Stable Prediction of Mood and Anxiety Disorders Based on Behavioral and Emotional Problems in Childhood: A 14-Year Follow-Up During Childhood, Adolescence, and Young Adulthood

Abstract

Objective: The goal of this study was to predict the onset of mood and anxiety disorders from parent-reported emo- tional and behavioral problems in child- hood across a 14-year period from child- hood into young adulthood. Method: In 1983, parent reports of be- havioral and emotional problems were obtained with the Child Behavior Check- list for children and adolescents 4-16 years of age from the Dutch general pop- ulation. At follow-up 14 years later, life- time mood and anxiety diagnoses were obtained by a standardized DSM-IV inter- view for 1,580 subjects. Cox proportional hazards models were used to predict the incidence of mood and anxiety disorders from childhood problems and demo- graphic covariates. Results: Mood disorders were signifi- cantly predicted by high scores on the anxious/depressed scale and on the inter- nalizing composite (withdrawn, somatic complaints, and anxious/depressed). Anx- iety disorders were significantly predicted by the social problems scale and the ex- ternalizing composite (delinquent behav- ior and aggressive behavior). Anxiety disorders predominantly started in child- hood and early adolescence, whereas the incidence of mood disorders increased sharply in adolescence and young adult- hood. Conclusions: These results suggest dif- ferent developmental pathways for mood and anxiety disorders. The predictions based on problem behavior remained stable during the 14-year period across adolescence and young adulthood. The results therefore underline the impor- tance of early intervention and preven- tion of behavioral and emotional prob- lems in childhood.