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Cited by 527Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessMental Health Research Topics

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study

Patton, George C, Coffey, Carolyn, Romaniuk, Helena, Mackinnon, Andrew, Carlin, John B, Degenhardt, Louisa, Olsson, Craig A, Moran, Paul·2014·The Lancet
DOI 10.1016/s0140-6736(13)62116-9
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Abstract

Background Most adults with common mental disorders report their first symptoms before 24 years of age. Although adolescent anxiety and depression are frequent, little clarity exists about which syndromes persist into adulthood or resolve before then. In this report, we aim to describe the patterns and predictors of persistence into adulthood.Methods We recruited a stratified, random sample of 1943 adolescents from 44 secondary schools across the state of Victoria, Australia. Between August, 1992, and January, 2008, we assessed common mental disorder at five points in adolescence and three in young adulthood, commencing at a mean age of 15.5 years and ending at a mean age of 29.1 years. Adolescent disorders were defined on the Revised Clinical Interview Schedule (CIS-R) at five adolescent measurement points, with a primary cutoff score of 12 or higher representing a level at which a family doctor would be concerned. Secondary analyses addressed more severe disorders at a cutoff of 18 or higher.Findings 236 of 821 (29%; 95% CI 25-32) male participants and 498 of 929 (54%; 51-57) female participants reported high symptoms on the CIS-R (≥12) at least once during adolescence. Almost 60% (434/734) went on to report a further episode as a young adult. However, for adolescents with one episode of less than 6 months duration, just over half had no further common mental health disorder as a young adult. Longer duration of mental health disorders in adolescence was the strongest predictor of clear-cut young adult disorder (odds ratio [OR] for persistent young adult disorder vs none 3.16, 95% CI 1.86-5.37). Girls (2.12, 1.29-3.48) and adolescents with a background of parental separation or divorce (1.62, 1.03-2.53) also had a greater likelihood of having ongoing disorder into young adulthood than did those without such a background. Rates of adolescent onset disorder dropped sharply by the late 20s (0.57, 0.45-0.73), suggesting a further resolution for many patients whose symptoms had persisted into the early 20s.Interpretation Episodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life.Funding Australia's National Health and Medical Research Council.

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Authors
Patton, G. C., Coffey, C., Romaniuk, H., Mackinnon, A., Carlin, J. B., Degenhardt, L., Olsson, C. A., & Moran, P.
Affiliations
  • Royal Children's Hospital (AU)
  • The University of Melbourne (AU)
  • King's College London (GB)
Corresponding author
Patton, George C
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2014-04
Volume
383
Issue
9926
Pages
1404-1411
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(13)62116-9
OpenAlex
W2160099057
Cited by
527
References
35
Citations by year
2026: 27 · 2025: 40 · 2024: 48 · 2023: 40 · 2022: 45 · 2021: 59 · 2020: 45 · 2019: 45 · 2018: 44 · 2017: 41 · 2016: 34 · 2015: 37 · 2014: 20 · 2012: 1
FWCI
52.07
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
  • State Government of Victoria
  • National Health and Medical Research Council
  • National Medical Research Council
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
common mental disorders, adolescent mental health, adolescent-onset depression, parental separation, sex differences, adolescent-onset psychosis, young adult mental health, family history of mental illness, parental mental illness, parental employment, parental income
MeSH terms
Adolescent, Adult, Mental Disorders, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Prognosis, Prospective Studies, Risk Factors, Victoria, Young Adult

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