The course of psychiatric disorders from childhood to adulthood

It has become increasingly clear that many child psychiatric disorders persist into adult life. 

However, large-scale long-term follow-up studies of child psychiatric patients into adulthood have been scarce.The main goal of the study is to gain more knowledge about how psychiatric disorders in childhood affect mental health and social function in adulthood. By increased understanding of the course of psychiatric disorders, this study may contribute to improve clinical understanding and treatment, including preventive measures in the future. 

We have followed up 550 former child psychiatric inpatients in a Norwegian child psychiatric inpatient population by linking their personal identification numbers to official databases in order to ascertain subsequent disability pension (DP), criminality, mortality and marital status 17- 41 years later. The children were about eight years old at inclusion.

So far, results show that among the participants, 24% were convicted of a criminal offence, 44% had received DP, 84% were unmarried and 5% were dead at follow-up. All data demonstrate markedly elevated rates compared to crude estimates in the general population. 

Conduct disorder in childhood was highly associated with later delinquency. Interestingly, ADHD was no more associated with later delinquency than the rest of the disorders in the study population (about 20% compared to about 10% in the general population). However, ADHD and especially autism spectrum disorders were highly associated with later receiving a DP compared with other externalizing and internalizing disorders. The high rate of working disability in former child psychiatric patients found in the present study, indicate that development of better services for these individuals should be given priority. As recent research has shown that DP is associated with low educational level, intensified treatment strategies that optimise school functioning should be prioritized. 

Overall, the results presented in this study indicate high frequency of impairment in adult life among former child psychiatric inpatients. High-quality professional care should be given to children presenting psychiatric disorders in order to prevent several negative outcomes in adulthood. To counteract criminal development, intervention programmes addressing early onset conduct problems is of major importance.

One PhD thesis has thus far resulted from this study:   https://www.med.uio.no/klinmed/forskning/aktuelt/arrangementer/disputaser/2013/moerdre-marianne.html