Effects of mental health status during adolescence on primary care costs in adulthood across three British cohorts

Derek King*, Petra Gronholm, Martin Knapp, Mauricio Scopel Hoffmann, Eva-Maria Bonin, Nicola Brimblecombe, Rajendra Kadel, Barbara Maughan, Nick O'Shea, Marcus Richards, Ties Hoomans, Sara Evans-Lacko

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


This study examines the association between mental health problems in adolescence and general practice (GP) costs during adulthood up to age 50 in the UK.

We conducted secondary analyses of three British birth cohorts (individuals born in single weeks in 1946, 1958 and 1970). Data for the three cohorts were analysed separately. All respondents who participated in the cohort studies were included. Adolescent mental health status was assessed in each cohort using the Rutter scale (or, for one cohort, a forerunner of that scale) completed in interviews with parents and teachers when cohort members were aged around 16. Presence and severity of conduct and emotional problems were modelled as independent variables in two-part regression models in which the dependent variable was costs of GP services from data collection sweeps up to mid-adulthood. All analyses were adjusted for covariates (cognitive ability, mother's education, housing tenure, father's social class and childhood physical disability).

Adolescent conduct and emotional problems, particularly when coexisting, were associated with relatively high GP costs in adulthood up to age 50. Associations were generally stronger in females than males.

Associations between adolescent mental health problems and annual GP cost were evident decades later, to age 50, suggesting that there could be significant future savings to healthcare budgets if rates of adolescent conduct and emotional problems could be reduced.

Trial registration
Not applicable.
Original languageEnglish
JournalSocial Psychiatry and Psychiatric Epidemiology
Publication statusPublished - 23 Jun 2023


  • Adolescence
  • Birth cohort
  • General practice
  • Mental health
  • Primary care
  • Service costs

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