An anonymous reader quotes a report from PsyPost: New research based on four decades of longitudinal data indicates that it is rare for a person to receive and keep a single mental disorder diagnosis. Rather, experiencing different successive mental disorders appears to be the norm. The findings, published in JAMA Open, suggest that psychiatrists and other mental health professionals should move toward adopting a life-course perspective on mental disorders.
The researchers examined data from the Dunedin Longitudinal Study in New Zealand, which used repeated standardized psychiatric assessments to track 17 mental health conditions from age 11 to age 45. The study included more than one thousand participants and the mental health conditions were diagnosed according to DSM criteria. “These disorders included externalizing disorders (for example, ADHD, conduct disorder, substance dependence), internalizing disorders (for example, depression, anxiety, eating disorders, PTSD), and thought disorders (for example, mania, schizophrenia, OCD). This is the most detailed time series of mental-disorder life-histories ever assembled,” explained Avshalom Caspi, a professor of psychology and neuroscience at Duke University.
The study also included neurocognitive examinations during childhood and adolescence, along with a neuroimaging-based assessment of brain aging at age 45. About one-third of the participants experienced the initial onset of a disorder by age 15 years and 86% met the criteria for at least one disorder by age 45 years. The researchers found an “ebb and flow” of mental disorders over time. Participants with a disorder from any one of the three diagnostic families were at higher risk for disorders from other diagnostic families in the future. Participants characterized by one consistent mental disorder were not the norm. “The primary finding is that over decades, individuals experience many changing disorder types, shifting between internalizing, externalizing, and/or thought disorder families. People seldom ‘get’ one disorder and keep it. Every disorder predicted significantly increased risk for every other disorder,” Caspi told PsyPost.