Periodic Reporting for period 1 - MENTALNET (Effects of mental disorders on the wellbeing and prosperity of family members and friends)
Reporting period: 2022-07-01 to 2024-12-31
Mental disorders have an enduring impact on individuals’ wellbeing and economic prosperity. Although it is often assumed that these effects extend to the wellbeing of family members and friends as well, comprehensive large-scale direct investigations have rarely been conducted and it remains unclear how enduring these influences are. This project addresses this fundamental gap in our understanding and substantially extends prior knowledge in three crucial ways. First, we will estimate how much a person’s mental disorder affects the wellbeing and prosperity of family members, including parents and siblings. Second, we study whether these effects extend to partners in later adulthood. Third, we will assess the broader social impact of mental disorders beyond the affected individual’s immediate family and partners to those persons who have grown up in the same social networks as the directly affected individual, also estimating the longevity of these wider harmful influences. We will use several interlinked nationwide Finnish registers to answer these questions. The linked datasets contain rich individual-level information for over three decades for the whole Finnish population, including complete details of healthcare utilization and prescription medication prescribing for approximately 5 million persons over a 20-year observation period. The main advantage of these nationwide registers is that they are truly population-based and free of the biases that are common in research surveys. We will use state-of-the-art research designs and statistical methods to identify potential causal links. The project will deliver cutting-edge knowledge on how mental disorders coalesce in social networks, which can potentially help to reduce the societal impact of mental disorders.
During the first year of the project, we updated all registers included in the present study and built various datasets that can be used more efficiently for data analyses than raw register data. Moreover, we built reproducible code on processes used across studies, which enables more efficient workflows. We have also developed methods for dealing with overlapping register entries in the health-care register data (Suokas et al., 2024) and build interactive websites for easier display of the project results. We are also in process of building social network data over the life course and have started developing methods that work efficiently with large scale social network data.
So far we have published two manuscript within the scope of the project. In our study including over 1.6 million parents from Finland and Denmark (Hakulinen et al., 2024), we showed that the risk of a parent receiving a mental disorder diagnosis was higher among those who had a child with a mental disorder compared to those who did not. Overall, the excess risk was at its highest in temporal proximity to the child’s mental disorder diagnosis among both women and men, and then declined over time. When examining specific disorders of a child, a similar time-dependent trend was generally observed across most diagnostic categories in women, while the temporal patterns in men were less consistent.
In our study that was published in JAMA Psychiatry (Alho et al., 2024), we found an association between having peers diagnosed with a mental disorder during adolescence and an increased risk of receiving a mental disorder diagnosis later in life. The risk we discovered was most pronounced in the first year of follow-up. Notably, the association showed a dose-response relationship, with higher risk when multiple diagnosed individuals were in the peer network. Of the mental disorders examined, the association was strongest for mood, anxiety, and eating disorders. These associations were not explained by differences in area-level general morbidity or socioeconomic characteristics, parental mental disorders or socioeconomic position during childhood, or random differences in predisposition to mental health problems occurring among schools’ student populations.
So far we have published two manuscript within the scope of the project. In our study including over 1.6 million parents from Finland and Denmark (Hakulinen et al., 2024), we showed that the risk of a parent receiving a mental disorder diagnosis was higher among those who had a child with a mental disorder compared to those who did not. Overall, the excess risk was at its highest in temporal proximity to the child’s mental disorder diagnosis among both women and men, and then declined over time. When examining specific disorders of a child, a similar time-dependent trend was generally observed across most diagnostic categories in women, while the temporal patterns in men were less consistent.
In our study that was published in JAMA Psychiatry (Alho et al., 2024), we found an association between having peers diagnosed with a mental disorder during adolescence and an increased risk of receiving a mental disorder diagnosis later in life. The risk we discovered was most pronounced in the first year of follow-up. Notably, the association showed a dose-response relationship, with higher risk when multiple diagnosed individuals were in the peer network. Of the mental disorders examined, the association was strongest for mood, anxiety, and eating disorders. These associations were not explained by differences in area-level general morbidity or socioeconomic characteristics, parental mental disorders or socioeconomic position during childhood, or random differences in predisposition to mental health problems occurring among schools’ student populations.
The project has so far demonstrated that (1) mental disorders spread in social networks and that (2) children’s mental disorders may temporarily increase their parents’ risk of mental disorders. These findings are important and novel as they increase our understanding of how mental disorders develop and transmit in social networks. From society and policy perspective, our findings point that it could be potentially beneficial to target interventive and preventive measures to wider school environment and to parents. More generally, when assessing the public health impact and cost-effectiveness of interventive and preventive measures, it should be taken into consideration that, due to the possible social transmission of mental disorders, these measures might have an effect not only on the directly treated individuals but also on various others in the treated individuals’ family, community or other social groups.