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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2015

Open Access 01-12-2015 | Research article

Adolescents in a residential school for behavior disorders have an elevated mortality risk in young adulthood

Authors: Marko Manninen, Maiju Pankakoski, Mika Gissler, Jaana Suvisaari

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2015

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Abstract

Background

Conduct problems during adolescence are associated with an elevated mortality risk. This study investigated the mortality rate, causes of death, and changes over time in a Finnish residential school (RS) population.

Methods

All adolescents (N = 885, M/F = 594/291, age mean 15.2 years at baseline) residing in the RS system in 1991, 1996, 2001, and 2006 and matched controls were included in a register-based study with a follow-up time of up to 22 years.

Results

The all-cause mortality rate for people with an RS background was 6.7 % compared to 1.0 % in the controls (Hazard Ratio HR = 6.95, 95 % 4.66–10.37, p < 0.001). 8.1 % of the RS boys had died compared to 2.2 % of the girls (HR = 2.2, p = 0.02). The HR for substance-related death was 24.31 (95 % CI 9.3–65.53, P < 0.001), for suicide 7.23 (95 % CI 3.24–16.11, P < 0.001) and for other external causes 5.45 (95 % CI 2.41–12.36, P < 0.001) compared to controls. Mortality peaked among RS boys at approximately 25 years, whereas for girls it peaked after 30 years.

Conclusions

Adolescents with severe disruptive behavior problems have a seven-fold risk for premature adult-age death compared to matched controls. The most common causes for death were avoidable, substance-related followed by suicide. Effective treatment of mental and substance use related problems during and after the placement is needed to reduce mortality.
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Metadata
Title
Adolescents in a residential school for behavior disorders have an elevated mortality risk in young adulthood
Authors
Marko Manninen
Maiju Pankakoski
Mika Gissler
Jaana Suvisaari
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2015
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-015-0078-z

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