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Child psychiatric symptoms and psychosocial impairment: relationship and prognostic significance

  • Andrew Pickles (a1), Richard Rowe (a2), Emily Simonoff (a3), Debra Foley (a4), Michael Rutter (a5) and Judy Silberg (a6)...
Abstract
Background

Relatively little is known about the relationships between psychiatric symptoms, diagnosis and psychosocial impairment.

Aims

To examine these contemporaneous relationships and prognostic significance in a large general population sample.

Method

Symptoms of major depression, conduct and oppositional defiant disorders were assessed by interview in two waves of the Virginia Twin Study of Adolescent behavioural Development (2800 children aged 8–16 years).

Results

Manychildren below the DSM–III–R diagnostic threshold, especially for depression, had symptom-related impairment, whereas many children reaching the symptom threshold for conduct and oppositional defiant disorders were little impaired. Impairment score was linearly related to symptom count, with no evidence of any additional impairment at the diagnostic threshold. For depression, only symptoms predicted later symptoms and diagnosis. For conduct and oppositional defiant disorders, impairment was additionally predictive of later symptoms and diagnosis.

Conclusions

Impairment, in addition to symptoms, is important for both nosology and prognosis.

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Copyright
Corresponding author
Professor Andrew Pickles, School of Epidemiology and Health Science, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT. UK. e-mail: andrew.pickles@man.ac.uk
Footnotes
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See editorial, pp. 189–190, this issue.

Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Child psychiatric symptoms and psychosocial impairment: relationship and prognostic significance

  • Andrew Pickles (a1), Richard Rowe (a2), Emily Simonoff (a3), Debra Foley (a4), Michael Rutter (a5) and Judy Silberg (a6)...
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