A long-term follow-up study of adolescent psychiatric in-patients. Part IV. Predictors of a non-negative outcome.

Abstract

Fifteen years after first hospitalization 932 patients were followed up by record linkage to national registers of criminality, disability and causes of death. On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on factors postulated to have predictive power with regard to a non-negative outcome, defined as having avoided entry into the above-mentioned registers at follow-up. Logistic regression showed that in males psychiatric diagnosis (odds ratio (OR)=2.4, 95% confidence interval (CI)=1.3-4.3), no psychoactive substance use (OR=3.2, CI=1.2-8.0), no disciplinary problems in school (OR=4.1, CI=2.4-6.9) and an IQ of > or = 90 (OR=1.9, CI=1.03-3.4) were strong and independent predictors of a non-negative outcome. In females, psychiatric diagnosis (OR=2.2, CI=1.3-3.6), no psychoactive substance use (OR=2.4, CI=1.5-3.8), DSM-IV GAF > or = 40 at admission (OR=2.9, CI=1.8-4.6) and an IQ of > or = 90 (OR=1.7, CI=1.01-2.8) were strong and independent predictors of a non-negative outcome. Only 5.1% of male patients with psychoactive substance use disorder and disciplinary problems in school had a non-negative outcome, while as many as 76.6% of female patients without psychoactive substance use and a DSM-IV GAF of > or = 40 at hospitalization had a non-negative outcome at 15 years follow-up.