Childhood psychiatric illness tied to adult psychopathology

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Lack of clarity makes prevention difficult

Several possible explanations might explain the causal links between childhood psychopathology and adult psychopathology. Children who experience mental health problems such as conduct disorder might alienate supportive family members and peers, which in turn, might “lead to curtailed education and incarceration, and increase the risk of brain and spinal cord injuries.” In addition, childhood and adult psychopathology might be influenced by some of the “same genetic and environmental factors.” Finally, certain external conditions exist for children and persist into adulthood that might lead to psychopathology. “For example, psychopathology at all ages may be fostered by chronic economic instability, pollution, living in disorganized and violent neighborhoods, and lack of stable social support.”

Unfortunately, there is little empirical data yet to choose between these explanations, and studies of the predictive association between childhood psychopathologies and adulthood psychopathologies raise more questions than they answer.

Benjamin B. Lahey, Ph.D., is with the department of public health sciences at the University of Chicago. These comments were taken from an editorial (JAMA Psychiatry 2015 July 15 [doi:10.1001/jama.2015.0798]).




Childhood psychiatric disorders are associated with significant increases in the risk of adverse outcomes in adulthood, including dropping out of high school, addiction, suicidality, serious criminal activity, and housing problems, even after accounting for childhood hardship and adult psychiatric problems.

A prospective, population-based cohort study of 1,420 individuals aged 9-16 at enrollment showed those diagnosed with childhood psychiatric disorders, such as childhood depression or conduct disorder, were six times more likely to develop at least one adverse adult outcome, and nine times more likely to develop more than one, compared with those with no history of psychiatric illness.

Individuals without a diagnosis who had subthreshold psychiatric problems had a threefold increase in the risk of later problems, according to a study published online July 15 in JAMA Psychiatry.

“Our study suggests that recognizing subthreshold cases needs to be a public health priority and that intervention for these individuals may forestall future impairments, distress, and societal costs,” wrote William E. Copeland, Ph.D., of Duke University, Durham, N.C., and his coauthors (JAMA Psychiatry 2015 July 15 [doi:10.1001/jamapsychiatry.2015.0730]).

The National Institute of Mental Health, the National Institute on Drug Abuse, the Brain and Behavior Research Foundation, and the William T. Grant Foundation supported the study. No conflicts of interest were declared.

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