Mental health conditions are lasting longer today than they did a decade ago

New research published in Psychological Medicine indicates that common mental health conditions, such as anxiety and depression, are lasting longer for people today than they did just over a decade ago. The findings provide evidence that existing mental health struggles are becoming more difficult to shake, presenting a growing challenge for treatment and long-term care.

Common mental disorders primarily include anxiety, mood, and substance use conditions. Anxiety involves excessive worry or fear, mood disorders involve persistent periods of sadness or elevated mood, and substance use conditions involve an inability to control the use of drugs or alcohol despite negative consequences. In psychiatry, the ongoing presence of one of these conditions over time is known as persistence.

Persistence can be measured in a narrow or broad way. A narrow definition checks whether a person continues to meet the criteria for the exact same category of disorder years later. A broad definition looks at whether the person continues to experience any mental health condition, even if their specific diagnosis has shifted from one issue to another.

Researchers tracking mental health in the Netherlands noticed a concerning trend leading up to this study. According to a 2023 population survey, the proportion of people experiencing these common mental health conditions climbed substantially between 2007 and 2022.

This discovery set off a search for what was driving the increase. Scientists initially wondered if the surge was entirely due to a wave of first-time cases. However, a 2026 study investigating the first onset of these disorders indicated that new cases alone could not fully explain the overall rise in people struggling with their mental health.

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This pushed researchers to ask another question: whether people’s existing conditions were simply lasting longer than they used to. The research was led by Artemis Gkitakou, a PhD candidate at the Department of Psychiatry at Amsterdam UMC and the Trimbos Institute (Netherlands Institute of Mental Health and Addiction), as part of the Psychiatric Epidemiology Lab.

“The idea for this study came from our previous research, which showed that anxiety, mood, and substance use disorders have become more prevalent over time, and that changes in common risk factors did not explain this increase,” Gkitakou told PsyPost. “We had also found that more people were developing these disorders for the first time, suggesting that increased incidence partly contributed to the rise in prevalence.”

“We wanted to know whether another part of the explanation could be that these disorders have also become more persistent over time,” she explained. “We therefore tested whether people with a mental disorder are nowadays more likely to continue experiencing mental health problems during the following three years than they were 12 years earlier.”

To answer this question, the researchers analyzed data from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS). The project consists of two large, representative surveys of the Dutch general population. The first group of participants were interviewed between 2007 and 2009, with follow-up assessments about three years later. The second group were interviewed between 2019 and 2022, and again followed up about three years later.

In both groups, trained interviewers used a highly structured questionnaire to evaluate participants for anxiety, mood, and substance use conditions. By comparing an older cohort of adults aged 18 to 64 with a similarly aged group from the more recent cohort, the scientists could track changes in persistence over a twelve-year gap. They looked at both narrow persistence and broad persistence across the three-year window for each participant.

The results point to a general increase in how long mental health problems last. Among the older group, 42.7% of people who had any mental disorder at the start of the study still had one three years later. In the recent group, that number rose to 57.9%.

“The difference was substantial,” Gkitakou noted. “Put simply, around 12 years ago just over 4 in 10 people with a mental disorder experienced a disorder during the following three years, whereas more recently this was almost 6 in 10. This suggests growing challenges for treatment, continuity of care, and sustained recovery.”

“I was expecting to see an increase in persistence, but it was unfortunate to see that some persistence percentages were over 50%, so more than half of the people continued to experience a mental disorder during the three-year follow-up,” she added. “It shows that, unfortunately, mental disorders can be quite persistent over time for a large group of affected persons.”

This pattern held true across specific categories. Narrow persistence for anxiety conditions increased from 24.4% to 40.1% between the two time periods. Mood conditions lasting across the three-year gap increased from 33.5% to 48.8%, and the persistence of substance use conditions increased from 33.7% to 45.5%.

The researchers also noted that persistence was consistently higher when using the broad definition compared to the narrow one. For instance, in the recent group, 41.6% of people with an initial anxiety disorder still had an anxiety disorder three years later. But when looking at broad persistence, 57.1% of those initial anxiety sufferers had some form of mental condition at the three-year mark, whether it was still anxiety or a new struggle like depression or substance use.

“The broader perspective is important because people may move from experiencing one disorder, let’s say depression, to another disorder, for instance anxiety, during follow-up,” Gkitakou pointed out. “Recovery should not necessarily be viewed only in terms of the original diagnosis.”

These findings are in line with research covered by PsyPost in 2020, which found that individuals typically experience shifting mental disorders across their lifespan rather than maintaining a single diagnosis. While that earlier study tracked diagnostic shifting across four decades in a birth cohort rather than three-year persistence across Dutch adult cohorts, both sets of findings suggest that psychiatric illness tends to cross diagnostic boundaries over time.

Beyond the general increase over time, Gkitakou and colleagues looked for factors that predicted whether a person’s condition would persist. After controlling for multiple demographic and lifestyle variables simultaneously, they identified a few consistent risk factors.

Younger adults and people living in cities were more likely to have persistent conditions. Additionally, individuals who had experienced childhood trauma and those who used drugs on a near-daily basis were also more prone to long-lasting mental health struggles.

The strength of these risk factors did not change much between the 2007 and 2019 groups. This indicates that while conditions are generally becoming more persistent, the basic factors that make an individual vulnerable to a chronic course have remained relatively stable.

As with all research, there are a few things to keep in mind. The study relied on diagnostic interviews that, while highly structured and validated, are still based on self-reported symptoms. The response rate for the more recent survey was also slightly lower than the older one, though the researchers adjusted their data to reflect the general population.

Additionally, the sample sizes for people with specific combinations of disorders were relatively small, making it difficult to detect subtle trends in how highly specific conditions interact over time. Gkitakou also emphasized how the team defined their terms.

“An important point is that ‘persistence’ in our study does not necessarily mean that someone had a mental disorder continuously for all days during the entire three years,” she explained. “We defined persistence as having a disorder at some point during the follow-up period, and people could also move from one type of mental disorder to another.”

Future research might explore what exactly is driving this trend toward longer-lasting mental health issues. Since neither changes in individual risk factors nor differences in mental health care utilization fully accounted for the increase, scientists may need to look at broader societal shifts, such as environmental stressors or economic pressures, to understand why recovery is becoming harder to achieve.

“An important next step is to understand why persistence has increased,” Gkitakou told PsyPost. “We found that persons with younger age, living in a city, with childhood trauma, and with near-daily drug use were most at risk for persistence of disorders, but these groups were not more prevalent over time, so these factors do not explain the increase over time.”

“Future research should investigate additional societal, environmental, and healthcare-related factors, follow these trends over a longer period, and examine whether greater continuity of care and attention to diagnostic transitions can help improve sustained recovery,” she noted.

“I see this study as one step toward understanding why common mental disorders have become more prevalent over time,” Gkitakou added. “NEMESIS gives us a valuable opportunity to study diagnosed mental disorders in the general Dutch population and to compare their course across different periods. I hope these findings encourage greater attention not only to preventing and treating mental disorders, but also to long-term recovery and continuity of care.”

The study, “Are common mental disorders more persistent over time? Insights from the Netherlands Mental Health Survey and Incident Studies (NEMESIS),” was authored by Artemis Gkitakou, Margreet Ten Have, Neeltje M. Batelaan, Annemarie I. Luik, and Brenda W.J.H. Penninx.