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

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.