Enduring mental health in the Baltimore epidemiologic catchment area follow-up study

Soc Psychiatry Psychiatr Epidemiol. 2019 Aug;54(8):997-1006. doi: 10.1007/s00127-019-01676-z. Epub 2019 Feb 21.


Purpose: To estimate the prevalence of enduring mental health (EMH) and examine important correlates of EMH 23 years later in the Baltimore Epidemiologic Catchment Area Follow-Up study.

Methods: We estimated the prevalence of EMH among 964 adults with diagnostic data at all four study waves (1981-2004). Those with EMH were compared to those with any mental or behavioral disorder by demographic, psychosocial, and health characteristics. We used forward selection models to identify the most important predictors of EMH.

Results: Twenty-six percent of participants met criteria for enduring mental health across the four waves. Neuroticism, GHQ-20 score, childhood conduct problems, female sex, maternal depression, and poor self-rated health were negatively associated with EMH.

Conclusions: We identified several malleable factors associated with a decreased likelihood of enduring mental health. Interventions that target high neuroticism, childhood conduct problems, or maternal depression may increase the likelihood that children achieve EMH later in life. Identifying and treating other factors such as poor self-reported health and greater psychological distress may also keep sub-clinical symptoms from developing into a full mental or behavioral disorder.

Keywords: Enduring mental health; Prospective cohort study; Psychiatric epidemiology; Resilience.

MeSH terms

  • Adolescent
  • Adult
  • Baltimore / epidemiology
  • Catchment Area, Health
  • Child
  • Conduct Disorder / epidemiology
  • Conduct Disorder / psychology
  • Depression / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Mental Health / trends*
  • Middle Aged
  • Neuroticism
  • Prevalence
  • Self Report
  • Young Adult