Children's Problems Predict Adults' DSM-IV Disorders Across 24 Years

Objective: The goal of this study was to determine continuities of a broad range of psychopathology from childhood into middle adulthood in a general population sample across a 24-year follow-up. Method: In 1983, parent ratings of children's problems were collected with the Child Behavior Checklist (CBCL) in a general population sample of 2,076 children and young adolescents aged 4 to 16 years. In 2007, 24 years later, 1,339 of these individuals were reassessed with the CIDI, a standardized DSM-IV interview. We used univariate logistic regression analyses to determine the associations between children's problems and adults' psychiatric disorders. Results: Parent reported total problems scores in the deviant range (>85th percentile) predicted disruptive disorders in adulthood (odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.1-2.8). Adjusted for sex, age, and socioeconomic status in all analyses, deviant levels of parent-reported childhood anxiety predicted anxiety disorders in middle adulthood (OR = 1.6, 95% Cl = 1.0-2.5). Conduct problems (i.e., cruelty to animals, lies) predicted both mood disorders (OR = 2.3, 95% Cl = 1.1-4.8) and disruptive disorders (OR 2.1, 95% Cl = 1.3-3.4), whereas oppositional defiant problems predicted only mood disorders (OR = 2.3, 95% Cl = 1.0-5.2). Attention-deficit/hyperactivity problems did not predict any of the DSM-IV disorders in adulthood (OR = 0.8, 95% Cl = 0.5-1.2). Conclusions: Children with psychopathology are at greater risk for meeting criteria for DSM-IV diagnoses in adulthood than children without psychopathology, even after 24 years. Moreover, different types of continuities of children's psychopathology exist across the lifespan. We found that anxious children, oppositional defiant children, and children with conduct problems are at greater risk for adult psychopathology. Effective identification and treatment of children with these problems may reduce long-term continuity of psychopathology. J. Am. Acad. Child Adolesc. Psychiatry, 2010;49(11)1117-1124