Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood

Background: A community-based longitudinal study was conducted to investiga te whether personality disorders (PDs) during adolescence increase the risk for Axis I psychiatric disorders and suicidality during early adulthood. Method: Psychosocial and psychiatric interviews were administered to a repr esentative community sample of 717 youths and their mothers from Z counties in the state of New York in 1975, 1983, 1985-1986, and 1991-1993. Anxiety, disruptive, eating, mood, personality, and substance use disorders and sui cidal ideation and behavior were assessed in 1983 and 1985-1986, when the p articipants were adolescents, and in 1991-1993, when they were young adults . Results: Adolescents with PDs were more than twice as likely as those witho ut PDs to have anxiety, disruptive, mood, and substance use disorders durin g early adulthood. These associations remained statistically significant af ter co-occurring Axis I disorders during adolescence were controlled statis tically. Cluster A, B, and C PDs and DSM-IV Appendix B PDs during adolescen ce were all associated with elevated risk for Axis I disorders during early adulthood after co-occurring Axis I and Axis II disorders during adolescen ce were controlled statistically. Cluster C PDs during adolescence were ass ociated with elevated risk for suicidal ideation or behavior during early a dulthood after co-occurring psychiatric disorders and suicidality during ad olescence were controlled statistically. Conclusions: Adolescents in the community with personality disorders are at elevated risk for major mental disorders and suicidal ideation or behavior during early adulthood. This increase in risk is not accounted for by co-o ccurring Axis I disorders or suicidality during adolescence.