PROSPECTIVE ASSOCIATIONS BETWEEN SOMATIC ILLNESS AND MENTAL-ILLNESS FROM CHILDHOOD TO ADULTHOOD

The association between somatic illness and psychiatric illness is wel l established in adults but is less clear in childhood and adolescence . A cohort of over 700 randomly selected children in Upstate New York were studied from ages 1-10 years in 1975 to young adulthood in 1992. Psychiatric and physical health were assessed by means of follow-up yo uth and parent interviews at 8-, 2 1/2-, and B-year intervals (in 1983 , 1985-1986, and 1991-1993). Cross-sectional and longitudinal analyses investigated: 1) the consistency of the relation between physical ill ness and mental illness in childhood; 2) the specificity of major depr essive disorder (MDD) in accounting for the relation; 3) the specifici ty of immunologically mediated medical disorders in this relation; and 4) whether this relation was attributable to risks associated with lo w socioeconomic status. Cross-sectionally, ill health was associated w ith increased risk of psychiatric disorders at all ages, with signific ant odds ratios (ORs) ranging from 1.76 to 3.26. In prospective analys es, ill health increased the risk of new-onset MDD at all ages (ORs = 2.05-4.48). MDD also predicted subsequent ill health, independent of p rior health problems (ORs = 3.81 and 4.04). Relations were not attribu table to familial socioeconomic status. Associations were particularly strong between MDD and medical disorders associated with alterations in immunologic factors (ORs = 1.83-6.41). Theories of common immune-me diated vulnerabilities to medical illness and depression are consisten t with these associations.