Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-08T08:43:30.827Z Has data issue: false hasContentIssue false
  • English
  • Français

Who is becoming personality disordered? A register-based follow-up study of 508 inpatient adolescents

Published online by Cambridge University Press:  23 March 2020

L. Kantojärvi ,
H. Hakko ,
P. Riipinen  and
K. Riala
L. Kantojärvi*
Affiliation:
Department of Psychiatry, Oulu University Hospital and University of Oulu,P.O. Box 26 Oys, 90029, Finland
H. Hakko
Affiliation:
Department of Psychiatry, Oulu University Hospital and University of Oulu,P.O. Box 26 Oys, 90029, Finland
P. Riipinen
Affiliation:
Department of Psychiatry, Oulu University Hospital and University of Oulu,P.O. Box 26 Oys, 90029, Finland
K. Riala
Affiliation:
Department of Psychiatry, Oulu University Hospital and University of Oulu,P.O. Box 26 Oys, 90029, Finland
*
*Corresponding author. Tel.: +35 8400 63337. E-mail address:liisa.kantojarvi@oulu.fi (L. Kantojarvi).
Get access

Abstract

Background

Our aim was to investigate which clinical and socio-demographic factors among adolescent psychiatric patient aged 13–17 are associated with a diagnosis of personality disorder (PD) in young adulthood after discharge from psychiatric hospitalization.

Methods

The study sample consisted of 508 adolescents (ages 13–17) admitted to acute psychiatric impatient care between April 2001 and March 2006. DSM IV-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The information on hospital treatments either in out- or inpatient settings until the end of 2012 was extracted from the national Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. The follow-up time was 9.2 years (mean, 95% CI 9.0–9.3 yrs).

Results

Altogether 57 (11.2%) of subjects were diagnosed PD in adulthood. Among girls with anxiety disorders in adolescence the risk for PD in adulthood increased to 4.39-fold (95% CI 2.02–9.53). Males with later PD were more likely to be admitted for hospital treatment from child welfare placements (OR 3.23, 95% CI 1.21–8.61). However, axis I disorders in adolescence was not associated with risk for PD among boys.

Conclusions

The results indicate that risk of PD developing later in life is increased among girls with anxiety disorders. A child welfare placement associated with PD in males later in life. These associations in adolescents should be considered in clinical work.

Keywords

Personality disorderAdolescencePsychiatric disordersUse of mental health servicesGender
Type
Original article
Information
European Psychiatry , Volume 31 , January 2016 , pp. 52 - 59
Copyright
Copyright © European Psychiatric Association 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ambrosini, PJHistorical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 2000;39(1):49–58.CrossRefGoogle Scholar
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Text revision 4th ed. (DSM-IV-TR)Washington, DC.: American Psychiatric Association; 2000.Google Scholar
Beesdo, K, Knappe, S, Pine, DAnxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am 2009;32(3):483–524.CrossRefGoogle ScholarPubMed
Bandelow, B, Krause, J, Wedekind, , Broocks, A, Hajak, G, Rüther, EEarly traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Res 2005;134(2):169–179.CrossRefGoogle Scholar
Bender, DS, Dolan, RT, Skodol, AE, Sanislow, CA, Dyck, IR, McGlashan, TH, et al.Treatment utilization by patients with personality disorders. Am J Psychiatry; 2001;158(2):295–302.CrossRefGoogle ScholarPubMed
Bernstein, DP, Cohen, P, Skodol, A, Bezirganian, S, Brook, JSChildhood antecedents of adolescent personality disorders. Am J Psychiatry 1996;153:907–913.Google ScholarPubMed
Chanen, AM, Kaess, MDevelopmental pathways to borderline personality disorder. Curr Psychiatry Rep 2012;14(1):45–53.CrossRefGoogle ScholarPubMed
Cohen, P, Crawford, TN, Johnson, JG, Kasen, SThe children in the community Study of developmental course of personality disorder. J Personal Disord 2005;19(5):466–486.CrossRefGoogle ScholarPubMed
Coid, J, Epidemiology, public health and the problem of personality disorder. Br J Psychiatry 2003;182:S3.–S10.CrossRefGoogle Scholar
Coid, J, Yang, M, Tyrer, P, Roberts, A, Ullrich, SPrevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 2006;188:423–431.CrossRefGoogle ScholarPubMed
Crawford, TN, Cohen, P, Brook, JSDramatic-erratic personality disorder symptoms: II. Developmental pathways from early adolescence to adulthood. J Personal Disord 2001;15(4):336–350.CrossRefGoogle Scholar
Crawford, TN, Cohen, P, Johnson, JG, Kasen, S, First, MB, Gordon, K, et al.Self-reported personality disorder in the children in the community sample: convergent and prospective validity in late adolescence and adulthood. J Personal Disord; 2005;19(1):30–52.CrossRefGoogle ScholarPubMed
Crawford, TN, Cohen, P, First, MB, Skodol, AE, Johnson, JG, Kasen, SComorbid axis I and axis II disorders in early adolescence. Arch Gen Psychiatry 2008;65(6):641–648.CrossRefGoogle ScholarPubMed
De Clercq, B, De Fruyt, FChildhood antecedents of personality disorder. Curr Opin Psychiatry 2007;20(7):57–61.CrossRefGoogle ScholarPubMed
Fava, M, Alpert, JE, Borus, JS, Nierenberg, AA, Pava, JA, Rosenbaum, JEPatterns of personality disorder comorbidity in early-onset versus late-onset major depression. Am J Psychiatry 1996;153(10):1308–1312.Google ScholarPubMed
Feenstra, DJ, Busschbach, JJV, Verheul, R, Hutsebaut, JPrevalence and comorbidity of axis I and axis II disorders among treatment refractory adolescents admitted for specialized psychotherapy. J Personal Disord 2011;25(6):842–850.CrossRefGoogle ScholarPubMed
Feenstra, DJ, Hutsebaut, J, Laurenssen, E.M.P, Verheul, R, Busschbach, JJV, Soeteman, DIThe burden of disease among adolescents with personality pathology: quality of life and costs. J Personal Disord 2012;26(4):593–604.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBWUser's guide for the structured clinical interview for DSM-IV axis II personality disorders Washington DC: American Psychiatric Press; 1997Google Scholar
Grilo, CM, Becker, DF, Fehon, DC, Walker, ML, Edell, WS, McGlashan, THGender differences in personality disorders in psychiatrically hospitalized adolescents. Am J Psychiatry 1996;153(8):1089–1091.Google ScholarPubMed
Grilo, CM, McGlashan, TH, Quinlan, DM, Walker, ML, Greenfeld, D, Edell, WSFreguency of personality disorders in two age cohorts of psychiatric inpatients. Am J Psychiatry 1998;155(1):140–142.CrossRefGoogle Scholar
Grilo, CM, McGlashan, TH, Skodol, AEStability and course of personality disorders: the need to consider comorbidities and continuities between axis I psychiatric disorders and axis II personality disorders. Psychiatr Q 2000;71(4):291–307.CrossRefGoogle ScholarPubMed
Gunderson, JG, Shea, MT, Skodol, AE, McGlashan, TH, Morey, LC, Stout, RL, et al.The Collaborative Longitudinal Personality Disorders Study: development, aims, design, and sample characteristics. J Personal Disord; 2000;14(4):300–315.CrossRefGoogle ScholarPubMed
Helgeland, MI, Kjelsberg, E, Torgersen, SContinuities between emotional and disruptive behavior disorders in adolescence and personality disorders in adulthood. Am J Psychiatry 2005;162(10):1941–1947.CrossRefGoogle ScholarPubMed
Hengartner, MP, Ajdacic-Gross, S, Rogers, M, Müller, M, Rössler, WChildhood adversity in association with personality disorder dimensions. New findings in an old debate. Eur Psychiatry 2013;28(8):476–482.CrossRefGoogle Scholar
Johnson, DM, Shea, MT, Yen, S, Battle, CL, Zlotnick, C, Sanislow, CA, et al.Gender differences in borderline personality disorder: findings from the Collaborative Longitudinal Personality Disorders Study. Compr Psychiatry; 2003;44(4):284–292.CrossRefGoogle ScholarPubMed
Joyce, PR, McKenzie, JM, Luty, SE, Mulder, RT, Carter, JD, Sullivan, PF, et al.Temperament, childhood environment and psychopathology as risk factors for avoidant and borderline personality disorders. Aust N Z J Psychiatry; 2003;37(6):756–764.CrossRefGoogle ScholarPubMed
Kasen, S, Cohen, P, Skodol, AE, Johnson, JG, Brook, JSInfluence of child and adolescent psychiatric disorders on young adult personality disorder. Am J Psychiatry 1999;156(10):1529–1535.CrossRefGoogle ScholarPubMed
Kasen, S, Cohen, P, Skodol, AE, Johnson, JG, Smailes, E, Brook, JSChildhood depression and adult personality disorder: alternative pathways of continuity. Arch Gen Psychiatry 2001;58(3):231–236.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, et al.Schedule for affective disorders and schizophrenia for school-age children – present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry; 1997;36(7):980–988.CrossRefGoogle ScholarPubMed
Kim, YS, Cheon, KA, Kim, BN, Chang, SA, Yoo, HJ, Kim, JW, et al.The reliability and validity of kiddies-schedule for affective disorders and schizophrenia – present and lifetime version-Korean version (K-SADS-PL-K). Yonsei Med J; 2004;45(1):81–89.CrossRefGoogle Scholar
Kokkevi, A, Hartgers, CEuropASI: European adaptation of a multidimensional assessment instrument for drug and alcohol dependents. Eur Addict Res 1995;1(4):208–210.CrossRefGoogle Scholar
Lenzenweger, MF, Loranger, AW, Korfine, LNDetecting personality disorders in a nonclinical population. Application of a 2-stage procedure for case identifcation. Arch Gen Psychiatry 1997;54(4):345–351.CrossRefGoogle Scholar
Lewinsohn, PM, Rohde, P, Seeley, JR, Klein, DNAxis II psychopathology as a function of axis I disorders in childhood and adolescence. J Am Acad Child Adolesc Psychiatry 1997;36(12):1752–1759.CrossRefGoogle ScholarPubMed
Loranger, AW, Sartorius, N, Andreoli, A, Berger, P, Buchheim, P, Channabasavanna, SM, et al.The international personality disorder examination. Arch Gen Psychiatry; 1994;51(3):215–224.CrossRefGoogle ScholarPubMed
Magallón-Neri, EM, Canalda, GC, De la Fuente, JE, Forns, M, Garcia, R, González, E, et al.The influence of personality disorders on the use of mental health services in adolescents with psychiatric disorders. Compr Psychiatry; 2012;53(5):509–515.CrossRefGoogle ScholarPubMed
McGlashan, TH, Grilo, CM, Skodol, AE, Gunderson, JG, Shea, MT, Morey, LC, et al.The Collaborative Longitudinal Personality Disorders Study: baseline axis I/II and II/II diagnostic occurrence. Acta Psychiatr Scand; 2000;102(4):256–264.CrossRefGoogle ScholarPubMed
Miettunen, J, Suvisaari, J, Haukka, J, Isohanni, MUse of register data for psychiatric epidemiology in the Nordic countries: textbook of psychiatric epidemiologyTsuang, MTohen, MJones, PTextbook of psychiatric epidemiology; Wiley-Balckwell; 2011Google Scholar
Moilanen, K, Veijola, J, Läksy, K, Mäkikyrö, T, Miettunen, J, Kantojärvi, L, et al.Reasons for the diagnostic disconcordance between clinicians and researcher in schizophrenia in the Northern Finland 1966 birth cohort. Soc Psychiatry Psychiatr Epidemiol; 2003;38(6):305–310.CrossRefGoogle Scholar
Moran, P, Coffey, C, Mann, A, Carlin, JB, Patton, GCPersonality and substance use disorders in young adults. Br J Psychiatry 2006;188:374–379.CrossRefGoogle ScholarPubMed
Paris, JBorderline personality disorder. CMAI 2005;172(12):1579–1583.Google ScholarPubMed
Ramklint, M, von Knorring, AL, von Knorring, L, Ekselius, LChild and adolescent psychiatric disorders predicting adult personality disorder: a follow-up study. Nord J Psychiatry 2003;57(1):23–28.CrossRefGoogle ScholarPubMed
Rey, JM, Morris-Yeates, A, Singh, M, Andrews, G, Stewart, GWContinuities between psychiatric disorders in adolescents and personality disorders in young adults. Am J Psychiatry 1995;152(6):895–900.Google ScholarPubMed
Salvador-Carulla, L, Bendeck, M, Ferrer, M, Andión, Ó., Aragonès, E, Casa, M, et al.Cost of borderline personality disorder in Catalonia (Spain). Eur Psychiatry; 2014;29(8):490–497.CrossRefGoogle Scholar
Samuels, J, Eaton, WW, Bienvenu, OJ 3rd., Brown, CH, Costa, PT Jr., Nestad, GPrevalence and correlates of personality disorders in a community sample. Br J Psychiatry 2002;180:536–542.CrossRefGoogle Scholar
Shaffer, D, Gould, MS, Brasic, J, Ambrosini, P, Fisher, P, Bird, H, et al.A children's global assessment scale (CGAS). Arch Gen Psychiatry; 1983;40(11):1228–1231.CrossRefGoogle Scholar
Skodol, AE, Gunderson, JG, Pfohl, B, Widiger, TA, Livesley, WJ, Siever, LJThe borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biol Psychiatry 2002;51(12):936–950.CrossRefGoogle ScholarPubMed
Stepp, SD, Olino, TM, Klein, DN, Seeley, JR, Lewinsohn, PMUnique influences of adolescence antecedents on adult borderline personality disorder features. J Personal Disord 2013;4(3):223–229.CrossRefGoogle ScholarPubMed
Sund, RQuality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health 2012;40(6):505–515.CrossRefGoogle ScholarPubMed
Wasserman, D, Rihmer, Z, Rujescu, D, Sarchiapone, M, Sokolowski, M, Titelman, D, et al.The European Psychiatric Association (EPA) guidance on suicide treatment and prevention. Eur Psychiatry; 2012;27(2):129–141.CrossRefGoogle ScholarPubMed
Woodward, L, Fergusson, DLife course outcomes of young people with anxiety disorders in adolescence. J Am Acad Child Adolesc Psychiatry 2011;40(9):1086–1093.CrossRefGoogle Scholar
World Health Organization, The ICD-10 classification of mental and behavioral disorders: diagnostic criteria for research Geneva: World Health Organization; 1993Google Scholar
Yang, M, Ullrich, S, Roberts, A, Coid, JChildhood institutional care and personality disorder traits in adulthood: findings from the British national surveys of psychiatric morbidity. Am J Orthopsychiatry 2007;77(1):67–75.CrossRefGoogle ScholarPubMed
Zimmerman, M, Mattia, JIAxis I diagnostic comorbidity and borderline personality disorder. Compr Psychiatry 1999;40(4):245–252.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.