Saint John of God Research Department (Grant ref 597).

Author information

Correspondence to Cliodhna O’Connor.

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Ethical statement

The GUI study received ethical approval and monitoring from the Irish Health Research Board and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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The authors declare that they have no conflict of interest.

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O’Connor, C., Reulbach, U., Gavin, B. et al. A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors. Eur Child Adolesc Psychiatry 27, 289–300 (2018).

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  • Child psychopathology
  • Persistence
  • Remission
  • Strengths and Difficulties Questionnaire
  • Longitudinal
  • Parental depression