CONTINUITY OF PSYCHOPATHOLOGY IN A COMMUNITY SAMPLE OF ADOLESCENTS

Objective: To examine the continuity between the primary (first) diagn osis and secondary (second) diagnosis of those adolescents who have mo re than one episode of psychiatric disorder. Data were examined to det ermine whether the second episode ''breeds true'' (i.e., remains withi n the same diagnostic category as the first) or involves a different d isorder. Method: The sample consisted of 236 youngsters selected from the larger (n = 1,507) population of adolescents (aged 14 through 18 y ears) from the Oregon Adolescent Depression Project who had been asses sed on two occasions, approximately 1 year apart. Results: Results sup port the continuity hypothesis for the categories of disorder studied (major depression, anxiety, disruptive, substance use), with the excep tion of dysthymia. Primary dysthymia did not result in the diagnosis o f secondary dysthymia, because most adolescents who had dysthymia had not recovered within the time frame of the study and were chronic case s, often with secondary anxiety. Also presented are data on age of ons et of disorder (lowest for anxiety and highest for substance use) and information on remission intervals between episodes (well time) (lowes t for substance use and highest for anxiety). Conclusions: The finding s are interpreted as providing support for the ''breed true'' hypothes is, although clearly not all second episodes are identical with the fi rst. While the psychosocial factors examined did not predict the natur e of the second disorder, this clearly needs further study.