Cumulative Prevalence of Psychiatric Disorders by Young Adulthood: A Prospective Cohort Analysis From the Great Smoky Mountains Study

Abstract

Objective-No longitudinal studies beginning in childhood have estimated the cumulative prevalence of psychiatric illness from childhood into young adulthood. The objective of this study was to estimate the cumulative prevalence of psychiatric disorders by young adulthood and to assess how inclusion of not otherwise specified (NOS) diagnoses affects cumulative prevalence estimates. Method-The prospective, population-based Great Smoky MountainsStudy assessed 1420 participants up to 9 times between ages 9 and 21 from 11 counties in southeastern US. Common psychiatric disorders were assessed in childhood and adolescence (ages 9 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Cumulative prevalence estimates were derived from multiple imputed datasets.Results-By age 21, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for an NOS disorder only, increasing the total cumulative prevalence for any disorder to 82.5%. Males had higher rates of both substance and disruptive behavior disorders compared to females; therefore they were more likely to meet criteria for either a well-specified disorder (67.8 vs. 56.7%) or any disorder (89.1 vs. 77.8%). Children with an NOS disorder only were at increased risk for a well-specified young adult disorder compared to children with no disorder in childhood.Conclusions-Only a small percentage of young people meet criteria for a DSM disorder at any given time, but most do by young adulthood. As with other medical illness, psychiatric illness is a nearly universal experience.

Early Detection and Prevention of Mental Health Problems: Developmental Epidemiology and Systems of Support

“…For example, our 20-year prospective study of a community sample found that by age 21 more than 50% of the participants had experienced at MENTAL HEALTH PROBLEM DETECTION AND PREVENTION least one DSM-IV (American Psychiatric Association, 1994) psychiatric disorder, and a further 10%-15% had significant functional impairment associated with psychiatric symptoms (Copeland, Shanahan, Costello, & Angold, 2011). Other longitudinal studies show similar results (Jaffee, Harrington, Cohen, & Moffitt, 2005).…”

Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

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False Negatives in the Assessment of Lifetime Alcohol Use Disorders: A Serious But Unappreciated Problem

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