A long-term follow-up study of adolescent psychiatric in-patients. Part III. Predictors of disability

Journal/Book: Acta Psychiat Scand. 1999; 99: 35 Norre Sogade, PO Box 2148, Dk-1016 Copenhagen, Denmark. Munksgaard Int Publ Ltd. 243-246.

Abstract: A total of 1095 adolescent psychiatric in-patients were followed up 15-33 years after hospitalization by record linkage to the National Register of Disability Benefits. On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on data postulated to have predictive power with regard to disability. The factors were investigated by Kaplan-Meyer survival analysis and Cox regression. A psychotic or organic disorder, low score on DSM-IV Axis V (GAF) and the use of psychotropic medication at hospitalization were among the strong predictors of later disability, as were low IQ, poor achievement at school, somatic disorders, and self-harming behaviour (all P < 0.01). Cox analysis showed that, of these, the following factors remained strong and independent predictors of disability: psychotic and organic disorders (relative risk (RR) = 3.1, 95% confidence Interval (CI) = 2.4-4.0), IQ < 90 (RR = 1.8, CI = 1.5-2.3); and GAF < 30 (RR = 1.9, CI = 1.5-2.4). Former adolescent psychiatric in-patients with a psychotic or organic disorder had a very high risk of later disability (71-81%), whereas those with other psychiatric diagnoses, and with IQ greater than or equal to 90 and GAF greater than or equal to 30 at hospitalization, had a relatively low risk of disability (22-29%).

Note: Article Kjelsberg E, Univ Oslo, Natl Ctr Child & Adolescent Psychiat, Dept Grp Psychiat, POB 26, N-0319 Oslo, NORWAY

Keyword(s): adolescent psychiatry; disabled; risk factors; in-patients; follow-up studies

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