Child and adolescent problems predict DSM-IV disorders in adulthood: a 14-year follow-up of a Dutch epidemiological sample

OBJECTIVE: Few studies exist that examine continuities between child and adult psychopathology in unselected samples. This study prospectively examined the adult outcomes of psychopathology in an epidemiological sample of children and adolescents across a 14-year period. METHOD: In 1983, parent ratings of behavioral and emotional problems were obtained for 1,578 children and adolescents aged 4 through 16 years from the Dutch general population. At follow-up, 14 years later, subjects were reassessed with a standardized DSM-IV interview. RESULTS: High levels of childhood problems predicted an approximate 2- to 6-fold increased risk for adulthood DSM-IV diagnoses. The associations between specific childhood problems and adulthood diagnoses were complex. Social Problems in girls predicted later DSM-IV disorder. Rule-breaking behavior in boys predicted both mood disorders and disruptive disorders in adulthood. CONCLUSIONS: High levels of childhood behavioral and emotional problems are related to DSM-IV diagnoses in adulthood. The strongest predictor of disorders in adulthood was childhood rule-breaking behavior. Attention Problems did not predict any of the DSM-IV categories when adjusted for the associations with other Child Behavior Checklist scales.