Children with mental health issues more likely to have poor mental and physical health into adulthood

Children with mental health issues are more likely to have poor mental and physical health in their late teens and early 20s, according to a large-scale Irish-led study.

They are also at greater risk of social isolation, low educational attainment, financial difficulties and heavy substance use, the study of more than 5,000 children and young adults in Ireland found.

Using data from the government study Growing Up in Ireland, researchers led by the Royal College of Surgeons in Ireland’s (RCSI) University of Medicine and Health Sciences tracked mental health trends throughout childhood for 5,141 people.

The vast majority (72.5 per cent) of children reported no significant mental health difficulties, but more than 1,400 appeared to have some type of mental health or behavioural issue across childhood.

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“Mental health symptoms often come and go throughout childhood and adolescence, so we do not want to over-rely on symptom levels at one point in time,” said the study’s lead author, Dr Niamh Dooley of the RCSI department of psychiatry. “We decided to investigate children who had persistent reports of mental health symptoms, regardless of whether they met the criteria for an official diagnosis.”

The study looked at how these patterns of childhood mental health affected a range of outcomes in participants’ late adolescence and early 20s. Taking a broad approach to life outcomes, it examined aspects such as Leaving Certificate results, social isolation and how often children used health services as young adults. Poor physical health issues – such as obesity, sleep difficulties, heavy alcohol use or smoking – and the young person’s general feelings of wellbeing were also examined.

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Researchers also took different types of childhood symptoms into account, such as whether a child tended to internalise their symptoms (as in depression and anxiety), externalise their symptoms (as in hyperactivity and behavioural problems), or both.

Children with externalising symptoms are at increased risk of heavy substance use as young adults, the research found. Children with internalising symptoms are at the highest risk of poor physical health in their late teens and early 20s.

“Our analysis shows that mental health problems in childhood are linked with a wide range of functional issues in adulthood, beyond the realms of mental health,” Dr Dooley said. “Some groups were at particular risk for specific outcomes. For instance, females with persistent symptoms across childhood, particularly internalising symptoms, had very high rates of poor physical health by young adulthood.”

The study, funded by the Health Research Board and published in JAMA Network Open journal, showed those who had mental health issues in childhood were as likely to encounter educational/economic difficulties in young adulthood as they were to face further mental health problems.

“Over 50 per cent of children with mental health issues had at least one educational or economic difficulty by young adulthood, compared to around 30 per cent of those without mental health issues in childhood,” Dr Dooley said.

The findings point to the need for better screening and treatment of mental health problems in childhood and adolescence, which may prevent problems later on in life, according to study co-author Mary Cannon, RCSI professor of psychiatric epidemiology and youth mental health.

“Our study shows that mental health symptoms in childhood can cast a long-lasting shadow on adult life,” Prof Cannon said. “If we understand more about which children in the general population are at greatest risk of poor outcomes, it will help to inform and improve early screening and approaches to support those children.”