research
Long-term outcome of psychopathology in childhood and adolescence : a clinical epidemiological study
- Publication date
- 13 November 2002
- Publisher
- Very different populations were used in these studies, two populations consisting of
adolescents only (Otto and Otto, 1978 and Rey et al., 1995, 1997), one population existing
of males only (Steinhausen, Meier, and Angst, 1998), and all studies differing on in- and
exclusion criteria. This leads to difficulties in comparing results. Excluding the all male
sample (Steinhausen, Meier, and Angst, 1998), populations consisted of an average of
64.5% males and 35.5% females. Response rates were on average 90.4% for studies
using records or registers only, and 65.9% for studies using direct assessment. Only one
study used standardized measures with well-validated, empirical syndromes at both times
of assessment (Stanger, et al., 1996). This was also the only study in which multiple
informants were used, but unfortunately at follow-up only. Analytic strategies were very
different across studies, so comparison at result level is extremely difficult.
Still, some general conclusions can be drawn. Among others, these studies seem to
confirm the stability and continuity of psychopathology found in general population
samples, especially for externalizing problems. Unfortunately no average figures can be
given, because different analytic strategies resulted in incomparable measures (e.g.,
percentages and stability coefficients). Furthermore, most authors agree that other
domains of functioning are likely to be hampered as well, e.g., family relations, educational
and professional achievements, and social functioning, and that other indices of poor
functioning are increased, e.g., mental health service use and judicial contacts. Results
indicate that prognosis can to some extent be predicted from factors known at initial
assessment, such as age at intake, gender, length of follow-up period, socio-economic
status, or initial type of problem. However, the inconsistency of results across studies on
these related factors hampers drawing firm conclusions on their influence. Results led us
to expect considerable stability of psychopathology, and to expect the type of problems to
remain mostly the same across time, and at follow-up to be predicted by comparable
problems at intake.