Adolescent Axis I and personality disorders predict quality of life during young adulthood

Purpose: To investigate and compare the prospective association of adolescent Axis I mental disorder and personality disorder (PD) with young adult quality of life (QOL) in the general population. Methods: Seven hundred fifty mothers and youths participating in a prospective longitudinal community-based study were interviewed. Mental disorders were measured at a mean age 16 years. QOL as the outcome indicators were assessed at a mean age 22. Results: Adolescent Axis I disorder predicted elevated negative affect and higher levels of stress some 6 years later. Adolescent PD predicted elevated negative affect and higher levels of stress, and also problems in social support and relationships, and poorer residential, mobility, and financial and health resources in adulthood. Youths with both Axis I disorder and one or more PDs had the worst outcomes with regard to health problems, stressful occupational or educational settings, and resources, net of the effects of adolescent health problems. Nevertheless, some aspects of adult QOL were not significantly related to adolescent disorder, including a positive perspective on the future, own morale in a chosen occupation or educational setting, or the amount of autonomy experienced in that setting. Conclusions: Among adolescents in the community, PDs during adolescence may have a more adverse impact on young adult QOL than do Axis I disorders. A combination of Axis I and PD may represent a particular risk for new physical health problems and resource inadequacy, including poor access to health care. (c) 2006 Society for Adolescent Medicine. All rights reserved.