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Adult functional outcomes of common childhood psychiatric problems
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Copeland, William E., Wolke, Dieter, Shanahan, Lilly and Costello, E. Jane (2015) Adult functional outcomes of common childhood psychiatric problems. JAMA Psychiatry, 72 (9). pp. 892-899. doi:10.1001/jamapsychiatry.2015.0730 ISSN 2168-622X.
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Official URL: http://dx.doi.org/10.1001/jamapsychiatry.2015.0730
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.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Science > Psychology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | JAMA Psychiatry | ||||||
Publisher: | American Medical Association | ||||||
ISSN: | 2168-622X | ||||||
Official Date: | September 2015 | ||||||
Dates: |
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Volume: | 72 | ||||||
Number: | 9 | ||||||
Page Range: | pp. 892-899 | ||||||
DOI: | 10.1001/jamapsychiatry.2015.0730 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Date of first compliant deposit: | 2 February 2016 |
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