Impact of early adolescent psychiatric and personality disorder on long-term physical health: a 20-year longitudinal follow-up study

Psychol Med. 2009 May;39(5):865-74. doi: 10.1017/S0033291708004182. Epub 2008 Sep 8.

Abstract

Background: Evidence regarding the long-term separate and combined impact of adolescent psychiatric disorder and personality disorder (PD) on physical health is absent.

Method: A total of 736 people randomly selected in childhood were contacted for home or telephone interviews four times over 20 years. DSM Axis I disorders and Axis II PDs were assessed at mean age 13.7 years in 1983 and physical health was assessed in 1985-1986, 1991-1994 and 2001-2004.

Results: Comparisons were made between 506 adolescents without Axis I disorder or PD and adolescents with Axis I disorder or PD or both. Adolescents with an Axis I disorder (n=150) had significantly higher odds of pain and physical illness and poorer physical health. Adolescents with a PD (n=149) had higher odds of pain and physical illness and poorer physical health and a more rapid decline in physical health. In addition, the 81 participants with an Axis I disorder without co-morbid PD had poorer physical health, but this effect did not reach statistical significance, whereas the 80 participants with a PD but no Axis I disorder reported significantly more pain and more rapid decline in physical health. However, the 69 participants with co-morbid Axis I disorder and PD had the highest rates of pain and physical illness and the worst physical health.

Conclusions: Co-morbid PD accounted for many of the associations of adolescent Axis I disorder with physical health over the ensuing two decades. Co-morbid adolescent Axis I disorder and PD represent a particularly high risk for physical health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Interview, Psychological
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • New York
  • Pain / epidemiology
  • Pain / psychology
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology*
  • Personality Disorders / psychology
  • Reference Values
  • Risk Factors
  • Young Adult