Juvenile mental health histories of adults with anxiety disorders.
OBJECTIVE
Information about the psychiatric histories of adults with anxiety disorders was examined to further inform nosology and etiological/ preventive efforts.


METHODS
The authors used data from a prospective longitudinal study of a representative birth cohort (N=1,037) from ages 11 to 32 years, making psychiatric diagnoses according to DSM criteria. For adults with anxiety disorders at 32 years, follow-back analyses ascertained first diagnosis of anxiety and other juvenile disorders.


RESULTS
Of adults with each type of anxiety disorder, approximately half had been diagnosed with a psychiatric disorder (one-third with an anxiety disorder) by age 15. The juvenile histories of psychiatric problems for adults with different types of anxiety disorders were largely nonspecific, partially reflecting comorbidity at 32 years. Histories of anxiety and depression were most common. There was also specificity. For example, adults with panic disorder did not have histories of juvenile disorders, whereas those with other anxiety disorders did. Adults with posttraumatic stress disorder had histories of conduct disorder, whereas those with other anxiety disorders did not. Adults with specific phobia had histories of juvenile phobias but not other anxiety disorders.


CONCLUSIONS
Strong comorbidity between different anxiety disorders and lack of specificity in developmental histories of adults with anxiety disorders supports a hierarchical approach to classification, with a broad class of anxiety disorders having individual disorders within it. The early first diagnosis of psychiatric difficulties in individuals with anxiety disorders suggests the need to target research examining the etiology of anxiety disorders and prevention early in life.
Gregory
Alice M
AM
Box P080, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. a.gregory@iop.kcl.ac.uk
Caspi
Avshalom
A
Moffitt
Terrie E
TE
Koenen
Karestan
K
Eley
Thalia C
TC
Poulton
Richie
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D001008:Anxiety Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D003625:Data Collection; D003866:Depressive Disorder / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010698:Phobic Disorders / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies