Skip to main content
Log in

The Stability of Axis I Diagnoses in Youth Across Multiple Psychiatric Hospitalizations

  • Published:
Child Psychiatry and Human Development Aims and scope Submit manuscript

Abstract

The literature has yet to reach a consensus as to the stability of severe psychiatric diagnoses in youth. Previous studies among youngsters tracked over set follow-up periods have reported diagnostic stability estimates that are similar to or slightly lower than those of adults. Less is known, however, about the stability of youth psychiatric diagnoses across multiple episodes of psychopathology, such as recurrent inpatient hospitalizations. The present study investigated diagnostic stability among inpatient youth with multiple hospitalizations through longitudinal and cross-sequential designs. Results indicate that diagnostic stability, as measured by positive concordance rates and the kappa coefficient, is highest for mood disorders, especially bipolar disorder. Externalizing disorders and schizophrenia displayed moderate to low stability, with oppositional-defiant disorder displaying the lowest stability. Substance use disorders were found to have moderate stability. Overall, across-episode diagnostic stability among hospitalized youngsters appears to be lower than that of adults. This finding appears to be due to lower stability among certain externalizing disorders and substance use disorders, whereas mood disorders display stability rates resembling those of adults. Potential explanations for and implications of these findings are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Reference

  1. JJF Mattanah DF Becker KN Levy WS Edell TH McGlashan (1995) ArticleTitleDiagnostic stability in adolescents followed up 2 years after hospitalization Am J Psychiatry 152 889–894 Occurrence Handle7755119

    PubMed  Google Scholar 

  2. DP Cantwell L Baker (1989) ArticleTitleStability and natural history of DSM-III childhood diagnoses J Am Acad Child Adolesc Psychiatry 28 691–700 Occurrence Handle2793796

    PubMed  Google Scholar 

  3. M Feehan R McGee SM Williams (1993) ArticleTitleMental health disorders from age 15 years to age 18 years J Am Acad Child Adolesc Psychiatry 32 1118–1126 Occurrence Handle8282655

    PubMed  Google Scholar 

  4. H Jarbin A Knorring Particlevon (2003) ArticleTitleDiagnostic stability in adolescent onset psychotic disorders Eur Child Adolesc Psychiatry 12 15–22 Occurrence Handle10.1007/s00787-003-0300-z Occurrence Handle12601560

    Article  PubMed  Google Scholar 

  5. PJ Clayton SB Guze CR Cloninger RL Martin (1992) ArticleTitleUnipolar depression: Diagnostic inconsistency and its implications J Affect Disord 26 111–116 Occurrence Handle10.1016/0165-0327(92)90042-5 Occurrence Handle1447428

    Article  PubMed  Google Scholar 

  6. M Kovacs TL Feinberg MA Crouse-Novack SL Paulauskas R Finkelstein (1984) ArticleTitleDepressive disorders in childhood. II. A longitudinal study of the risk for a subsequent major depression Arch Gen Psychiatry 41 643–649 Occurrence Handle6732424

    PubMed  Google Scholar 

  7. PM Lewinsohn P Rohde JR Seeley (1998) ArticleTitleMajor depressive disorder in older adolescents: Prevalence, risk factors, and clinical implications Clin Psychol Rev 18 765–794 Occurrence Handle10.1016/S0272-7358(98)00010-5 Occurrence Handle9827321

    Article  PubMed  Google Scholar 

  8. TI Mueller AC Leon MB Keller DA Solomon J Endicott W Coryell M Warshaw JD Maser (1999) ArticleTitleRecurrence after recovery from major depressive disorder during 15 years of observational follow-up Am J Psychiatry 156 1000–1006 Occurrence Handle10401442

    PubMed  Google Scholar 

  9. DA Solomon MB Keller AC Leon TI Mueller PW Lavori MT Shea W Coryell M Warshaw C Turvey JD Maser J Endicott (2000) ArticleTitleMultiple recurrences of major depressive disorder Am J Psychiatry 157 229–233 Occurrence Handle10.1176/appi.ajp.157.2.229 Occurrence Handle10671391

    Article  PubMed  Google Scholar 

  10. A Forrester DCG Owens EC Johnstone (2001) ArticleTitleDiagnostic stability in subjects with multiple admissions for psychotic illness Psychol Med 331 151–158 Occurrence Handle10.1017/S0033291799003116

    Article  Google Scholar 

  11. GJ August L Braswell P Thuras (1998) ArticleTitleDiagnostic stability of ADHD in a community sample of school-aged children screened for disruptive behavior J Ab Child Psychol 26 345–356 Occurrence Handle10.1023/A:1021999722211

    Article  Google Scholar 

  12. RA Barkley M Fischer CS Edelbrook L Smallish (1990) ArticleTitleThe adolescent outcome of hyperactive children diagnosed by research criteria, I: and 8-year prospective follow-up study J Am Acad Child Adolesc Psychiatry 29 546–557 Occurrence Handle2387789

    PubMed  Google Scholar 

  13. MA Schuckit TL Smith GP Danko KK Bucholz T Reich (2001) ArticleTitleFive-year clinical course associated with DSM-IV alcohol abuse or dependence in a large group of men and women Am J Psychiatry 158 1084–1090 Occurrence Handle10.1176/appi.ajp.158.7.1084 Occurrence Handle11431230

    Article  PubMed  Google Scholar 

  14. J McClellan C McCurry (1999) ArticleTitleEarly onset psychotic disorders: diagnostic stability and clinical characteristics Eur Child Adolesc Psychiatry 8 13–19 Occurrence Handle10.1007/s007870050122 Occurrence Handle10638364

    Article  PubMed  Google Scholar 

  15. C Hollis (2001) ArticleTitleAdult outcomes of child- and adolescent-onset schizophrenia: diagnostic stability and predictive validity Am J Psychiatry 157 1652–1659 Occurrence Handle10.1176/appi.ajp.157.10.1652

    Article  Google Scholar 

  16. InstitutionalAuthorNameAmerican Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders EditionNumber3 APA Washington, DC

    Google Scholar 

  17. InstitutionalAuthorNameAmerican Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders EditionNumber4 APA Washington, DC

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeremy W. Pettit.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pettit, J.W., Morgan, S. & Paukert, A.L. The Stability of Axis I Diagnoses in Youth Across Multiple Psychiatric Hospitalizations. Child Psychiatry Hum Dev 36, 53–71 (2005). https://doi.org/10.1007/s10578-004-3493-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-004-3493-6

Keywords

Navigation