BACKGROUND: An increasing importance is being placed on mental health and wellbeing at individual and population levels. While there are several interventions that have been proposed to improve wellbeing, more evidence is needed to understand which aspects of wellbeing are most influential. This study aimed to identify key items that signal improvement of mental health and wellbeing. METHODS: Using network analysis, we identified the most central items in the graph network estimated from the well-established Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Results were compared across four major UK cohorts comprising a total of 47,578 individuals: the Neuroscience in Psychiatry Network, the Scottish Schools Adolescent Lifestyle and Substance Use Survey, the Northern Ireland Health Survey, and the National Child Development Study. RESULTS: Regardless of gender, the three items most central in the network were related to positive self-perception and mood: 'I have been feeling good about myself'; 'I have been feeling confident'; and 'I have been feeling cheerful'. Results were consistent across all four cohorts. CONCLUSIONS: Positive self-perception and positive mood are central to psychological wellbeing. Psychotherapeutic and public mental health interventions might best promote psychological wellbeing by prioritising the improvement of self-esteem, self-confidence and cheerfulness. However, empirical testing of interventions using these key targets is needed.

Department of Psychiatry University of Cambridge Cambridge Biomedical Campus Herschel Smith Building for Brain and Mind Sciences Cambridge CB2 0SZ Cambridge UK

Department of Psychiatry University of Cambridge Cambridge Biomedical Campus Herschel Smith Building for Brain and Mind Sciences Cambridge CB2 0SZ Cambridge UK National Institute for Health Research Cambridge UK

Department of Psychiatry University of Cambridge Cambridge Biomedical Campus Herschel Smith Building for Brain and Mind Sciences Cambridge CB2 0SZ Cambridge UK National Institute for Health Research Cambridge UK Department of Kinanthropology Charles University Prague Czech Republic

National Institute for Health Research Cambridge UK Norwich Medical School University of East Anglia Norwich UK

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