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Functionele uitkomsten van psychische stoornissen bij kinderen en adolescenten

Functional outcomes of child and adolescent mental disorders

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Kind en adolescent

Samenvatting

Inleiding

Psychische stoornissen beginnen vaak in de kindertijd of de adolescentie. Dit kan leiden tot een slechte start van het volwassen leven. Deze studie onderzocht de voorspellende waarde van de huidige en vroegere geestelijke gezondheid voor het functioneren van jongvolwassenen op economisch, sociaal en psychologisch gebied en voor het gezondheidsgedrag, verder aangegeven als functionele uitkomsten.

Methoden

Bij 1.584 jongeren die vanaf de preadolescentie (11 jaar) tot in de volwassenheid worden gevolgd (deelnemers aan het TRAILS-onderzoek), werd op 19-jarige leeftijd de Composite International Diagnostic Interview (CIDI) afgenomen om de aanwezigheid van huidige en vroegere psychische stoornissen volgens CIDI-DSM-IV te meten. Tevens werden 19 functionele uitkomsten in vier domeinen (economisch, sociaal, psychologisch en gezondheidsgedrag) gemeten.

Resultaten

Veertien uitkomsten werden voorspeld door zowel huidige als vroegere stoornissen, drie alleen door vroegere stoornissen en twee alleen door huidige stoornissen. Welk type stoornis de belangrijkste voorspeller was, hing af van de uitkomst; vroegere internaliserende stoornissen voorspelden vooral psychologische uitkomsten, maar vroegere externaliserende stoornissen vooral gezondheidsgedrag. Een geschiedenis van comorbiditeit voorspelde economische en sociale uitkomsten.

Conclusie

Om het functioneren van 19-jarigen te begrijpen, is het nodig om zowel de huidige als vroegere geestelijke gezondheid te onderzoeken.

Abstract

Introduction

This study examined the predictive value of current and past mental disorders for early adult functional outcomes.

Methods

We took 1,584 youngsters aged 19 who are being followed from preadolescence through to adulthood in the Dutch TRAILS study and administered the Composite International Diagnostic Interview (CIDI) to measure current and past CIDI-DSM-IV psychiatric disorders as well as 19 functional outcomes in four domains (economic, social, psychological and health behaviour).

Results

Fourteen outcomes were predicted by both current and past disorders, three by previous disorders only, and two by current disorders only. The category of disorder that was most important in predicting the outcome depended on the specific outcome. Previous internalizing disorders were mainly predictors of psychological outcomes whereas earlier externalizing disorders were primarily predictors of health behaviour. A history of comorbidity was a predictor of economic and social outcomes.

Conclusion

To understand the functioning of 19-year-olds, it is necessary to investigate both current and past mental health.

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Dankbetuiging

Dit onderzoek maakt deel uit van TRAILS (TRacking Adolescents’ Individual Lives Survey). Deelnemende centra van TRAILS bevatten diverse afdelingen van het Universitair Medisch Centrum en de Rijksuniversiteit Groningen; het Erasmus Universitair Medisch Centrum Rotterdam; de Universiteit Utrecht; het Radboud Universitair Medisch Centrum Nijmegen en de Parnassia Bavo groep, allen in Nederland. We zijn alle adolescenten, hun ouders en leraren die aan dit onderzoek hebben deelgenomen dankbaar, en we willen iedereen die aan dit project heeft gewerkt en het mogelijk heeft gemaakt bedanken.

Financiering

TRAILS wordt financieel ondersteund door verschillende fondsen van de Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO, o. a. NWO-groot 175-010-2003.005 en Zwaartekracht Consortium Individual Development 024.001.003), ZonMW (o. a. Geestkracht 100-001-004), GB-MaGW, het Nederlandse Ministerie van Justitie, de European Science Foundation, BBMRI-NL en de deelnemende universiteiten.

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Authors and Affiliations

  1. Universitair Medisch Centrum Groningen, Afdeling Psychiatrie, Interdisciplinair Centrum voor Psychopathologie en Emotieregulatie (ICPE), CC 72, Rijksuniversiteit Groningen, Postbus 30.001, 9700 RB, Groningen, Nederland

    Johan Ormel,  Anoek M. Oerlemans,  Dennis Raven,  Catharina M. Hartman &  Albertine J. Oldehinkel

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  1. Johan Ormel
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  2. Anoek M. Oerlemans
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  3. Dennis Raven
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  4. Catharina M. Hartman
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  5. Albertine J. Oldehinkel
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Correspondence to Johan Ormel.

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Ormel, J., Oerlemans, A.M., Raven, D. et al. Functionele uitkomsten van psychische stoornissen bij kinderen en adolescenten. Kind Adolesc 39, 183–204 (2018). https://doi.org/10.1007/s12453-018-0176-9

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