Abstract
Importance: Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies.
Objective: To investigate the odds of poor outcomes in emerging adulthood (late teens-early 20s), for children with different mental health trajectories.
Design: Growing Up in Ireland is a longitudinal, nationally representative, cohort study. Data collection began in 2007/8, and was repeated most recently in 2018/9. All results were weighted to account for sampling bias and attrition, and were adjusted for socioeconomic factors. Data analysis took place June 2022-April 2023.
Setting: Population-based.
Participants: 5,141 individuals.
Exposure: Previously, we found that 4 latent classes captured variation in mental health at ages 9 and 13, based on the parent-completed Strengths and Difficulties Questionnaire (SDQ). Classes included: no psychopathology, internalising, externalising and high (comorbid) psychopathology. We focused on those who remained in the same class from ages 9-13.
Main Outcomes: Poor functional outcomes in emerging adulthood were measured at approximate ages 17 (range: 16-18) and 20 (19-21). Outcomes included: poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective wellbeing, and adverse educational/economic outcomes.
Results: The sample included 5,141 individuals, classed as having no childhood psychopathology (3,726 [72%]), persistent externalising (1025 [20%]), persistent internalising (243 [5%]), or persistent high psychopathology (147 [3%]). Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalising group had elevated odds of most outcomes (ORs = 1.38-3.09), but not heavy substance use. The externalising group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (ORs = 1.38-1.98). The high psychopathology group had elevated odds of all outcomes (ORs = 1.31-2.91), though with wide confidence intervals. Females with any psychopathology had significantly higher odds of poor physical health and frequent health service use, compared to males.
Conclusions and Relevance: In this longitudinal cohort study, we found that childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need to for a wider range of preventative interventions in child and adolescent mental health services.
Objective: To investigate the odds of poor outcomes in emerging adulthood (late teens-early 20s), for children with different mental health trajectories.
Design: Growing Up in Ireland is a longitudinal, nationally representative, cohort study. Data collection began in 2007/8, and was repeated most recently in 2018/9. All results were weighted to account for sampling bias and attrition, and were adjusted for socioeconomic factors. Data analysis took place June 2022-April 2023.
Setting: Population-based.
Participants: 5,141 individuals.
Exposure: Previously, we found that 4 latent classes captured variation in mental health at ages 9 and 13, based on the parent-completed Strengths and Difficulties Questionnaire (SDQ). Classes included: no psychopathology, internalising, externalising and high (comorbid) psychopathology. We focused on those who remained in the same class from ages 9-13.
Main Outcomes: Poor functional outcomes in emerging adulthood were measured at approximate ages 17 (range: 16-18) and 20 (19-21). Outcomes included: poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective wellbeing, and adverse educational/economic outcomes.
Results: The sample included 5,141 individuals, classed as having no childhood psychopathology (3,726 [72%]), persistent externalising (1025 [20%]), persistent internalising (243 [5%]), or persistent high psychopathology (147 [3%]). Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalising group had elevated odds of most outcomes (ORs = 1.38-3.09), but not heavy substance use. The externalising group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (ORs = 1.38-1.98). The high psychopathology group had elevated odds of all outcomes (ORs = 1.31-2.91), though with wide confidence intervals. Females with any psychopathology had significantly higher odds of poor physical health and frequent health service use, compared to males.
Conclusions and Relevance: In this longitudinal cohort study, we found that childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need to for a wider range of preventative interventions in child and adolescent mental health services.
| Original language | English |
|---|---|
| Journal | JAMA Network open |
| Publication status | E-pub ahead of print - 29 Sept 2023 |
