Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-28T13:02:20.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of early adolescent psychiatric and personality disorder on long-term physical health: a 20-year longitudinal follow-up study

Published online by Cambridge University Press:  08 September 2008

H. Chen ,
P. Cohen ,
T. N. Crawford ,
S. Kasen ,
B. Guan  and
K. Gorden
H. Chen*
Affiliation:
Division of Biostatistics, New York State Psychiatric Institute, NY, USA Division of Epidemiology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
P. Cohen
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
T. N. Crawford
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
S. Kasen
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
B. Guan
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
K. Gorden
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, NY, USA
*
*Address for correspondence: H. Chen, M.D., Ph.D., Columbia University/NYSPI, 100 Haven Avenue, 31F, New York, NY 10032, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Evidence regarding the long-term separate and combined impact of adolescent psychiatric disorder and personality disorder (PD) on physical health is absent.

Method

A total of 736 people randomly selected in childhood were contacted for home or telephone interviews four times over 20 years. DSM Axis I disorders and Axis II PDs were assessed at mean age 13.7 years in 1983 and physical health was assessed in 1985–1986, 1991–1994 and 2001–2004.

Results

Comparisons were made between 506 adolescents without Axis I disorder or PD and adolescents with Axis I disorder or PD or both. Adolescents with an Axis I disorder (n=150) had significantly higher odds of pain and physical illness and poorer physical health. Adolescents with a PD (n=149) had higher odds of pain and physical illness and poorer physical health and a more rapid decline in physical health. In addition, the 81 participants with an Axis I disorder without co-morbid PD had poorer physical health, but this effect did not reach statistical significance, whereas the 80 participants with a PD but no Axis I disorder reported significantly more pain and more rapid decline in physical health. However, the 69 participants with co-morbid Axis I disorder and PD had the highest rates of pain and physical illness and the worst physical health.

Conclusions

Co-morbid PD accounted for many of the associations of adolescent Axis I disorder with physical health over the ensuing two decades. Co-morbid adolescent Axis I disorder and PD represent a particularly high risk for physical health.

Keywords

Co-morbiditypersonality disorderphysical healthpsychiatric disorder
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 5 , May 2009 , pp. 865 - 874
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

AACAP (2003). The American Academy of Child and Adolescent Psychiatry (www.aacap.org). Accessed 28 November 2003.Google Scholar
Andreoli, A, Gressot, G, Aapro, N, Tricot, L (1989). Personality disorders as a predictor of outcome. Journal of Personality Disorders 3, 307–320.CrossRefGoogle Scholar
APA (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn (DSM-III). American Psychiatric Association: Washington, DC.Google Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised (DSM-III-R). American Psychiatric Association: Washington, DC.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). American Psychiatric Association: Washington, DC.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Bank, PA, Silk, KR (2001). Axis I and axis II interactions. Current Opinion in Psychiatry 14, 137–142.Google Scholar
Bernstein, D, Cohen, P, Skodol, A (1996). Childhood antecedents of adolescent personality disorders. American Journal of Psychiatry 153, 907–913.Google ScholarPubMed
Bernstein, DP, Cohen, P, Velez, CN (1993). Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents. American Journal of Psychiatry 150, 1237–1243.Google Scholar
Bjorntorp, P, Rosmond, R (1999). Hypothalamic origin of the metabolic syndrome X. Annals of the New York Academy of Sciences 892, 297–307.CrossRefGoogle ScholarPubMed
Boehnert, CE, Popkin, MK (1986). Psychological issues in treatment of severely noncompliant diabetics. Psychosomatics: Journal of Consultation and Liaison Psychiatry 27, 11–20.CrossRefGoogle ScholarPubMed
Bower, JE, Ganz, PA, Aziz, N (2005). Altered cortisol response to psychologic stress in breast cancer patients with persistent fatigue. Psychosomatic Medicine 67, 277–280.CrossRefGoogle ScholarPubMed
Brown, J, Berenson, K, Cohen, P (2005). Documented and self-reported child abuse and adult pain in a community sample. Clinical Journal of Pain 21, 374–377.CrossRefGoogle Scholar
Chen, H, Cohen, P (2006). Using individual growth model to analyze the change in quality of life from adolescence to adulthood. Health and Quality of Life Outcomes 4, 10. doi: 10.1186/1477-7525-4-10.CrossRefGoogle ScholarPubMed
Chen, H, Cohen, P, Crawford, TN (2006 a). Relative impact of young adult personality disorders on subsequent quality of life: findings of a community-based longitudinal study. Journal of Personality Disorders 20, 510–523.CrossRefGoogle ScholarPubMed
Chen, H, Cohen, P, Kasen, S, Gordan, K, Dufur, R, Smailes, E (2004). Construction and validation of a quality of life instrument for young adults. Quality of Life Research 13, 747–759.CrossRefGoogle ScholarPubMed
Chen, H, Cohen, P, Kasen, S, Johnson, JG (2006 c). Adolescent Axis I and personality disorders predict quality of life during young adulthood. Journal of Adolescent Health 39, 14–19.CrossRefGoogle ScholarPubMed
Chen, H, Cohen, P, Kasen, S, Johnson, JG, Berenson, K, Gordon, K (2006 b). Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later. Archives of Pediatrics and Adolescent Medicine 160, 93–99.Google Scholar
Clark, LA (2007). Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization. Annual Review of Psychology 58, 227–257.CrossRefGoogle Scholar
Cohen, P, Chen, H, Crawford, T, Brook, JS, Gordon, K (2007). Personality disorders in early adolescence and the development of later substance use disorders in the general population. Drug and Alcohol Dependence 88 (Suppl. 1), S71–S84.CrossRefGoogle ScholarPubMed
Cohen, P, Cohen, J, Kasen, S, Velez, CN, Hartmark, C, Johnson, J, Rojas, M, Brook, J, Streuning, EL (1993). An epidemiological study of disorders in late childhood and adolescence. 1. Age- and gender-specific prevalence. Journal of Child Psychology and Psychiatry and Allied Disciplines 34, 851–867.CrossRefGoogle Scholar
Cohen, P, O'Connor, P, Lewis, SA, Malachowski, B (1987). A comparison of the agreement between DISC and K-SADS-P interviews of an epidemiological sample of children. Journal of the American Academy of Child Psychiatry 26, 662–667.CrossRefGoogle Scholar
COM(95) 449 (1995). Communication from the Commission concerning a Community action programme on health monitoring in the context of the framework for action in the field of public health. Commission of the European Communities: Brussels, 16 October 1995.Google Scholar
Compton, MT, Rudisch, BE, Weiss, PS, West, JC, Kaslow, NJ (2005). Predictors of psychiatrist-reported treatment-compliance problems among patients in routine U.S. psychiatric care. Psychiatry Research 137, 29–36.CrossRefGoogle ScholarPubMed
Crawford, TN, Cohen, P, Johnson, JG, Kasen, S, First, MB, Gordon, K, Brook, JS (2005). Self-reported personality disorder in the Children in the Community sample: convergent and prospective validity in late adolescence and adulthood. Journal of Personality Disorders 19, 30–52.CrossRefGoogle ScholarPubMed
de Bruin, A, Picavet, HSJ, Nossikov, A (1996). Health interview surveys. Towards international harmonization of methods and instruments. WHO Regional Publications. European Series 58, 1–161.Google ScholarPubMed
Epel, ES, McEwan, B, Seeman, T, Matthews, K, Castellazzo, G, Brownell, KD (2000). Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine 62, 623–632.CrossRefGoogle ScholarPubMed
Fayers, PM, Sprangers, MAG (2002). Understanding self-rated health. Lancet 359, 187–189.CrossRefGoogle ScholarPubMed
Fenton, WS, Stover, ES (2006). Mood disorders: cardiovascular and diabetes comorbidity. Current Opinion in Psychiatry 194, 421–427.CrossRefGoogle Scholar
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Huang, B (2005). Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Psychiatric Research 39, 1–9.CrossRefGoogle ScholarPubMed
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Pickering, RP (2004). Prevalence, correlates, and disability of personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 65, 948–958.CrossRefGoogle ScholarPubMed
Hays, RD, Wells, KB, Sherbourne, CD, Rogers, W, Spritzer, K (1995). Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Archives of General Psychiatry 52, 11–19.CrossRefGoogle ScholarPubMed
Heijnen, CJ, Kavelaars, A (2005). Psychoneuroimmunology and chronic autoimmune diseases: rheumatoid arthritis. In Human Psychoneuroimmunology (ed. Vedhara, K. and Irwin, M.), pp. 195–218. Oxford University Press: New York.Google Scholar
Hennessy, CH, Moriary, DG, Zack, MM, Scherr, PA, Brackbill, R (1994). Measuring health-related quality of life for public health surveillance. Public Health Reports 109, 665–672.Google Scholar
Huprich, SK, Frisch, MB (2004). The depressive personality disorder inventory and its relationship to quality of life, hopefulness, and optimism. Journal of Personality Assessment 83, 22–28.CrossRefGoogle ScholarPubMed
Hyler, SE, Reider, RO, Williams, JBW, Spitzer, RL, Hendler, J, Lyons, M (1988). The Personality Diagnostic Questionnaire: development and preliminary results. Journal of Personality Disorders 2, 229–237.CrossRefGoogle Scholar
Idler, EL, Benyamini, Y (1997). Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior 38, 21–37.CrossRefGoogle ScholarPubMed
Jackson, HJ, Burgess, PM (2002). Personality disorders in the community: results from the Australian National Survey of Mental Health and Wellbeing. Social Psychiatry and Psychiatric Epidemiology 37, 251–260.CrossRefGoogle ScholarPubMed
Johnson, JG, Cohen, P, Skodol, A, Oldham, JM, Kasen, S, Brook, JS (1999). Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood. Archives of General Psychiatry 56, 805–811.CrossRefGoogle ScholarPubMed
Jylha, M, Volpato, S, Guralnik, JM (2006). Self-rated health showed a graded association with frequently used biomarkers in a large population sample. Journal of Clinical Epidemiology 59, 465–471.CrossRefGoogle Scholar
Kasen, S, Cohen, P, Skodol, AE, Johnson, JG, Smailes, E, Brook, JS (2001). Childhood depression and adult personality disorder: alternative pathways of continuity. Archives of General Psychiatry 58, 231–236.CrossRefGoogle ScholarPubMed
Koenigsberg, HW, Kaplan, RD, Gilmore, MM, Cooper, AM (1985). The relationship between syndrome and personality disorder in DSM-III: experience with 2462 patients. American Journal of Psychiatry 142, 207–212.Google Scholar
Lekander, M, Elofsson, S, Neve, IM, Hansson, LO, Unden, AL (2004). Self-rated health is related to levels of circulating cytokines. Psychosomatic Medicine 66, 559–563.CrossRefGoogle ScholarPubMed
Lieb, K, Rexhausen, JE, Kahl, KG, Schweiger, U, Philipsen, A, Hellhammer, DH, Bohus, M (2004). Increased diurnal salivary cortisol in women with borderline personality disorder. Journal of Psychiatric Research 38, 559–565.CrossRefGoogle ScholarPubMed
Littell, RC, Milliken, GA, Stroup, WW, Wolfinger, RD (1996). SAS System for Mixed Models. SAS Institute Inc.: Cary, NC.Google Scholar
Matas, M, Staley, D, Griffin, W (1992). A profile of the noncompliant patient: a thirty-month review of outpatient psychiatry referrals. General Hospital Psychiatry 4, 124–130.CrossRefGoogle Scholar
McCullough, ME, Laurenceau, JP (2004). Gender and the natural history of self-rated health: a 59-year longitudinal study. Health Psychology 23, 651–655.CrossRefGoogle Scholar
McDonough, P, Berglund, P (2003). Histories of poverty and self-rated health trajectories. Journal of Health and Social Behavior 44, 198–214.CrossRefGoogle ScholarPubMed
McEwen, BS (2000). The neurobiology of stress: from serendipity to clinical relevance. Brain Research 886, 172–189.CrossRefGoogle ScholarPubMed
Oldham, JM, Skodol, AE, Kellman, HD, Hyler, SE, Doidge, N, Rosnick, L, Gallaher, PE (1995). Comorbidity of axis I and axis II disorders. American Journal of Psychiatry 152, 571–578.Google ScholarPubMed
Ormel, J, Von Korff, M, Ustun, B, Pini, S, Korten, A, Oldehinkel, T (1994). Common mental disorders and disabilities across cultures: results from the WHO Collaborative Study on Psychological Problems in General Health Care. Journal of the American Medical Association 272, 1741–1748.CrossRefGoogle Scholar
Papakostas, GI, Petersen, T, Mahal, Y, Mischoulon, D, Nierenberg, AA, Fava, M (2004). Quality of life assessments in major depressive disorder: a review of the literature. General Hospital Psychiatry 26, 13–17.CrossRefGoogle ScholarPubMed
Rapaport, MH, Clary, C, Fayyad, R, Endicott, J (2005). Quality of life impairment in depressive and anxiety disorders. American Journal of Psychiatry 162, 1171–1178.CrossRefGoogle ScholarPubMed
SAS Institute (2007). Statistical Analysis System, Version 9.1. SAS Institute Inc.: Cary, NC.Google Scholar
Sephton, SE, Speigel, D (2003). Circadian disruption in cancer: a neuroendocrine-immune pathway from stress to disease. Brain, Behavior, and Immunity 17, 321–328.CrossRefGoogle Scholar
Shapiro, PA, Williams, DL, Foray, AT, Gelman, IS, Wukich, N, Sciacca, R (1995). Psychosocial evaluation and prediction of compliance problems and morbidity after heart transplantation. Transplantation 60, 1462–1466.CrossRefGoogle ScholarPubMed
Skodol, AE, Grilo, CM, Pagano, ME, Bender, DS, Gunderson, JG, Shea, MT, Yen, S, Zanarini, MC, McGlashan, TH (2005). Effects of personality disorders on functional and well-being in major depressive disorder. Journal of Psychiatric Practice 11, 363–368.CrossRefGoogle ScholarPubMed
Skodol, AE, Stout, RL, McGlashan, TH, Grilo, CM, Gunderson, JG, Shea, MT, Morey, LC, Zanarini, MC, Dyck, IR, Oldham, JM (1999). Co-occurrence of mood and personality disorders: a report from the Collaborative Longitudinal Personality Disorders Study (CLPS). Depression and Anxiety 10, 175–182.3.0.CO;2-2>CrossRefGoogle Scholar
Smith, SM, Vale, WW (2006). The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience 8, 383–395.CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Linzer, M, Hahn, SR, Williams, JB, deGruy, FV 3rd, Brody, D, Davies, M (1995). Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study. Journal of the American Medical Association 274, 1511–1517.CrossRefGoogle ScholarPubMed
Zack, MM, Moriarty, DG, Stroup, DF, Ford, ES, Mokdad, AH (2004). Worsening trends in adult health-related quality of life and self-rated health – United States, 1993–2001. Public Health Reports 119, 493–505.CrossRefGoogle ScholarPubMed