Impact of early adolescent psychiatric and personality disorder on long-term physical health: a 20-year longitudinal follow-up study.
BACKGROUND
Evidence regarding the long-term separate and combined impact of adolescent psychiatric disorder and personality disorder (PD) on physical health is absent.


METHODS
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.
Chen
H
H
Division of Biostatistics, New York State Psychiatric Institute, NY 10032, USA. hc657@columbia.edu
Cohen
P
P
Crawford
T N
TN
Kasen
S
S
Guan
B
B
Gorden
K
K
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009518:New York; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012016:Reference Values; D012307:Risk Factors; D055815:Young Adult