Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
J Am Acad Child Adolesc Psychiatry. 2010 Nov;49(11):1117-24. doi: 10.1016/j.jaac.2010.08.002. Epub 2010 Sep 27.
The goal of this study was to determine continuities of a broad range of psychopathology from childhood into middle adulthood in a general population sample across a 24-year follow-up.
In 1983, parent ratings of children's problems were collected with the Child Behavior Checklist (CBCL) in a general population sample of 2,076 children and young adolescents aged 4 to 16 years. In 2007, 24 years later, 1,339 of these individuals were reassessed with the CIDI, a standardized DSM-IV interview. We used univariate logistic regression analyses to determine the associations between children's problems and adults' psychiatric disorders.
Parent reported total problems scores in the deviant range (>85th percentile) predicted disruptive disorders in adulthood (odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.1-2.8). Adjusted for sex, age, and socioeconomic status in all analyses, deviant levels of parent-reported childhood anxiety predicted anxiety disorders in middle adulthood (OR = 1.6, 95% CI = 1.0-2.5). Conduct problems (i.e., cruelty to animals, lies) predicted both mood disorders (OR = 2.3, 95% CI = 1.1-4.8) and disruptive disorders (OR 2.1, 95% CI = 1.3-3.4), whereas oppositional defiant problems predicted only mood disorders (OR = 2.3, 95% CI = 1.0-5.2). Attention-deficit/hyperactivity problems did not predict any of the DSM-IV disorders in adulthood (OR = 0.8, 95% CI = 0.5-1.2).
Children with psychopathology are at greater risk for meeting criteria for DSM-IV diagnoses in adulthood than children without psychopathology, even after 24 years. Moreover, different types of continuities of children's psychopathology exist across the lifespan. We found that anxious children, oppositional defiant children, and children with conduct problems are at greater risk for adult psychopathology. Effective identification and treatment of children with these problems may reduce long-term continuity of psychopathology.
本研究旨在通过 24 年的随访，在一般人群样本中确定从儿童期到中年期广泛的精神病理学的连续性。
1983 年，在一个年龄为 4 至 16 岁的 2076 名儿童和青少年的一般人群样本中，使用儿童行为检查表（CBCL）收集了父母对儿童问题的评分。24 年后，即 2007 年，其中 1339 人接受了 CIDI（一种标准化的 DSM-IV 访谈）的重新评估。我们使用单变量逻辑回归分析来确定儿童问题与成人精神障碍之间的关联。
父母报告的异常范围（>第 85 个百分位数）的总问题得分预测了成年期的破坏性行为障碍（比值比[OR] = 1.7，95%置信区间[95%CI] = 1.1-2.8）。在所有分析中，调整性别、年龄和社会经济地位后，父母报告的儿童期焦虑异常水平预测了中年期的焦虑障碍（OR = 1.6，95%CI = 1.0-2.5）。行为问题（即虐待动物、撒谎）预测了心境障碍（OR = 2.3，95%CI = 1.1-4.8）和破坏性行为障碍（OR 2.1，95%CI = 1.3-3.4），而对立违抗性问题仅预测心境障碍（OR = 2.3，95%CI = 1.0-5.2）。注意力缺陷/多动障碍问题在成年后没有预测任何 DSM-IV 障碍（OR = 0.8，95%CI = 0.5-1.2）。
与没有精神病理学的儿童相比，有精神病理学的儿童在成年后更有可能符合 DSM-IV 诊断标准，即使经过 24 年。此外，儿童精神病理学的不同类型在整个生命周期中存在连续性。我们发现焦虑儿童、对立违抗性儿童和行为问题儿童患成人精神病理学的风险更高。有效识别和治疗这些问题的儿童可能会减少精神病理学的长期连续性。
