Epidemiology, development and prevention of mental health problems using a life span perspective – HEALTHY

While physical illnesses account for most of the social and economic burden among adults, Mental Health Problems (MHPs) are the first cause of disability among youths. Point estimates in the past decade suggest that at least 20% of children will have a MHP in any given year, and the rates are as high as 36.7% when considering the risk of having at least one disorder by age 16 years. Preventive measures are less costly and intrusive than curative ones, which explains why prevention of MHPs has been adopted in many societies. There is much left to learn, however, about the development and the aetiology of MHPs, and about the risk and protective factors that could successfully be targeted through preventive interventions.

Cédric Galéra (Child and adolescent psychiatrist, Professor of Universities – Hospital Practitioner (PU-PH) at the University of Bordeaux and Charles Perrens Hospital) is taking the leadership and Christophe Tzourio the co leadership (a trained neurologist, former clinical director of Hôpitaux de Paris, director of the Centre INSERM U1219 Bordeaux Population Health from 2016 to 2021, professor of epidemiology at University of Bordeaux, and a doctor at Bordeaux university hospital) of the team.


The Healthy Team is a multidisciplinary group of epidemiologists, biostatisticians, psychologists and child psychiatrists whose research aims at:

1) generating knowledge about the developmental epidemiology of MHPs, their causes and consequences over the life course (ie. from conception to adulthood);

2) understanding the mechanisms and risk factors (both biological and environmental) underlying MHPs;

3) testing health promotion interventions to prevent MPH and their personal, social and economic impacts.


Research areas

  • Projects using correlational designs and population-based samples

The team members use population based cross-sectional and longitudinal data sets as well as experimental prevention studies to generate knowledge on the etiology and prevention of MHPs and psychosocial problems among youth. All data sets include some biological level information such as brain imaging (functional and structural), hormonal (e.g. cortisol assessing stress levels), gene expression (assessing epigenetic marks) and/or genomic information allowing team members to study the biological underpinnings of MHPs.

The i-Share study is a large cohort of university students led by Christophe Tzourio and used by several team members to generate knowledge about the epidemiology of MHPs among university students. To date, nearly 20,000 French students have participated in the i-Share study. The team also relies on data from cohorts generated in industrialized countries including France, Canada, United Kingdom, Finland, Norway, and the United States and spanning birth to adolescence or adulthood.


  • Projects using experimental designs.

Over the past 2 years, the Healthy team has been developing a research axis in health promotion while adopting a life span perspective. The team is currently becoming the epicenter of a series of randomized trials in health promotion via early childhood education (preschool). Large cluster randomized control trials (n= 1200 children in France and n=1280 in Canada) where child care centers are randomized to a preventive intervention are led jointly with the EUCLID (EUropean CLInical Trials Platform & Development) team at the U of Bordeaux. Euclid is an internationally renewed clinical platform for RCTs.  The expertise of the EUCLID team is used to implement early childhood education trials with state of the art scientific and ethical clinical RCT standards.  In order to have a societal impact, the Healthy team will 1) mobilize human and financial resources for the use of existing cohort data and 2) collect new data, in particular via early childhood experiments, based on best practices, benevolence and scientific rigor.


Team members have built solid and fruitful scientific collaborations both within the center and with other teams in Europe and North America.
One aim of the healthy team is to analyse the complex longitudinal data sets with state-of-the-art digital public health statistical methods. To this end, the members are participating in the digital public health initiative led by BPH team director Rodolphe Thiebaut (epidemiology and biostatistics team).  
The team has also strong relationships with the IETO team (e.g. childhood maltreatment, attention-deficit hyperactivity disorder and injury outcomes) as they share interest in the substantive questions of the impact of child maltreatment on MHPs. The experimental child care projects are supported, within Bordeaux University, by the EUCLID group, a team of highly qualified professionals and researchers conducting clinical trials on an international scale. Our international work is based on the use of a set of French (EDEN, ELFE, i-Share), British (ALSPAC, BMCS), Finish (1987 FBC) and Canadian (ELEMQ, ELEM, ELNEJ, ELDEQ, EJNQ) longitudinal studies as well as Irish, Canadian and French experimental studies.  To successfully work with these data, team members actively collaborate with researchers leading the different studies. The heads of the team are leading early childhood experiments in both Canada and France which allows the mutualisation of the resources and expertise necessary to successfully realize these studies.

Main publications

  1. Heckman JJ, Mosso S. The Economics of Human Development and Social Mobility. Annu Rev Econ. 2014;6:689-733.
  2. Japel C, Tremblay RE, Côté S. La qualité, ça compte! Résultats de l’Étude longitudinale du développement des enfants du Québec concernant la qualité des services de garde. Choix IRPP. 2005;11(4).
  3. OCDE. Petite enfance, grands défis IV : Le suivi de la qualité dans les services d’éducation et d’accueil des jeunes enfants. Paris, France: OCDE;2015.
  4. Petitclerc A, Côté S, Doyle O, Burchinal M, Herba C, Zachrisson HD, Boivin M, Tremblay RE, Tiemeier H, Jaddoe V. Who uses early childhood education and care services? Comparing socioeconomic selection across five western policy contexts. Int. J. Child Care Educ. Policy. 2017;11(1):3.
  5. Côté SM, Doyle O, Petitclerc A, Timmins L. Child care in infancy and cognitive performance until middle childhood in the Millennium Cohort Study. Child Dev. 2013;84(4):1191-1208.
  6. Geoffroy M-C, Séguin JR, Lacourse É, Boivin M, Tremblay RE, Côté SM. Parental characteristics associated with childcare use during the first 4 years of life: Results from a representative cohort of Québec families. 2012;103(1):76-80.
  7. Côté SM, Boivin M, Nagin DS, Japel C, Xu Q, Zoccolillo M, Junger M, Tremblay RE. The role of maternal education and non-maternal care services in the prevention of children’s physical aggression. Arch Gen Psychiatry. 2007;64(11):1305-1312.
  8. Orri M, Galera C, Turecki G, Forte A, Renaud J, Boivin M, Tremblay RE, Cote SM, Geoffroy MC. Association of Childhood Irritability and Depressive/Anxious Mood Profiles With Adolescent Suicidal Ideation and Attempts. JAMA Psychiatry. 2018.
  9. Geoffroy M-C, Côté SM, Giguere C-E, Dionne G, Zelazo PD, Tremblay RE, Boivin M, Seguin JR. Closing the gap in academic readiness and achievement: The role of early childcare. J Child Psychol Psychiatry. 2010;51(12):1359-1367.
  10. Laurin JC, Geoffroy M-C, Boivin M, Japel C, Raynault M-F, Tremblay RE, Côté SM. Child care services, socioeconomic inequalities, and academic performance. Pediatr. 2015;136(6):1112-1124.
  11. Herba CM, Tremblay RE, Boivin M, Liu X, Mongeau C, Séguin JR, Côté SM. Maternal depressive symptoms and children’s emotional problems can early child care help children of depressed mothers? JAMA Psychiatry. 2013;70(8):830-838.
  12. Charrois J, Côté SM, Japel C, Séguin JR, Paquin S, Tremblay RE, Herba CM. Child-care quality moderates the association between maternal depression and children’s behavioural outcome. J Child Psychol Psychiatry. 2017;58(11):1210-1218.
  13. Ahun MN, Consoli A, Pingault JB, Falissard B, Battaglia M, Boivin M, Tremblay RE, Côté SM. Maternal depression symptoms and internalising problems in the offspring: the role of maternal and family factors. European child & adolescent psychiatry. 2017.
  14. Côté SM, Boivin M, Liu XC, Nagin DS, Zoccolillo M, Tremblay RE. Depression and anxiety symptoms: onset, developmental course and risk factors during early childhood. J Child Psychol Psychiatry. 2009;50(10):1201-1208.
  15. Côté SM, Ahun MN, Vitaro F, Liu X, Herba CM, Brendgen M, Geoffroy M-C, Boivin M, Melchior M, Tremblay RE. The long-term associations between maternal depression and internalizing problems in the offspring: A search for mediators in a 15-year population based study. J Am Acad Child Adolesc Psychiatry. 2018.
  16. Tremblay RE, Vitaro F, Côté SM. Developmental Origins of Chronic Physical Aggression: A Bio-Psycho-Social Model for the Next Generation of Preventive Interventions. Annu Rev Psychol. 2018;69:383-407.
  17. Ouellet-Morin I, Côté SM, Vitaro F, Hébert M, Carbonneau R, Lacourse É, Turecki G, Tremblay RE. Effects of the MAOA gene and levels of exposure to violence on antisocial outcomes. Br. J. Psychiatry. 2016;208(1):42-48.
  18. Ministère de la Santé et des Services sociaux du Québec. Politique gouvernementale de prévention en santé. 2018; http://www.msss.gouv.qc.ca/ministere/politique-prevention-sante/.
  19. Raynault M-F, Côté D. Services de garde et clientèles vulnérables – Synthèse des connaissances sur l’accessibilité et l’utilisation des services de garde: leçons pour le Québec. Rapport de recherche Présenté à France Veilleux, directrice Direction de la recherche, de l’évaluation et de la statistique Ministère de la Famille;2014.
  20. Banerjee A, Duflo E, Goldberg N, Karlan D, Osei R, Pariente W, Shapiro J, Thuysbaert B, Udry C. Development economics. A multifaceted program causes lasting progress for the very poor: evidence from six countries. Science (New York, N.Y.). 2015;348(6236):1260799.
  21. Webster-Stratton C. 30th Annual Faculty Lecture. University of Washington. 2006.
  22. Côté SM, Vaillancourt T, LeBlanc JC, Nagin DS, Tremblay RE. The development of physical aggression from toddlerhood to pre-adolescence: A nation wide longitudinal study of Canadian children. J Abnorm Child Psychol. 2006;34(1):71-85.
  23. Côté SM, Vaillancourt T, Barker ED, Nagin DS, Tremblay RE. The joint development of physical and indirect aggression: Predictors of continuity and change during early childhood. Dev Psychopathol. 2007;19(1):37-55.
  24. Scott S, Knapp M, Henderson J, Maughan B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ. 2001;323(7306):191.
  25. Clark C, Rodgers B, Caldwell T, Power C, Stansfeld S. Childhood and adulthood psychological ill health as predictors of midlife affective and anxiety disorders: the 1958 British Birth Cohort. Arch Gen Psychiatry. 2007;64(6):668-678.
  26. Geoffroy MC, Gunnell D, Power C. Prenatal and childhood antecedents of suicide: 50-year follow-up of the 1958 British Birth Cohort study. Psychol Med. 2014;44(6):1245-1256.
  27. Larose MP, Ouellet-Morin I, Vitaro F, Geoffroy MC, Ahun M, Tremblay RE, Côté SM. Impact of a Child Care-Based Social Skills Training Program on Children’s Level of Stress: A Cluster-Randomized Controlled Trial. J Child Psychol Psychiatry. soumis.
  28. Yun SS, Choi J, Park SK, Bong GY, Yoo H. Social skills training for children with autism spectrum disorder using a robotic behavioral intervention system. Autism research : official journal of the International Society for Autism Research. 2017;10(7):1306-1323.
  29. Zheng Z, Warren Z, Weitlauf A, Fu Q, Zhao H, Swanson A, Sarkar N. Brief Report: Evaluation of an Intelligent Learning Environment for Young Children with Autism Spectrum Disorder. J. Autism Dev. Disord. 2016;46(11):3615-3621.
  30. Pingault J-B, Tremblay RE, Vitaro F, Carbonneau R, Genolini C, Falissard B, Côté SM. Childhood trajectories of inattention and hyperactivity and prediction of educational attainment in early adulthood: A 16-Year longitudinal population-based study. Am J Psychiaty. 2011;168(11):1164-1170.
  31. Pingault JB, Côté SM, Galéra C, Genolini C, Falissard B, Vitaro F, Tremblay RE. Childhood trajectories of inattention, hyperactivity and oppositional behaviors and prediction of substance abuse/dependence: A 15-year longitudinal population-based study. Mol. Psychiatr. 2013;18(7):806-812.
  32. Galéra C, Côté SM, Bouvard MP, Pingault J-B, Melchior M, Michel G, Boivin M, Tremblay RE. Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Arch Gen Psychiatry. 2011;68(12):1267-1275.
  33. Galéra C, Pingault J-B, Michel G, Bouvard M-P, Melchior M, Falissard B, Boivin M, Tremblay RE, Côté SM. Clinical and social factors associated with attention-deficit hyperactivity disorder medication use: Population-based longitudinal study. 2014;205(4):291-297.
  34. Côté S, Tremblay RE, Nagin DS, Zoccolillo M, Vitaro F. The development of impulsivity, fearfulness, and helpfulness during childhood: Patterns of consistency and change in the trajectories of boys and girls. 2002;43(5):609-618.
  35. Côté SM, Borge AI, Geoffroy M-C, Rutter M, Tremblay RE. Nonmaternal care in infancy and emotional/behavioral difficulties at 4 years old: Moderation by family risk characteristics. Dev Psychol. 2008;44(1):155-168.


Centre de recherche INSERM U1219
Université de Bordeaux, ISPED case 11
146 rue Léo-Saignat 33076 BORDEAUX cedex
Tél : +33 (0)5 57 57 16 59  

  • Director : Cédric Galéra
  • Co-director  : Christophe Tzourio
  • Contacts  : Nathalie Wattrelos




  • Julie Arsandaux
    Docteur en épidémiologie

    2016-2019     Doctorat de santé publique spécialité Epidémiologie – équipe HEALTHY – Santé et réussite des jeunes du Centre de Recherche Inserm-université de Bordeaux U1219 Bordeaux Population Health, université de Bordeaux

    2012-2013     Master Sciences, Technologies, Santé, Mention Santé Publique – Spécialité Epidémiologie – ISPED, Université Bordeaux Segalen

    2009-2011     Licence Sciences, Technologies, Santé, Mention Biologie santé, spécialité Biologie Cellulaire et Physiologie – Université Bordeaux Segalen

  • Laura Castel
  • Francois Jean

    2006 – 2012 Premier et Deuxième cycle des études médicales Faculté Hyacinthe Vincent UFR2, Université Bordeaux 2 Victor Ségalen

    2012 – 2017 Internat de Psychiatrie à Bordeaux

    2014 – 2016 Master 2 Recherche Biologie Santé Environnement, spécialité Cognition Naturelle et Artificielle, à l’École Pratique des Hautes Etudes (EPHE) à Paris, Responsable : Pr Thierry Dupressoir

    2017 – 2019 Clinicat de Psychiatrie de l’enfant et de l’adolescent à Bordeaux

    2019 Praticien hospitalier contractuel au CH de Calais

    2019 – 2021 Responsable de la filière adolescents et jeunes adultes dans le pôle de Psychiatrie du CH de Calais :

    2020 – / Praticien hospitalier au CH de Calais

    2020 – / Doctorant en santé publique épidémiologie, sous la direction du Pr Cédric Galéra, Association entre le TDAH et les substances illicites, Bordeaux Population Health, U1219, Université de Bordeaux – INSERM, équipe HEALTHY (Health, well being and achievement in the young )

    2021 – / Chef de service de la filière adolescents et jeunes adultes dans le pôle de Psychiatrie du CH de Calais

  • Shérazade Kinouani
    MD, PhD

    Médecin généraliste, docteure en épidémiologie

  • Melissa Macalli
    Post-doctorante en Santé Publique, spécialité Epidémiologie

    Infirmière de formation, Mélissa a travaillé dans différentes structures de soins avant d’intégrer l’ONG Médecins sans frontières comme coordinatrice projet. Après une thèse en santé publique, épidémiologie en 2021, elle poursuit ses travaux en post-doctorat au sein de l’équipe Healthy. Ses recherches portent sur la santé mentale des étudiants à partir de données de cohorte (i-Share, CONFINS) et plus particulièrement sur les facteurs de risque de la dépression et des conduites suicidaires.  

  • Elena Milesi
    Responsable communication étude i-Share


    Après avoir été assistante de communication interne pour la Direction du Développement du Système d’Information d’Orange France Télécom, j’ai occupé le poste de chargée de communication projets européens de coopération transfrontalière à l’Université de Perpignan Via Domitia pendant près de 3 ans. J’ai intégré l’équipe i-Share en avril 2013. Ma mission principale : coordonner la communication de l’étude i-Share.

  • Ilaria Montagni
    Researcher-Lecturer BPH-ISPED

    Academic background

    I graduated in Communication Theories at the University of Florence, Italy. I received a European doctorate in Psychological and Psychiatric Sciences from the University of Verona (Italy) and the INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France. My research projects are in the area of communication, internet, and new technologies concerning mental health. I am particularly interested in young adults’ use of the web for mental health information and advice seeking, and on mental health polices for students. 

  • Marie Mougin
    Chef de projets opérationnels

    Diplômée en psychologie clinique santé à l’université de Bordeaux, j’ai travaillé pour l’équipe INSERM U897 sur des études-actions relatives à la prévention du suicide ainsi que pour le CEID (Comité d’Étude et d’Information sur la Drogue) sur un projet concernant la problématique des alcoolisations massives des jeunes bordelais. J’ai rejoint l’équipe en avril 2013 pour coordonner les étudiants relais de l’étude i-Share et gérer différents projets opérationnels.

  • Massimiliano Orri
    Marie-Curie postdoctoral fellow

    My research aims to identify developmental risk factors for suicidal behaviours across the lifespan in population-based cohorts. It relies on different approaches, such as psychiatric epidemiology, developmental psychopathology, and behavioural genetics.

    I received my training in psychology at the University of Padova, Italy, where I completed a Bachelor’s degree in Psychology and Master degree in Clinical Psychology. I the persuaded my training in France, completing a PhD in Psychology and Cognitive Science at the University of Paris Descartes as well as a Master’ s degree in public health methodology and biostatistics at the University Paris Sud. I am currently a Marie-Curie postdoctoral fellow at the McGill Group for Suicide Studies and Research Unit on Children Psychosocial Maladjustment (McGill University, Canada) and Bordeaux Population Health Research Centre (Inserm, U1219, University of Bordeaux, France).

  • Garance Perret
    Ingénieure statisticienne
  • Ashlyn Schwartz
    Doctoral Candidate

    I am a PhD candidate of Public Health Sciences at the University of Tennessee, Knoxville currently on a Fulbright Fellowship in Bordeaux, France. My research utilizes mixed-methodological approaches in addressing youth and perinatal health challenges related to substance use. Since 2017, I have continued my research on developmental outcomes related to childhood trauma and neonatal abstinence syndrome.

  • Christophe Tzourio


    Christophe Tzourio est neurologue et épidémiologiste. Il a été Interne des Hôpitaux de Paris et Chef de Clinique en neurologie à l’Hôpital Lariboisière. Il a rejoint l’INSERM en 1994 comme Chargé de Recherche et a été promu Directeur de Recherche en 2000. En 2005, il est devenu directeur d’une nouvelle unité de recherche INSERM U708, à l’hôpital de la Pitié-Salpêtrière à Paris. En 2001, il a été nommé professeur d’épidémiologie à l’Université de Bordeaux et praticien hospitalier au CHU de Bordeaux. En Septembre 2013, il est devenu directeur du Bordeaux Population Health (BPH), Inserm U1219, à l’Université de Bordeaux.

  • Nathalie Wattrelos
    Gestionnaire administrative et financière
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