Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Lancet. 2014 Apr 19;383(9926):1404-11. doi: 10.1016/S0140-6736(13)62116-9. Epub 2014 Jan 16.

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study.

Author information

  • 1Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. Electronic address: george.patton@rch.org.au.
  • 2Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.
  • 3Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.
  • 4Orygen Youth Health Research Centre, University of Melbourne, Parkville, VIC, Australia.
  • 5Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.
  • 6School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia; National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia.
  • 7Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Psychological Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; School of Psychology, Deakin University, Geelong, VIC, Australia.
  • 8Institute of Psychiatry, Health Service and Population Research Department, King's College London, London, UK.

Erratum in

  • Lancet. 2014 May 3;383(9928):1548.

Abstract

BACKGROUND:

Most adults with common mental disorders report their first symptoms before 24 years of age. Although adolescent anxiety and depression are frequent, little clarity exists about which syndromes persist into adulthood or resolve before then. In this report, we aim to describe the patterns and predictors of persistence into adulthood.

METHODS:

We recruited a stratified, random sample of 1943 adolescents from 44 secondary schools across the state of Victoria, Australia. Between August, 1992, and January, 2008, we assessed common mental disorder at five points in adolescence and three in young adulthood, commencing at a mean age of 15.5 years and ending at a mean age of 29.1 years. Adolescent disorders were defined on the Revised Clinical Interview Schedule (CIS-R) at five adolescent measurement points, with a primary cutoff score of 12 or higher representing a level at which a family doctor would be concerned. Secondary analyses addressed more severe disorders at a cutoff of 18 or higher.

FINDINGS:

236 of 821 (29%; 95% CI 25-32) male participants and 498 of 929 (54%; 51-57) female participants reported high symptoms on the CIS-R (≥12) at least once during adolescence. Almost 60% (434/734) went on to report a further episode as a young adult. However, for adolescents with one episode of less than 6 months duration, just over half had no further common mental health disorder as a young adult. Longer duration of mental health disorders in adolescence was the strongest predictor of clear-cut young adult disorder (odds ratio [OR] for persistent young adult disorder vs none 3.16, 95% CI 1.86-5.37). Girls (2.12, 1.29-3.48) and adolescents with a background of parental separation or divorce (1.62, 1.03-2.53) also had a greater likelihood of having ongoing disorder into young adulthood than did those without such a background. Rates of adolescent onset disorder dropped sharply by the late 20s (0.57, 0.45-0.73), suggesting a further resolution for many patients whose symptoms had persisted into the early 20s.

INTERPRETATION:

Episodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life.

FUNDING:

Australia's National Health and Medical Research Council.

Copyright © 2014 Elsevier Ltd. All rights reserved.

Comment in

PMID:
24439298
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk