Cumulative prevalence of psychiatric disorders by young adulthood: A prospective cohort analysis from the Great Smoky Mountains Study
Open accessAbstract
Objective No longitudinal studies beginning in childhood have estimated the cumulative prevalence of psychiatric illness from childhood into young adulthood. The objective of this study was to estimate the cumulative prevalence of psychiatric disorders by young adulthood and to assess how inclusion of not otherwise specified diagnoses affects cumulative prevalence estimates.Method The prospective, population-based Great Smoky Mountains Study assessed 1,420 participants up to nine times from 9 through 21 years of age from 11 counties in the southeastern United States. Common psychiatric disorders were assessed in childhood and adolescence (ages 9 to 16 years) with the Child and Adolescent Psychiatric Assessment and in young adulthood (ages 19 and 21 years) with the Young Adult Psychiatric Assessment. Cumulative prevalence estimates were derived from multiple imputed datasets.Results By 21 years of age, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for a not otherwise specified disorder only, increasing the total cumulative prevalence for any disorder to 82.5%. Male subjects had higher rates of substance and disruptive behavior disorders compared with female subjects; therefore, they were more likely to meet criteria for a well-specified disorder (67.8% vs 56.7%) or any disorder (89.1% vs 77.8%). Children with a not otherwise specified disorder only were at increased risk for a well-specified young adult disorder compared with children with no disorder in childhood.Conclusions Only a small percentage of young people meet criteria for a DSM disorder at any given time, but most do by young adulthood. As with other medical illness, psychiatric illness is a nearly universal experience.
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Diagnosis of generalized anxiety or major depression increases the risk of receiving the other diagnosis in the future.
“For example, diagnosis of generalized anxiety or major depression increases the risk of receiving the other diagnosis in the future (10–12).”
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- Authors
- Copeland, W., Shanahan, L., Costello, E. J., & Angold, A.
- Affiliations
- Duke University (US)
- University of North Carolina at Greensboro (US)
- Duke Medical Center (US)
- Corresponding author
- Copeland, William
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 50
- Issue
- 3
- Pages
- 252-261
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3049293
- OpenAlex
- W2024040583
- Cited by
- 324
- References
- 42
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 23 · 2023: 21 · 2022: 12 · 2021: 26 · 2020: 27 · 2019: 15 · 2018: 20 · 2017: 19 · 2016: 31 · 2015: 32 · 2014: 32 · 2013: 20 · 2012: 14
- FWCI
- 23.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression (MH63970, MH48085, MH63671, DA/MH11301)
- University of North Carolina at Greensboro
- National Institute of Mental Health (MH-63671, R01MH063970, R01MH048085, DA/MH11301, MH-63970, MH-48085, K23MH080230, R01MH063671)
- National Institute on Drug Abuse (DA/MH11301, R01DA011301)
- National Institute of Child Health and Human Development
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- cumulative prevalence, mental illness, early adulthood, childhood and adolescence, substance use disorders, disruptive behavior disorders, sex differences, Great Smoky Mountains Study, longitudinal cohort
- MeSH terms
- Adolescent, Mental Disorders, Child, Community Mental Health Services, Female, Humans, Longitudinal Studies, Male, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Southeastern United States, Cohort Studies, Prevalence, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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