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Nineteen and Up study (19Up): understanding pathways to mental health disorders in young Australian twins
  1. Baptiste Couvy-Duchesne1,2,
  2. Victoria O’Callaghan1,
  3. Richard Parker2,
  4. Natalie Mills1,2,3,
  5. Katherine M Kirk2,
  6. Jan Scott4,5,
  7. Anna Vinkhuyzen1,6,
  8. Daniel F Hermens4,
  9. Penelope A Lind2,
  10. Tracey A Davenport4,
  11. Jane M Burns7,
  12. Melissa Connell8,
  13. Brendan P Zietsch2,9,
  14. James Scott8,
  15. Margaret J Wright1,10,
  16. Sarah E Medland2,
  17. John McGrath1,11,
  18. Nicholas G Martin2,
  19. Ian B Hickie4,
  20. Nathan A Gillespie2,12
  1. 1 Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
  3. 3 School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
  4. 4 Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
  5. 5 Institute of Neuroscience, Newcastle University, Newcastle, UK
  6. 6 Institute of Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
  7. 7 Young and Well CRC, University of Melbourne, Melbourne, Victoria, Australia
  8. 8 UQCCR, The University of Queensland, Brisbane, Queensland, Australia
  9. 9 School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
  10. 10 Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia
  11. 11 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
  12. 12 Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
  1. Correspondence to Dr Baptiste Couvy-Duchesne; b.couvyduchesne{at}


Purpose The Nineteen and Up study (19Up) assessed a range of mental health and behavioural problems and associated risk factors in a genetically informative Australian cohort of young adult twins and their non-twin siblings. As such, 19Up enables detailed investigation of genetic and environmental pathways to mental illness and substance misuse within the Brisbane Longitudinal Twin Sample (BLTS).

Participants Twins and their non-twin siblings from Queensland, Australia; mostly from European ancestry. Data were collected between 2009 and 2016 on 2773 participants (age range 18–38, 57.8% female, 372 complete monozygotic pairs, 493 dizygotic pairs, 640 non-twin siblings, 403 singleton twins).

Findings to date A structured clinical assessment (Composite International Diagnostic Interview) was used to collect lifetime prevalence of diagnostic statistical manual (4th edition) (DSM-IV) diagnoses of major depressive disorder, (hypo)mania, social anxiety, cannabis use disorder, alcohol use disorder, panic disorder and psychotic symptoms. Here, we further describe the comorbidities and ages of onset for these mental disorders. Notably, two-thirds of the sample reported one or more lifetime mental disorder.

In addition, the 19Up study assessed general health, drug use, work activity, education level, personality, migraine/headaches, suicidal thoughts, attention deficit hyperactivity disorder (ADHD) symptomatology, sleep–wake patterns, romantic preferences, friendships, familial environment, stress, anorexia and bulimia as well as baldness, acne, asthma, endometriosis, joint flexibility and internet use.

The overlap with previous waves of the BLTS means that 84% of the 19Up participants are genotyped, 36% imaged using multimodal MRI and most have been assessed for psychological symptoms at up to four time points. Furthermore, IQ is available for 57%, parental report of ADHD symptomatology for 100% and electroencephalography for 30%.

Future plans The 19Up study complements a phenotypically rich, longitudinal collection of environmental and psychological risk factors. Future publications will explore hypotheses related to disease onset and development across the waves of the cohort. A follow-up study at 25+years is ongoing.

  • twins
  • comorbidity
  • prevalence
  • substance misuse

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  • NGM, IBH and NAG contributed equally.

  • BC-D and VO’C contributed equally.

  • Contributors NGM, IBH, NAG, JJM, SEM, MJW, JS, BPZ and PAL designed the 19Up study. BCD, VO, RP, KMK, JS and NM processed the data. BCD and VO analysed the data and drafted the manuscript. RP, NM, KMK, JS, AV, DFH, PAL, TAD, JMB, MC, BPZ, JS, MJW, SEM, JJM, NGM IBH and NAG revised the article and agree with the final version and the findings.

  • Funding The NHMRC (APP10499110) and the NIH (K99R00, R00DA023549) funded the 19Up study. The MRI was supported by grants from NIH (R01HD050735) and the NHMRC (496682, 1009064). Genotyping was funded by the NHMRC (389891).

  • Competing interests BCD is supported by an UQI scholarship, VOC by a UQ winter scholarship. SEM is supported by an NHMRC fellowship (APP1103623), JGS by a NHMRC Practitioner Fellowship (1105807), JJMG by a NHMRC John Cade Fellowship (APP1056929), BPZ is supported by an ARC Discovery Early Career Research Award (DE120100562), NAG by NIH/NIDA grants (5R00DA023549, R21DA038852).

  • Patient consent Obtained.

  • Ethics approval QIMR Human Research and Ethics Committee and the Virginia Commonwealth University Institutional Review Board approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data used in this analysis and described in this article are available to all interested researchers through collaboration. Please contact NGM (

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