The waxing and waning of mental disorders: Evaluating the stability of syndromes of mental disorders in the population

This article examines the stability of symptoms, syndromes, and diagnoses o f specific anxiety and depressive disorders, as well as diagnostic shifts f rom one syndrome to another over time. Using retrospective and longitudinal prospective data from the baseline and first follow-up investigation (19.7 months later) of the Early Developmental Stages of Psychopathology Study ( EDSP), we focus on establishing stability measures for early stages of ment al disorders in a community sample of adolescents aged 14 to 17 years at ba seline. The results are as follows: (1) Although only about 30%. developed a full-blown DSM-IV disorder, psychopathological syndromes are widespread i n adolescents: 15% of the population aged 14 to 17 at baseline were not aff ected by at least some clinically relevant symptoms of mental disorders eit her throughout their previous life or throughout the follow-up period. (2) The likelihood of staying free of symptoms and threshold disorders during f ollow-up was highest among subjects who were completely well at baseline. T he probability of a positive outcome decreased as a function of severity of baseline diagnostic status. (3) There was a considerable degree of fluctua tion not only in the diagnostic status and severity of specific disorders, but also in terms of complete remissions and shifts from one syndrome and d isorder to another, (4) Anxiety disorders, overall, slightly differ with re gard to the persistence and stability of the diagnostic status from depress ive disorders. (5) However, there were remarkable differences between speci fic types of anxiety and depressive disorders. Consistent with other longit udinal epidemiological studies in the general population, this study finds that the syndromes and diagnoses of mental disorders have a strong tendency to wax and wane over time in this age group. Copyright (C) 2000 by W.B. Sa unders Company.