Predictors of delayed social maturation and mental health disorders in young adults chronically ill since childhood

To ascertain the influence of juvenile-onset chronic physical diseases and associating factors of social environment on delayed social maturation and mental health disorders in young adults, we analysed a group of 407 (184 fe male, 223 male) subjects with these conditions and compared the results wit h those of 123 (63 female, 60 male) healthy controls studied at the age of 19-25 years. The social maturation index was formed on the basis of a demog raphic interview, which also reviewed the state of social development and t he family situation during childhood. Mental health disorders were assessed with a Present State Examination (PSE) interview analysed with the CATEGO program. With regard to social maturation at least half of the patients and controls were doing well, whereas for 29% (CI95, 25%-33%) of the patients and 17% (CI95, 10%-24%) of the controls the index showed delayed maturation . Subjects with poor social maturation were found most often among the disa bled patients but also among the patients without severe diseases. The prev alence of PSE-CATEGO-identified psychiatric syndromes was equal in the pati ents and the controls (22% versus 20%). However, the patients with severe o r disabling diseases had more severe psychiatric syndromes. The prevalences of depressive syndromes were also equal, but the depression of the patient s was more often a profound affective disorder. Male sex, poor scholastic a nd vocational success, and social problems in the family during childhood w ere significantly associated with poor social maturation. On the other hand , the most significant predictors of mental health problems in young adults were female sex, family distress during childhood, and a severe disease. J uvenile-onset physical disease was considered to delay social maturation in some subjects and to deepen or modulate the clinical picture of mental hea lth disorders. It is concluded that juvenile-onset physical diseases combin ed with family-related factors affect in different ways the social growth a nd psychiatric well-being. The results suggest that the subjects with chron ic diseases during childhood should be thoroughly assessed by a child psych iatrist to evaluate the orientation of psychological development and the im pact of the child's disease on the family and to ensure balanced psychologi cal and social growth.