European Child & Adolescent Psychiatry

, Volume 27, Issue 7, pp 867–876 | Cite as

Trajectories of mental health problems in children of parents with mental health problems: results of the BELLA study

  • Angela Plass-Christl
  • Christiane Otto
  • Fionna Klasen
  • Silke Wiegand-Grefe
  • Claus Barkmann
  • Heike Hölling
  • Michael Schulte-Markwort
  • Ulrike Ravens-Sieberer
Original Contribution


Children of parents with mental health problems (CPM) have an increased risk for behavioral and psychological problems. This study investigated the age- and gender-specific course as well as predictors of mental health problems in CPM using the longitudinal data (baseline 1- and 2-year follow-ups) of a German general population sample from the BELLA study. Children and adolescents aged 11–17 years (at baseline) who had a parent with mental health problems (n = 325) were analyzed. The mental health problems of the children were assessed by the self-reported version of the strengths and difficulties questionnaire (SDQ). We used individual growth modeling to investigate the age- and gender-specific course, and the effects of risk as well as personal, familial and social protective factors on self-reported mental health problems in CPM. Additionally, data were examined differentiating internalizing and externalizing mental health problems in CPM. Results indicated that female compared to male CPM showed increasing mental health problems with increasing age. Mental health problems in CPM were associated with lower self-efficacy, worse family climate and less social competence over time. Internalizing problems were associated with lower self-efficacy, less social competence and more severe parental mental health problems. Externalizing problems were associated with lower self-efficacy, worse family climate and lower social competence. The main limitations of the study are the short time period (2 years) covered and the report of mental health problems by only one parent. Our findings should be considered in the development of treatment and prevention programs for mental health problems in CPM.


Longitudinal studies Child development Mental health Risk factors Protective factors 



The authors thank all participants of the BELLA study and their parents for their time and involvement. We also would like to thank the Robert-Koch Institute for their ongoing support and co-operation. The baseline, 1- and 2-year follow-up assessments of the BELLA study were financed by the German Science Foundation.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Angela Plass-Christl
    • 1
  • Christiane Otto
    • 1
  • Fionna Klasen
    • 1
  • Silke Wiegand-Grefe
    • 1
  • Claus Barkmann
    • 1
  • Heike Hölling
    • 2
  • Michael Schulte-Markwort
    • 1
  • Ulrike Ravens-Sieberer
    • 1
  1. 1.Department of Child and Adolescent Psychiatry, Psychotherapy, and PsychosomaticsUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Epidemiology and Health MonitoringRobert-Koch-InstituteBerlinGermany

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