Psychological Medicine

Original Articles

Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort

B. Maughana1, M. Stafforda2 c1, I. Shaha2 and D. Kuha2

a1 MRC Social, Genetic and Developmental Psychiatry Centre at King's College London Institute of Psychiatry, London, UK

a2 MRC Unit for Lifelong Health and Ageing, London, UK


Background Severe youth antisocial behaviour has been associated with increased risk of premature mortality in high-risk samples for many years, and some evidence now points to similar effects in representative samples. We set out to assess the prospective association between adolescent conduct problems and premature mortality in a population-based sample of men and women followed to the age of 65 years.

Method A total of 4158 members of the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort) were assessed for conduct problems at the ages of 13 and 15 years. Follow-up to the age of 65 years via the UK National Health Service Central Register provided data on date and cause of death.

Results Dimensional measures of teacher-rated adolescent conduct problems were associated with increased hazards of death from cardiovascular disease by the age of 65 years in men [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.04–1.32], and of all-cause and cancer mortality by the age of 65 years in women (all-cause HR 1.16, 95% CI 1.07–1.25). Adjustment for childhood cognition and family social class did little to attenuate these risks. Adolescent conduct problems were not associated with increased risks of unnatural/substance-related deaths in men or women in this representative sample.

Conclusions Whereas previous studies of high-risk delinquent or offender samples have highlighted increased risks of unnatural and alcohol- or substance abuse-related deaths in early adulthood, we found marked differences in mortality risk from other causes emerging later in the life course among women as well as men.

(Received November 16 2012)

(Revised May 10 2013)

(Accepted May 20 2013)

(Online publication August 21 2013)

Key words

  • Conduct problems;
  • life course;
  • mortality;
  • National Survey of Health and Development


c1 Address for correspondence: M. Stafford, MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London WC1B 5JU, UK. (Email: