Adult Outcomes of Youth Irritability: A 20-Year Prospective Community-Based Study

易怒 焦虑 精神科 心理学 精神病理学 优势比 临床心理学 广泛性焦虑症 心情 青少年精神病学 医学 内科学
作者
Argyris Stringaris,Patricia Cohen,Daniel S. Pine,Ellen Leibenluft
出处
期刊:American Journal of Psychiatry [American Psychiatric Association Publishing]
卷期号:166 (9): 1048-1054 被引量:437
标识
DOI:10.1176/appi.ajp.2009.08121849
摘要

Objective: Irritability is a widely occurring DSM-IV symptom in youths. However, little is known about the relationship between irritability in early life and its outcomes in mid-adulthood. This study examines the extent to which youth irritability is related to adult psychiatric outcomes by testing the hypothesis that it predicts depressive and generalized anxiety disorders. Method: The authors conducted a longitudinal community-based study of 631 participants whose parents were interviewed when participants were in early adolescence (mean age=13.8 years [SD=2.6]) and who were themselves interviewed 20 years later (mean age=33.2 years [SD=2.9]). Parent-reported irritability in adolescence was used to predict self-reported psychopathology, assessed by standardized diagnostic interview at 20-year follow-up. Results: Cross-sectionally, irritability in adolescence was widely associated with other psychiatric disorders. After adjustment for baseline emotional and behavioral disorders, irritability in adolescence predicted major depressive disorder (odds ratio=1.33, 95% confidence interval [CI]=1.00–1.78]), generalized anxiety disorder (odds ratio=1.72, 95% CI=1.04–2.87), and dysthymia (odds ratio=1.81, 95% CI=1.06–3.12) at 20-year follow-up. Youth irritability did not predict bipolar disorder or axis II disorders at follow-up. Conclusions: Youth irritability as reported by parents is a specific predictor of self-reported depressive and anxiety disorders 20 years later. The role of irritability in developmental psychiatry, and in the pathophysiology of mood and anxiety disorders specifically, should receive further study.
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