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

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.

Body size at birth and psychiatric disorders among adolescents: a clinical study of 310 under-age inpatient adolescents in Northern Finland.

BACKGROUND: Deviant birth measure is a risk factor for later somatic illness but also for later psychiatric disorders of the offspring. Only a few studies have examined the association of birth measures to later psychiatric disorders among adolescents. Studies on sex differences in these associations are scarce as well. METHODS: The cases consisted of 508 adolescents (208 boys and 300 girls) aged 12-17 years, who were admitted to inpatient psychiatric hospitalization between 2001 and 2006. In addition, 478 healthy controls were derived from the Northern Finnish Birth Cohort 1986, born in approximately the same period and same area as the cases. Data of birth measures were collected from the National Birth Register for cases and from antenatal clinics for controls. Both cases and controls were interviewed using the Schedule for Affective Disorder and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) to assess psychiatric disorders. RESULTS: The adolescent patients were statistically significantly shorter and had higher ponderal index at birth compared to healthy controls. In addition, the age of the mothers at adolescent's birth was significantly younger in the patients than the controls. After controlling for various covariates, a 2.4-fold increased likelihood for internalizing disorders was seen among male adolescents with high ponderal index. CONCLUSIONS: The association of birth measures to psychiatric disorders was confirmed in our study, particularly among male adolescents suffering from internalizing disorders. Further studies in larger adolescent samples are needed to confirm our findings and clear up the association of high ponderal index to specific psychiatric disorders.

Overweight of adolescent girls is associated with self-mutilative behavior.

BACKGROUND: The purpose of the present study was to examine the association of overweight with suicide ideation, self-mutilative behavior (SMB) and suicide attempts among underage psychiatric inpatient adolescents. SAMPLING AND METHODS: Data were collected from 439 adolescents (age = 12-17 years) admitted to psychiatric hospitalization between April 2001 and March 2006. Information on adolescents' suicidal behavior and psychiatric DSM-IV diagnoses was obtained by using the Schedule for Affective Disorder and Schizophrenia for School-Age Children. An adolescent was defined as overweight if his/her BMI exceeded the 85th percentile BMI in the age- and sex-matched Finnish population. RESULTS: Compared to adolescents without overweight, a 2.5-fold likelihood for SMB was found among overweight girls, but not among boys. CONCLUSIONS: Low self-esteem, depression or dysfunctional emotion regulation may be possible mediating factors between overweight and SMB.

Bullying behaviour and substance abuse among underage psychiatric inpatient adolescents.

BACKGROUND AND OBJECTIVE: Only a few studies have examined the putative association between substance use and bullying others, and to our knowledge none of the previous studies have investigated substance abuse among victims or those who are both bullies and victims. The aim of our study was to investigate substance use among all of these three bullying subgroups and to examine the putative association between substance use and bullying behaviour. METHODS: The study sample consisted of 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April2001 and March2006. We used the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) to obtain DSM-IV psychiatric diagnoses, information about bullying behaviour and substance abuse of the adolescents. The level of nicotine dependence (ND) was assessed by using the modified Fagerström Tolerance Questionnaire (mFTQ). RESULTS: Our study showed that both among boys and girls, regular daily smoking and alcohol use among boys were statistically significantly associated with bullying behaviour. Further, among girls, but not among boys, there was also an association between bullying behaviour and more severe substance use, such as ND, use of cannabis and hard drugs. CONCLUSION: Since an association between bullying and severe substance use was found in this study, our novel finding needs replication in adolescent general population samples.