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Children with psychiatric problems more likely to have dysfunctional adulthood

Individuals with psychiatric problems in childhood were more likely to have problems functioning in adulthood, according to study findings in JAMA Psychiatry.

“Prospective studies that observe children into early adulthood and retrospective studies of adults confirm that most adults with psychiatric disorders previously had a disorder in childhood. Optimal adult functioning, however, includes much more than psychiatric status,” study researcher William E. Copeland, PhD, of Duke University Medical Center, and colleagues wrote. “A successful transition to adulthood involves a bevy of developmental challenges… Failure in any area can be a major barrier to a successful transition to adulthood.”

William E. Copeland

To determine if psychiatric problems in childhood affect functioning in adulthood, researchers interviewed 1,420 individuals from 11 rural counties of North Carolina during childhood and young adulthood. Study participants were assessed up to six times during childhood, at ages 9 to 16 years, and three times during adulthood, at ages 19, 21 and 24 to 26 years.

Assessed psychiatric disorders included separation anxiety, generalized anxiety, social phobia, specific phobia, agoraphobia, panic disorder, obsessive-compulsive disorder and PTSD; major depression, dysthymia, mania and hypomania; and conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder and substance disorders.

Individuals with psychiatric problems during childhood were six times more likely to experience at least one adverse outcome in adulthood related to health, the legal system, personal finances or social functioning (OR = 5.9; 95% CI, 3.6-9.7), compared with those with no history of psychiatric problems.

Further, individuals with a childhood psychiatric problem were nine times more likely to experience two or more adverse outcomes in adulthood (OR = 8.7; 95% CI, 4.3-17.8).

These associations remained true when controlling for childhood psychosocial hardships and adult psychiatric problems, according to researchers.

Benjamin B. Lahey

Risk was not limited to those with diagnosed disorders, as individuals with subthreshold psychiatric problems were three times more likely to experience one adult adverse outcome (OR = 2.9; 95% CI, 1.8-4.8) and five times more likely to experience two or more (OR = 5.1; 95% CI, 2.4-10.7), compared with those with no history of psychiatric problems.

“This study by Copeland et al in this issue of JAMA Psychiatry adds to this literature by suggesting that exhibiting a subthreshold or threshold mental disorder at some time from late childhood through adolescence predicts lower levels of adaptive functioning in early adulthood, even when adult mental disorders are controlled,” Benjamin B. Lahey, PhD, of the University of Chicago, wrote in an accompanying editorial. “This suggests that even subthreshold child and adolescent disorders predict dysfunction in early adulthood, and do so even beyond the dysfunction associated with mental disorders in adulthood.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.