Adolescent psychiatric hospitalization and mortality distress levels, and educational attainment - Follow-up after 11 and 20 years

Harvard University, Cambridge, Massachusetts, United States
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 4.25). 09/2004; 158(8):749-52. DOI: 10.1001/archpedi.158.8.749
Source: PubMed

ABSTRACT Adolescents with early psychiatric hospitalization are likely to be at a significant risk for long-term difficulties.
To examine early adulthood outcomes of psychiatrically hospitalized adolescents.
Inception cohort recruited from 1978 to 1981 and observed until 2002.
Northeastern United States.
Adolescents (aged 12-15 years) from 2 matched cohorts were recruited and assessed repeatedly across 20 years: 70 psychiatrically hospitalized youths and 76 public high school students.
Death, emotional distress, high school completion, and educational attainment.
Psychiatrically hospitalized youths were significantly more likely to die and to report higher levels of emotional distress. Hospitalized youths were significantly less likely to graduate from high school and complete college and graduate school.
The association between psychiatric symptoms sufficient to result in psychiatric hospitalization during adolescence and later mortality, emotional distress, high school completion, and educational attainment is striking. Further study is needed to identify and understand linkages between adolescent psychiatric impairment and decrements in adult functioning, particularly the processes that may underlie these linkages. Increasing school completion and educational attainment among hospitalized youths may minimize decrements in adult adaptation.


Available from: J. Heidi Gralinski-Bakker, Dec 18, 2013
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    ABSTRACT: Objective: To examine the relationship between mental health and socioeconomic status. Specifically, whether SES in adolescence is associated with increased risk of poor mental health in adulthood. The role of school and community characteristics will also be assessed, including peer's mental health, access to mental health care in school and community, adolescent and parent perceptions of neighborhood community, and neighborhood poverty. Population: Students interviewed in Waves I, II and III of the National Longitudinal Survey of Adolescent Health (AddHealth), a nationally representative survey of students in grades 7-12 at Wave I (1994-95). Wave III follow-up was conducted in 2001-02 when respondents were 18-27 years old. Methods: Mental health is assessed as depressive symptoms (CES-D score), substance abuse, delinquency and suicidality. SES is assessed via educational attainment, income, occupation, and income relative to median income in county. All models control for a vector of personal and family characteristics, including age, gender, race/ethnicity, nativity, and household structure. OLS and negative binomial models are used to examine individual and family characteristics, and HLM will be used to examine nested models of school and community-level factors. Findings: The association between adolescent SES and adult mental health varied depending on the mental health outcome examined. Lower SES in adolescence was associated with higher rates of depression in adulthood, but results were only statistically significant when parental education and income differentials were used as the measure of SES. Higher SES in adolescence was associated with higher rates of substance abuse in young adulthood, and this held constant across all measures of SES. SES in adolescence was not significantly associated with delinquency or suicidality in young adulthood. The role of school and community characteristics in each of these questions has not yet been examined. Conclusions: SES in adolescence is associated with mental health outcomes into early adulthood, particularly depression and substance abuse. Adolescents with low SES may be at particular risk for depression, while adolescence with high SES may be at particular risk for substance abuse. Since the adolescent years are when most students are making human capital investments, it is important to recognize students most at risk.
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