BELLA study

Logo BELLA-Studie

The BELLA study measures mental health, behavior and health-related quality of life among children, adolescents, their families and young adults in Germany. The longitudinal BELLA study is the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents (KiGGS), conducted by the Robert Koch Institute between 2003 and 2006 (basis), between 2009 and 2012 (wave 1), and between 2014 and 2017 (wave 2).

The BELLA cohort comprises a representative subsample of the KiGGS Survey of 3.000 children, adolescents and their families as well as young adults. In addition to the baseline assessment (2003-2006), the BELLA cohort was followed-up in four additional waves conducted in 2004 to 2007, 2005 to 2008, 2009 to 2012 and 2014 to 2017. Data was collected through telephone interview and subsequent questionnaires or online survey by parent report and above 11 years by additional self report. The assessed information provides evidence for the prevalence and determinants of mental health problems in childhood and adolescence in Germany.

Further, BELLA wave 4 (2014 - 2017) has been completed. A KiGGS subsample of approximately 3,500 young people aged 7 to 31 participated in the survey. The fourth wave was conducted as an online-survey. Parents of younger children (7 to 13 years) were surveyed, as well as children, adolescents and young adults themselves (11 years and older). Besides instruments on mental health problems and healthcare, a dynamic measurement instrument - a computer-adaptive test (CAT) - was used for the first time to assess health-related quality of life.

Contact: Dr. Franziska Reiß ( f.reiss@uke.de )

Publications from the BELLA study

(by clicking on the respective doi you will be directed to the corresponding publication; selected internationally published articles and articles written in German with English abstracts are provided, the complete publication list can be found below).

The design, methodology, and important results of the BELLA study are described in the following core articles:

  • BELLA study baseline assessment:
    • Ravens-Sieberer, U., Kurth, B. M., the KiGGS study group, & the BELLA Study Group. (2008). The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents(KiGGS): study design and methods. European Child and Adolescent Psychiatry, 17(1), 10-21. doi: 10.1007/s00787-008-1002-3
    • Ravens-Sieberer, U., Wille, N., Bettge, S., & Erhart, M. (2007) Psychische Gesundheit von Kindern und Jugendlichen in Deutschland. Ergebnisse aus der BELLA-Studie im Kinder- und Jugendgesundheitssurvey (KiGGS). [Mental health of children and adolescents in Germany. Results from the BELLA study within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 50(5-6), 871-878. doi: 10.1007/s00103-007-0250-6

  • BELLA study baseline to 3rd wave:
    • Ravens-Sieberer, U., Otto, C., Kriston, L., Rothenberger, A., Döpfner, M., Herpertz-Dahlmann, B., Barkmann, C., Schön, G., Hölling, H., Schulte-Markwort, M., & Klasen, F. (2015). The longitudinal BELLA study: Design, methods and first results on the course of mental health problems. European Child and Adolescent Psy-chiatry, 24(6), 651-663. doi: 10.1007/s00787-014-0638-4
  • BELLA study 4th wave:
    • Otto, C., Reiss, F., Voss, C., Wüstner, A., Meyrose, A.-K., Hölling, H., & Ravens-Sieberer, U. (2020). Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. European Child and Adolescent Psychiatry, 1-19. doi: 10.1007/s00787-020-01630-4

Prevalences and courses of mental health problems are also described in the following articles, among others:

  • Ravens-Sieberer, U., Wille, N., Erhart, M., Bettge, S., Wittchen, H. U., Rothenberger, A., Herpertz-Dahlmann, B., Resch, F., Holling, H., Bullinger, M., Barkmann, C., Schulte-Markwort, M., & Dopfner, M. (2008). Prevalence of mental health problems among children and adolescents in Germany: Results of the BELLA study within the National Health Interview and Examination Survey. European Child and Adolescent Psychiatry, 17 (Suppl. 1), 22-33. doi: 10.1007/s00787-008-1003-2
  • Klasen, F., Petermann, F., Meyrose, A.-K., Barkmann, C., Otto, C., Haller, A.-C., Schlack, R., Schulte-Markwort, M.,& Ravens-Sieberer, U. (2016). Verlauf psychischer Auffälligkeiten von Kindern und Jugendlichen: Ergebnisse der BELLA-Kohortenstudie. [Trajectories of Mental Health Problems in Children and Adolescents:Results of the BELLA Cohort Study]. Kindheit und Entwicklung, 25(1), 10-20. doi: 10.1026/0942-5403/a000184
  • Klasen, F., Meyrose, A.-K., Otto, C., Reiß, F., & Ravens-Sieberer, U. (2017). Psychische Auffälligkeiten von Kindern und Jugendlichen in Deutschland. Ergebnisse der BELLA-Studie. [Mental problems of children and adolescents in Germany Results of the BELLA study].Kinderheilkunde. doi: 10.1007/s00112-017-0270-8

The health-related quality of life is analyzed in the following articles, among others:

  • Ravens-Sieberer, U., Erhart, M., Wille, N., Bullinger, M., & the BELLA Study Group. (2008). Health-related quality of life in children and adolescents in Germany: results of the BELLA study. European Child and Adolescent Psychiatry, 17 (Suppl. 1), 148-156. doi: 10.1007/s00787-008-1016-x
  • Barkmann, C., Petermann, F., Schlack, R., Bullinger, M., Schulte-Markwort, M., Klasen, F., & Ravens-Sieberer, U. (2016). Verlauf gesundheitsbezogener Lebensqualität: Ergebnisse der BELLA-Kohortenstudie. [Course of Health-Related Quality of Life: Results of the BELLA Cohort Study]. Kindheit und Entwicklung, 25(1). doi: 10.1026/0942-5403/a000188
  • Otto, C., Haller, A.-C., Klasen, F., Hölling, H., Bullinger, M., Ravens-Sieberer, U., & on behalf of the Bella study group. (2017). Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study. PloS One, 12(12), e0190363. doi: 10.1371/journal.pone.0190363

Risk and protective factors are investigated in the following articles, among others:

  • Wille, N., Bettge, S., & Ravens-Sieberer, U. (2008). Risk and protective factors for children's and adolescents' mental health: Results of the BELLA study. European Child and Adolescent Psychiatry, 17(Suppl. 1), 133-147. doi: 10.1007/s00787-008-1015-y
  • Klasen, F., Otto, C., Kriston, L., Patalay, P., Schlack, R., Ravens-Sieberer, U., & The BELLA study group. (2015). Risk and protective factors for the development of depressive symptoms in children and adolescents: results of the longitudinal BELLA study. European Child and Adolescent Psychiatry, 24(6), 695-703. doi: 10.1007/s00787-014-0637-5
  • Kaman, A., Otto, C., Klasen, F., Westenhöfer, J., Reiss, F., Hölling, H., & Ravens-Sieberer, U. (2021). Risk and resource factors for depressive symptoms during adolescence and emerging adulthood – A 5-year followup using population-based data of the BELLA study. Journal of Affective Disorders, 280, 258-266. doi: 10.1016/j.jad.2020.11.036

Regarding the use of mental health care, the following articles provide information in addition to the core articles:

  • Hintzpeter, B., Klasen, F., Schön, G., Voss, C., Hölling, H., & Ravens-Sieberer, U. (2015). Mental health care use among children and adolescents in Germany: Results of the longitudinal BELLA study. European Child and Adolescent Psychiatry, 24(6), 705-713. doi: 10.1007/s00787-015-0676-6
  • Plass-Christl, A., Klasen, F., Otto, C., Barkmann, C., Hölling, H., Klein, T., Wiegand-Grefe, S., Schulte-Markwort, M., & Ravens-Sieberer, U. (2017). Mental Health Care Use in Children of Parents with Mental Health Problems: Results of the BELLA Study. Child Psychiatry and Human Development, 1-10. doi: 10.1007/s10578- 017-0721-4
  • Reiß, F., Schlack, R., Otto, C., Meyrose, A.-K., & Ravens-Sieberer, U. (2021). Zur Rolle des sozioökonomischen Status bei der Inanspruchnahme fachspezifischer Versorgung von psychisch auffälligen Kindern und Jugendlichen in Deutschland: Ergebnisse der BELLA-Studie. [The Role of the Socioeconomic Status in Mental Health Care Utilization by Children and Adolescents in Germany: Results of the BELLA Study]. Gesundheitswesen(EFirst). doi: 10.1055/a-1335-4212

In our reference list you can find all publications resulting from the BELLA study. Reference list