Mental Health and Illness In Relation to Physical Health Across the Lifespan

  • Sanne M. A. Lamers
  • Gerben J. Westerhof
  • Ernst T. Bohlmeijer
  • Corey L. M. Keyes


This chapter addresses mental health as more than the absence of disease, also approaching it from a positive perspective as the presence of well-being across the lifespan. The study described in the chapter investigated the association of age with psychopathology and positive mental health, controlling for potential confounding effects of physical health. The study draws on data of the representative LISS panel (N = 1,506) covering the adult lifespan (ages 18–87). Positive mental health, psychopathology, and physical health were measured. Older adults experienced both lower psychopathology and lower positive mental health, which remained after controlling for positive mental health or psychopathology respectively, demographics, and physical health. Demographics and physical health were more strongly associated with psychopathology than with positive mental health. Positive mental health and psychopathology were related, but showed distinct patterns across the lifespan. This emphasizes the importance of assessing both psychopathology and positive mental health when investigating age in relation to mental health.


Positive mental health Well-being Psychopathology Two continua model Physical health Aging paradox Age Lifespan Mediation Moderation 


  1. Beekman, A. T. F., Copeland, J. R. M., & Prince, M. J. (1999). Review of community prevalence of depression in later life. British Journal of Psychiatry, 174, 307–311.PubMedCrossRefGoogle Scholar
  2. Beekman, A. T. F., Penninx, B. W. J. H., Deeg, D. J. H., Ormel, J., Braam, A. W., & van Tilburg, W. (1997). Depression and physical health in later life: Results from the Longitudinal Aging Study Amsterdam. Journal of Affective Disorders, 46, 219–231.PubMedCrossRefGoogle Scholar
  3. Bijl, R. V., Ravelli, A., & van Zessen, G. (1998). Prevalence of psychiatric disorder in the general population: Results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology, 33, 587–595.PubMedCrossRefGoogle Scholar
  4. Brandtstädter, J., & Greve, W. (1994). The aging self: Stabilizing and protective processes. Developmental Review, 14, 52–80.CrossRefGoogle Scholar
  5. Carstensen, L. L., Fung, H. H., & Charles, S. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27, 103–123.CrossRefGoogle Scholar
  6. de Beurs, E., & Zitman, F. (2006). De Brief Symptom Inventory (BSI): De betrouwbaarheid en validiteit van een handzaam alternatief. [The Brief Symptom Inventory (BSI): The reliability and validity of a practical alternative to the SCL 90]. Maandblad Geestelijke Volksgezondheid, 61, 120–141.Google Scholar
  7. Deci, E. L., & Ryan, R. M. (2008). Hedonia, eudaimonia, and well-being: An introduction. Journal of Happiness Studies, 9, 1–11.CrossRefGoogle Scholar
  8. Diener, E., & Suh, E. M. (1998). Subjective well-being and age: An international analysis. Annual Review of Gerontology and Geriatrics, 17, 304–324.Google Scholar
  9. Diener, E., Suh, E. M., Lucas, R., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276–302.CrossRefGoogle Scholar
  10. Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41, 924–936.PubMedCrossRefGoogle Scholar
  11. Henchoz, K., Cavalli, S., & Girardin, M. (2008). Health perception and health status in advanced old age: A paradox of association. Journal of Aging Studies, 22, 282–290.CrossRefGoogle Scholar
  12. House, J. S., Kessler, R. C., & Herzog, A. R. (1990). Age, socioeconomic status, and health. The Milbank Quarterly, 68, 383–411.PubMedCrossRefGoogle Scholar
  13. Howell, R. T., Kern, M. L., & Lyubomirsky, S. (2007). Health benefits: Meta-analytically determining the impact of well-being on objective health outcomes. Health Psychology Review, 1, 83–136.CrossRefGoogle Scholar
  14. Isaacowitz, D. M., & Smith, J. (2003). Positive and negative affect in very old age. Journal of Gerontology: Psychological Sciences, 58B, 143–152.CrossRefGoogle Scholar
  15. Joshanloo, M., & Nosratabadi, M. (2009). Levels of mental health continuum and personality traits. Social Indicators Research, 90, 211–224.CrossRefGoogle Scholar
  16. Kendler, K. S., Myers, J. M., Maes, H. H., & Keyes, C. L. M. (2011, online first). The relationship between the genetic and environmental influences on common internalizing psychiatric disorders and mental well-being. Behavior Genetics, 41(5), 641–650.PubMedCrossRefGoogle Scholar
  17. Kessler, R. C., Mickelson, K. D., Walters, E. E., Zhao, S., & Hamilton, L. (2004). Age and depression in the MIDUS survey. In O. G. Brim, C. D. Ryff, & R. C. Kessler (Eds.), How healthy are we: A national study of the well-being at midlife (pp. 227–251). Chicago: University of Chicago Press.Google Scholar
  18. Keyes, C. L. M. (1998). Social well-being. Social Psychology Quarterly, 61, 121–140.CrossRefGoogle Scholar
  19. Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539–548.PubMedCrossRefGoogle Scholar
  20. Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62, 95–108.PubMedCrossRefGoogle Scholar
  21. Keyes, C. L. M., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100, 2366–2371.PubMedCrossRefGoogle Scholar
  22. Keyes, C. L. M., & Shapiro, A. D. (2004). Social well-being in the United States: A descriptive epidemiology. In O. G. Brim, C. D. Ryff, & R. C. Kessler (Eds.), How healthy are we: A national study of the well-being at midlife (pp. 350–373). Chicago: University of Chicago Press.Google Scholar
  23. Keyes, C. L. M., & Westerhof, G. J. (2012). Chronological and subjective age differences in flourishing mental health and major depressive episode. Aging and Mental Health, 16, 67–74.PubMedCrossRefGoogle Scholar
  24. Keyes, C. L. M., Wissing, M., Potgieter, J. P., Temane, M., Kruger, A., & van Rooy, S. (2008). Evaluation of the mental health continuum-short form (MHC-SF) in Setswana-speaking South Africans. Clinical Psychology and Psychotherapy, 15, 181–192.PubMedCrossRefGoogle Scholar
  25. Kivela, S., & Pahkala, K. (2001). Depressive disorder as predictor of physical disability in old age. Journal of the American Geriatrics Society, 49, 290–296.PubMedCrossRefGoogle Scholar
  26. Knoef, M., & de Vos, K. (under review). The representativeness of LISS, an online probability panel.Google Scholar
  27. Kunzmann, U., Little, T. D., & Smith, J. (2000). Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study. Psychology and Aging, 15, 511–526.PubMedCrossRefGoogle Scholar
  28. Lamers, S. M. A., Bolier, L., Westerhof, G. J., Smit, F., & Bohlmeijer, E. T. (2012a). The impact of emotional well-being on long-term recovery and survival in physical illness: A meta-analysis. Journal of Behavioral Medicine, 35, 538–547.CrossRefGoogle Scholar
  29. Lamers, S. M. A., Glas, C. A. W., Westerhof, G. J., & Bohlmeijer, E. T. (2012b). Longitudinal evaluation of the Mental Health Continuum-Short Form (MHC-SF): Measurement invariance across demographics, physical illness and mental illness. European Journal of Psychological Assessment, 28, 290–296.CrossRefGoogle Scholar
  30. Lamers, S. M. A., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M., & Keyes, C. L. M. (2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). Journal of Clinical Psychology, 67, 99–110.PubMedCrossRefGoogle Scholar
  31. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131, 803–855.PubMedCrossRefGoogle Scholar
  32. Mirowsky, J. & Ross, C. E. (1999). Well-being across the life-course. In A. V. Horwitz & T. L. Scheids (Eds.), A handbook for the study of mental health: Social contexts, theories, and systems (pp. 328–347). New York: Cambridge University Press.Google Scholar
  33. Mroczek, D. K. & Kolarz, C. M. (1998). The effect of age on positive and negative affect: A developmental perspective on happiness. Journal of Personality and Social Psychology, 75, 1333–1349.PubMedCrossRefGoogle Scholar
  34. Newman, J. P., & Engel, R. J. (1991). Age differences in depressive experiences. Journal of Gerontology, 46, 224–235.CrossRefGoogle Scholar
  35. Pinquart, M. (2001). Correlates of subjective health in older adults: A meta-analysis. Psychology and Aging, 16, 414–426.PubMedCrossRefGoogle Scholar
  36. Pinquart, M. (2002). Creating and maintaining purpose in life in old age: A meta analysis. Ageing International, 27, 90–114.CrossRefGoogle Scholar
  37. Ryff, C. D. (1995). Psychological well-being in adult life. Current Directions in Psychological Science, 4, 99–104.CrossRefGoogle Scholar
  38. Ryff, C. D., & Keyes, C. L. M. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719–727.PubMedCrossRefGoogle Scholar
  39. Staudinger, U. M., Freund, A. M., Linden, M., & Maas, I. (1999). Self, personality and life regulation: Facets of psychological resilience in old age. In P. B. Baltes & K. U. Mayer (Eds.), The Berlin Aging Study: Aging from 70 to 100 (pp. 302–328). New York: Cambridge University Press.Google Scholar
  40. Steverink, N., Westerhof, G. J., Bode, C., & Dittmann-Kohli, F. (2001). The personal experience of aging, individual resources and subjective well-being. Journal of Gerontology: Psychological Sciences, 56B, 364–373.CrossRefGoogle Scholar
  41. The ESEMeD/MHEDEA 2000 Investigators (2004). Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavia, 109, 21–27.CrossRefGoogle Scholar
  42. van den Akker, M., Buntinx, F., Metsemakers, J. F., Roos, S., & Knottnerus, J. A. (1998). Multimordidity in general practice: Prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. Journal of Clinical Epidemiology, 51, 367–375.CrossRefGoogle Scholar
  43. Vaux, A., & Meddin, J. (1987). Positive and negative life change and positive and negative affect among the rural elderly. Journal of Community Psychology, 15, 447–458.CrossRefGoogle Scholar
  44. Veenhoven, R. (2008). Healthy happiness: Effects of happiness on physical health and the consequences for preventive health care. Journal of Happiness Studies, 9, 449–469.CrossRefGoogle Scholar
  45. Waterman, A. S. (1993). Two conceptions of happiness: Contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. Journal of Personality and Social Psychology, 64, 678–691.CrossRefGoogle Scholar
  46. Westerhof, G. J., Dittmann-Kohli, F., & Bode, C. (2003). The aging paradox: Toward personal meaning in gerontological theory. In S. Biggs, A. Lowenstein, & J. Hendricks (Eds.), The need for theory: Critical approaches to social gerontology (pp. 127–143). Amityville: Baywood.Google Scholar
  47. Westerhof, G. J., & Keyes, C. L. M. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17, 110–119.PubMedCrossRefGoogle Scholar
  48. Wood, A. M., & Joseph, S. (2009). The absence of positive psychological (eudemonic) well-being as a risk factor for depression: A ten year cohort study. Journal of Affective Disorders, 122, 213–217.PubMedCrossRefGoogle Scholar
  49. World Health Organization (2004). Promoting mental health: Concepts, emerging evidence, practice (summary report). Geneva: WHO.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  • Sanne M. A. Lamers
    • 1
  • Gerben J. Westerhof
    • 1
  • Ernst T. Bohlmeijer
    • 1
  • Corey L. M. Keyes
    • 2
  1. 1.Department of Psychology, Health, & TechnologyUniversity of TwenteEnschedeThe Netherlands
  2. 2.Department of SociologyEmory UniversityAtlantaUSA

Personalised recommendations