Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
Acta Psychiatr Scand. 2018 Jan;137(1):6-17. doi: 10.1111/acps.12792. Epub 2017 Aug 31.
To examine unfavorable sociodemographic, clinical, and functional long-term outcomes for a range of adolescent mental disorders.
A total number of 2210 adolescents and young adults (14-24 years at baseline, T0) from a representative community sample were prospectively followed up (T1-T3) over 10 years. DSM-IV mental disorders, sociodemographic, clinical, and functional outcomes were assessed using the DIA-X/M-CIDI and its embedded assessment modules.
In (multinomial) logistic regressions adjusted for sex, age, other baseline disorders and sociodemographics, baseline anxiety, affective, substance use, somatoform and eating disorders (lifetime) predicted various unfavorable sociodemographic, clinical, and functional outcomes at T3. Particularly, strong associations were found between baseline disorders and adverse clinical outcomes at T3 (12-month diagnosis of the same/other disorder(s), drug use, suicide attempts, and help-seeking due to psychological problems). While substance use disorders were primarily associated with unfavorable sociodemographic and educational outcomes, anxiety and eating disorders were associated with unfavorable interpersonal outcomes, affective disorders with pregnancy-/childbirth-related complications and financial issues, and somatoform disorders with unfavorable educational/occupational and interpersonal outcomes. The risk of unfavorable outcomes increased with clinical severity, especially a higher number of baseline diagnoses.
Our findings emphasize the importance of effective treatment of mental disorders to prevent unfavorable long-term outcomes in various life domains.
研究一系列青少年精神障碍患者在社会人口学、临床和功能方面的长期不良结局。
从一个代表性的社区样本中，共有 2210 名青少年和年轻人（基线时年龄为 14-24 岁，T0）进行了 10 年的前瞻性随访（T1-T3）。使用 DIA-X/M-CIDI 及其嵌入式评估模块评估 DSM-IV 精神障碍、社会人口学、临床和功能结局。
在调整了性别、年龄、其他基线障碍和社会人口统计学因素的（多项）逻辑回归中，基线时的焦虑症、情感障碍、物质使用障碍、躯体形式障碍和进食障碍（终生）预测了 T3 时各种不良的社会人口学、临床和功能结局。特别是，基线障碍与 T3 时的不良临床结局之间存在强烈关联（12 个月内诊断出相同/其他障碍、药物使用、自杀企图以及因心理问题寻求帮助）。尽管物质使用障碍主要与不良的社会人口学和教育结局相关，焦虑症和进食障碍与不良的人际关系结局相关，情感障碍与妊娠/分娩相关并发症和财务问题相关，躯体形式障碍与不良的教育/职业和人际关系结局相关，但这些关联的强度因障碍类型而异。不良结局的风险随着临床严重程度的增加而增加，尤其是基线诊断数量的增加。
我们的研究结果强调了有效治疗精神障碍以预防各种生活领域不良长期结局的重要性。
