Context
Psychiatric problems are
among the most common health problems of childhood.
Objective
To test whether these health
problems adversely affect adult functioning even if the problems themselves do
not persist.
Design
Prospective,
population-based study of 1420 participants assessed with structured interviews
up to 6 times in childhood (ages 9 to 16; 6674 observations) for common
psychiatric diagnoses and subthreshold psychiatric problems.
Main outcome measure
Participants were then
assessed 3 times in young adulthood (ages 19, 21, and 24–26; 3215 observations
of 1273 subjects) for adverse outcomes related to health, legal, financial, and
social functioning.
Results
Participants with a
childhood disorder had 6 times higher odds of at least one adverse adult
outcome as compared to those with no history of psychiatric problems and 9
times higher odds of 2 or more such indicators (1 indicator: 59.5% vs. 19.9%, p
<0.001; 2+ indicators: 34.2% vs. 5.6%, p <0.001). These associations
persisted after statistically controlling for childhood psychosocial hardships
and adult psychiatric problems. Risk was not limited to those with a diagnosis:
participants with subthreshold psychiatric problems had 3 times higher odds of
adult adverse outcomes and 5 time higher odds of 2 or more outcomes (1
indicator: 41.9% vs. 19.9%, p <0.001; 2+ indicators: 23.2% vs. 5.6%, p
<0.001). The best diagnostic predictor of adverse outcomes was cumulative
childhood exposure to psychiatric disorders.
Conclusions
Common, typically
moderately-impairing, childhood psychiatric problems are associated with a
disrupted transition to adulthood even if the problems do not persist into
adulthood and even if the problems are subthreshold. Such problems provide
potential target for public health efforts to ameliorate adult suffering and
morbidity.
Below: Associations between adult outcomes and childhood diagnostic groups
Full article at: http://goo.gl/tK7ttb
By:
William E. Copeland,
Dieter
Wolke: ku.ca.kciwraw@ekloW.D; Lilly Shanahan: ude.cnu@nahanahs_yllil; E. Jane Costello: ude.ekud@olletsoc.htebazile
Corresponding author: William E. Copeland, Ph.D., Center for
Developmental Epidemiology, Duke University Medical Center, Department of
Psychiatry and Behavioral Sciences, Box 3454, Durham NC 27710, Email: ude.ekud@dnalepoc.mailliw,
Phone: (919) 687-4686, Fax: (919) 687-4737
More at: https://twitter.com/hiv
insight
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