A total of 1095 adolescent psychiatric in-patients were followed up 15-33 years after hospitalization by record linkage to the National Register of Disability Benefits.
On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on data postulated to have predictive power with regard to disability.
The factors were investigated by Kaplan-Meyer survival analysis and Cox regression.
A psychotic or organic disorder, low score on DSM-IV Axis V (GAF) and the use of psychotropic medication at hospitalization were among the strong predictors of later disability, as were low IQ, poor achievement at school, somatic disorders, and self-harming behaviour (all P<0.01).
Cox analysis showed that, of these, the following factors remained strong and independent predictors of disability :
psychotic and organic disorders (relative risk (RR)=3.1,95% confidence interval (CI)=2.4-4.0),
IQ<90 (RR=1.8, CI=1.5-2.3) ;
and GAF<30 (RR=1.9, Cl=1.5-2.4).
Former adolescent psychiatric in-patients with a psychotic or organic disorder had a very high risk of later disability (71-81%), whereas those with other psychiatric diagnoses, and with IQ>=90 and GAF>=30 at hospitalization, had a relatively low risk of disability (22-29%).
Mots-clés Pascal : Trouble psychiatrique, Adolescent, Homme, Prédiction, Evolution, Etude longitudinale, Long terme, Facteur risque, Maladie, Epidémiologie, Santé mentale
Mots-clés Pascal anglais : Mental disorder, Adolescent, Human, Prediction, Evolution, Follow up study, Long term, Risk factor, Disease, Epidemiology, Mental health
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0283139
Code Inist : 002B18C14. Création : 16/11/1999.