Adolescence is not only a transitional stage between childhood and adulthood, it is also a critical phase in brain development and maturity during which the brain undergoes progressive and regressive changes [1, 2]. Excessive alcohol use at a young age can disturb this process and can seriously damage the development of the brain [3, 4]. Binge drinking in particularly is a harmful way to consume alcohol [5, 6]. During puberty, adolescents exhibit risk behaviour [7–9], such as drinking too much, [10–13], and studies have shown that excessive alcohol consumption in adolescents is strongly related to problem behaviour and an increased risk of suicidal behaviour [14, 15], with six or more glasses of alcohol weekly being associated with an increased risk of depression . Moreover, boys with clinical depression start drinking alcohol at a younger age than their non-depressed peers [17, 18]. Subclinical mood changes are common in adolescence, ranging from "dips" in mood that usually last no longer than a few weeks to subclinical depression, which affects 17% of young people . Depression and anxiety disorders have a high disease burden, even in a mild form  and teenagers with subclinical depression have a 6 times higher risk of developing clinical depression than teenagers without subclinical depression , and adolescents diagnosed with a depressive disorder are at higher risk of substance abuse, future depression, and suicidal behaviour [14, 21, 22]. Fifteen percent of adolescents report anxiety , with social phobia and generalized anxiety disorder in particular developing during childhood and adolescence . These young people are at increased risk of developing other anxiety disorders, depression, and substance dependence . Indeed, current anxiety is strongly associated with alcohol abuse in adolescents seen in primary care settings .
Although the number of binge drinking youngsters aged 12-14 years has decreased in recent years from 28% in 2003 to 19% in 2007, the proportion of binge drinking students aged 15-16 years has remained stable (57%). Compared with their peers in other European countries, Dutch students can be considered heavy drinkers [27–29]. In the Netherlands, the Youth Health Service provides the parents and guardians of children aged 4-18 years with guidance regarding the physical, mental, and social development of their children. One of the Service's primary tasks is to identify health risks at an early stage, which necessitates monitoring mental health and lifestyle risks, including alcohol consumption. Little is known about the drinking behaviour, and especially binge drinking, of secondary school students who have moderate or poor mental health but who have not been clinically diagnosed with depression or anxiety disorder. The aim of this study was to establish whether self-reported moderate or poor mental health is associated with binge drinking in boys and girls aged 12 to18 years.