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

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.

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).

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.

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.