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Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well

Published online by Cambridge University Press:  09 January 2017

J. Ormel ,
A. M. Oerlemans ,
D. Raven ,
O. M. Laceulle ,
C. A. Hartman ,
R. Veenstra ,
F. C. Verhulst ,
W. Vollebergh ,
J. G. M. Rosmalen  and
S. A. Reijneveld
...Show all authors
J. Ormel*
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
A. M. Oerlemans
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
D. Raven
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
O. M. Laceulle
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands Department of Developmental Psychology, University of Utrecht, Utrecht, The Netherlands
C. A. Hartman
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
R. Veenstra
Affiliation:
Department of Sociology, University of Groningen, Groningen, The Netherlands
F. C. Verhulst
Affiliation:
Department of Child and Adolescent Psychiatry & Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
W. Vollebergh
Affiliation:
Department of Interdisciplinary Social Science, University of Utrecht, Utrecht, The Netherlands
J. G. M. Rosmalen
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
S. A. Reijneveld
Affiliation:
Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
A. J. Oldehinkel
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
*
*Address for correspondecne: J. Ormel, PhD, Department of Psychiatry, University of Groningen, University Medical Center Groningen, CC 72, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. (Email: [email protected])
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Abstract

Background

Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes.

Method

We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use).

Results

Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder.

Conclusion

To understand current functioning, it is necessary to examine both current and past psychiatric status.

Keywords

Adolescenceco-morbiditydevelopmentfunctional outcomesmental disordersparticipationpsychiatric historyyouth mental health
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 7 , May 2017 , pp. 1271 - 1282
Copyright
Copyright © Cambridge University Press 2017 

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