William E Copeland1, Dieter Wolke2, Lilly Shanahan3, E Jane Costello1. 1. Center for Developmental Epidemiology, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. 2. Department of Psychology and Division of Mental Health and Wellbeing, University of Warwick, Coventry, Warwickshire, England. 3. Department of Psychology, University of North Carolina, Chapel Hill, North Carolina.
Abstract
IMPORTANCE: 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, SETTING, AND PARTICIPANTS: Prospective, population-based study of 1420 participants from 11 predominantly rural counties of North Carolina who were assessed with structured interviews up to 6 times during childhood (9-16 years of age, for a total 6674 observations) for common psychiatric diagnoses and subthreshold psychiatric problems. The period for this study was from 1993 to 2010. MAIN OUTCOMES AND MEASURES: A total of 1273 participants were assessed 3 times during young adulthood (19, 21, and 24-26 years of age, for a total of 3215 observations) for adverse outcomes related to health, the legal system, personal finances, and social functioning. RESULTS: Participants with a childhood disorder had 6 times higher odds (odds ratio [OR], 5.9 [95% CI, 3.6-9.7]) of at least 1 adverse adult outcome (ie, indicator) compared with those with no history of psychiatric problems and 9 times higher odds (OR, 8.7 [95% CI, 4.3-17.8]) of 2 or more such indicators (1 indicator: 59.5% vs 19.9% [P < .001]; ≥ 2 indicators: 34.2% vs 5.6% [P < .001]). These associations persisted after statistically controlling for childhood psychosocial hardships and adult psychiatric problems. Risk was not limited to those who received a diagnosis; participants with subthreshold psychiatric problems had 3 times higher odds (OR, 2.9 [95% CI, 1.8-4.8]) of adult adverse outcomes and 5 times higher odds (OR, 5.1 [95% CI, 2.4-10.7]) of 2 or more outcomes (1 indicator: 41.9% vs 19.9% [P < .001]; ≥ 2 indicators: 23.2% vs 5.6% [P < .001]). The best diagnostic predictor of adverse outcomes was cumulative childhood exposure to psychiatric disorders. CONCLUSIONS AND RELEVANCE: 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 a potential target for public health efforts to ameliorate adult suffering and morbidity.
IMPORTANCE: 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, SETTING, AND PARTICIPANTS: Prospective, population-based study of 1420 participants from 11 predominantly rural counties of North Carolina who were assessed with structured interviews up to 6 times during childhood (9-16 years of age, for a total 6674 observations) for common psychiatric diagnoses and subthreshold psychiatric problems. The period for this study was from 1993 to 2010. MAIN OUTCOMES AND MEASURES: A total of 1273 participants were assessed 3 times during young adulthood (19, 21, and 24-26 years of age, for a total of 3215 observations) for adverse outcomes related to health, the legal system, personal finances, and social functioning. RESULTS:Participants with a childhood disorder had 6 times higher odds (odds ratio [OR], 5.9 [95% CI, 3.6-9.7]) of at least 1 adverse adult outcome (ie, indicator) compared with those with no history of psychiatric problems and 9 times higher odds (OR, 8.7 [95% CI, 4.3-17.8]) of 2 or more such indicators (1 indicator: 59.5% vs 19.9% [P < .001]; ≥ 2 indicators: 34.2% vs 5.6% [P < .001]). These associations persisted after statistically controlling for childhood psychosocial hardships and adult psychiatric problems. Risk was not limited to those who received a diagnosis; participants with subthreshold psychiatric problems had 3 times higher odds (OR, 2.9 [95% CI, 1.8-4.8]) of adult adverse outcomes and 5 times higher odds (OR, 5.1 [95% CI, 2.4-10.7]) of 2 or more outcomes (1 indicator: 41.9% vs 19.9% [P < .001]; ≥ 2 indicators: 23.2% vs 5.6% [P < .001]). The best diagnostic predictor of adverse outcomes was cumulative childhood exposure to psychiatric disorders. CONCLUSIONS AND RELEVANCE: 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 a potential target for public health efforts to ameliorate adult suffering and morbidity.
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Adrian Angold; Alaattin Erkanli; Elizabeth M Z Farmer; John A Fairbank; Barbara J Burns; Gordon Keeler; E Jane Costello Journal: Arch Gen Psychiatry Date: 2002-10
Authors: Kristin N Javaras; Mary C Zanarini; James I Hudson; Shelly F Greenfield; John G Gunderson Journal: J Psychiatr Res Date: 2017-01-24 Impact factor: 4.791
Authors: Autumn Kujawa; Anna Weinberg; Nora Bunford; Kate D Fitzgerald; Gregory L Hanna; Christopher S Monk; Amy E Kennedy; Heide Klumpp; Greg Hajcak; K Luan Phan Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2016-08-02 Impact factor: 5.067
Authors: Jennifer Zink; Michele Nicolo; Kellie Imm; Shayan Ebrahimian; Qihan Yu; Kyuwan Lee; Kaylie Zapanta; Jimi Huh; Genevieve F Dunton; Michael I Goran; Kathleen A Page; Christina M Dieli-Conwright; Britni R Belcher Journal: J Psychosom Res Date: 2020-05-15 Impact factor: 3.006