Mental health in UK Biobank - development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis

Katrina A S Davis; Jonathan R I Coleman; Mark Adams; Naomi Allen; Gerome Breen; Breda Cullen; Chris Dickens; Elaine Fox; Nick Graham; Jo Holliday; Louise M Howard; Ann John; William Lee; Rose McCabe; Andrew McIntosh; Robert Pearsall; Daniel J Smith; Cathie Sudlow; Joey Ward; Stan Zammit; Matthew Hotopf

doi:10.1192/bjo.2019.100

Mental health in UK Biobank - development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis

BJPsych Open. 2020 Feb 6;6(2):e18. doi: 10.1192/bjo.2019.100.

Authors

Katrina A S Davis¹, Jonathan R I Coleman², Mark Adams³, Naomi Allen⁴, Gerome Breen⁵, Breda Cullen⁶, Chris Dickens⁷, Elaine Fox⁸, Nick Graham⁹, Jo Holliday¹⁰, Louise M Howard¹¹, Ann John¹², William Lee¹³, Rose McCabe¹⁴, Andrew McIntosh¹⁵, Robert Pearsall¹⁶, Daniel J Smith¹⁷, Cathie Sudlow¹⁸, Joey Ward¹⁹, Stan Zammit²⁰, Matthew Hotopf²¹

Affiliations

¹ Researcher, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and South London and Maudsley NHS Foundation Trust, NIHR Biomedical Research Centre, UK.
² Lecturer in Statistical Genetics, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and South London and Maudsley NHS Foundation Trust, NIHR Biomedical Research Centre, UK.
³ Data Scientist, Division of Psychiatry, University of Edinburgh, UK.
⁴ Professor, University of Oxford; and Chief Scientist, UK Biobank, Nuffield Department of Population Health, University of Oxford Big Data Institute, UK.
⁵ Professor of Psychiatric Genetics, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and South London and Maudsley NHS Foundation Trust, NIHR Biomedical Research Centre, UK.
⁶ Senior Lecturer, Institute of Health and Wellbeing, University of Glasgow, UK.
⁷ Professor of Psychological Medicine, Institute of Health Research, University of Exeter Medical School, University of Exeter, UK.
⁸ Professor of Psychology and Affective Neuroscience, Department of Experimental Psychology, University of Oxford, UK.
⁹ Clinical Lecturer in General Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK.
¹⁰ Senior Research Facilitator, University of Oxford; and UK Biobank: UK Biobank, Nuffield Department of Population Health, University of Oxford Big Data Institute, UK.
¹¹ NIHR Research Professor in Women's Mental Health and NIHR Senior Investigator, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
¹² Professor of Public Health and Psychiatry and Consultant Public Health Medicine, Population Data Science, Farr Institute of Health Informatics Research, Swansea University Medical School, Swansea University; and Public Health Wales NHS Trust, UK.
¹³ Consultant Liaison Psychiatrist and Honorary Clinical Senior Lecturer, Devon Partnership NHS Trust; and University of Exeter Medical School, University of Exeter, UK.
¹⁴ Professor of Clinical Communication, School of Health Sciences, City, University of London, UK.
¹⁵ Professor of Biological Psychiatry, Division of Psychiatry, University of Edinburgh, UK.
¹⁶ Consultant Psychiatrist and Honorary Clinical Senior Lecturer in Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK.
¹⁷ Lecturer in Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK.
¹⁸ Director of the British Heart Foundation Data Science Centre, BHF Data Science Centre; Former Chief Scientist, UK Biobank; and Chair of Neurology and Clinical Epidemiology, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK.
¹⁹ Researcher, Institute of Health and Wellbeing, University of Glasgow, UK.
²⁰ Professor of Psychiatric Epidemiology, Centre for Academic Mental Health, University of Bristol; and Institute of Psychological Medicine and Clinical Neurosciences, University of Cardiff, Cardiff University School of Medicine, UK.
²¹ Director, National Institute of Health Research Biomedical Research Centre at the Maudsley; Institute of Psychiatry, Psychology and Neuroscience, King's College London; and South London and Maudsley NHS Foundation Trust, NIHR Biomedical Research Centre, UK.

Abstract

Background: UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential.

Aims: Describe the development, implementation and results of this questionnaire.

Method: An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use.

Results: A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45-82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.

Conclusions: The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.

Keywords: Mental health; UK Biobank; alcohol disorders; cohort study; depressive disorders.

Abstract

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