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Biomedical subjects

David M Fergusson

Publications and source records attributed to David M Fergusson.

At least 19 recordsLinked to original sources

Stability and instability in alcohol diagnosis from ages 18 to 21 and ages 21 to 25 years.

BACKGROUND: Only in recent years have longitudinal studies of adolescents diagnosed alcohol use disorders and these have not distinguished between abuse and dependence. This study describes the course of disorder from age 18 to age 25 for abuse and dependence and investigates the extent to which continuities in disorder can be explained by background factors. METHODS: A birth cohort of 1,265 individuals from Christchurch, New Zealand, followed annually to age 16 years then at 18, 21 and 25 years (1,003 at age 25). DSM-IV diagnoses were made from reports of alcohol symptoms at 18, 21 and 25 years. RESULTS: The most stable diagnosis was that of no diagnosis, with 83-91% staying the same from one interview to the next. There were high rates of remission to no disorder; 57-75% for those with initial abuse and 50-54% of those with initial dependence. Nonetheless prior diagnosis was a strong predictor of subsequent diagnosis (ORs of 3.7-27.6). Adjustment for background risk factors reduced these odds ratios but all remained significant and substantial (minimum 2.6). CONCLUSIONS: The dual finding of substantial discontinuity and substantial continuity indicates that both public health and treatment interventions are warranted.

Adolescent↗

Subthreshold depression in adolescence and mental health outcomes in adulthood.

BACKGROUND: There is increasing interest in the extent to which individuals with subthreshold depression face increased risks of subsequent major depression and other disorders. OBJECTIVE: To examine linkages between the extent of depressive symptoms (asymptomatic, subthreshold, major depression) at ages 17 to 18 years and mental health outcomes up to age 25 years in a New Zealand birth cohort. DESIGN: Data were gathered during the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of 1265 New Zealand children (635 males, 630 females). SETTING: General community sample. PARTICIPANTS: The analysis was based on 1006 participants who represented 80% of the original cohort. MAIN OUTCOME MEASURES: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria for major depression and anxiety disorder, treatment-seeking, suicidal ideation, and suicide attempt. RESULTS: There were significant associations (P<.01) between the extent of depression at ages 17 to 18 years and rates of subsequent depressive symptoms, major depression, treatment for depression, anxiety disorder, treatment for anxiety disorder, suicidal ideation, and suicide attempts. After adjustment for covariate factors, the extent of depression at ages 17 to 18 years remained associated with later depression and suicidal tendencies. Planned comparisons showed that sample members with subthreshold depression had a similar prognosis to those meeting criteria for major depression. CONCLUSIONS: Findings suggest that sample members with subthreshold depression are a group with elevated risks of later depression and suicidal behaviors. Current diagnostic procedures, which classify people with subthreshold depression into complex discrete groups, might obscure the fact that depressive symptoms are dimensional and range from none to severe.

Adolescent↗

Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood.

BACKGROUND: The objectives of the study were to examine linkages between exposure to childhood abuse and interparental violence and the subsequent development of panic attacks and panic disorder using data gathered on a birth cohort of 1265 New Zealand young people studied to the age of 21 years. METHOD: Data on: (a) exposure to child abuse and interparental violence; (b) the development of panic attacks and panic disorder; and (c) other childhood and related factors were gathered over the course of a 21-year longitudinal study. RESULTS: After adjustment for childhood and related factors, exposure to childhood physical abuse was associated with a significantly increased risk of later panic attack (OR 2.3, 95% CI 1.1-4.9) and panic disorder (OR 3.0, 95% CI 1.1-7.9); childhood sexual abuse was associated with a significantly increased risk of panic attack (OR 4.1, 95% CI 2.3-7.2) and a marginally significant increase risk of panic disorder (OR 2.2; 95% CI 0.98-5.0). Exposure to interparental violence was unrelated to later panic attack or disorder after adjustment. CONCLUSIONS: Exposure to childhood sexual and physical abuse was associated with increased risks of later panic attack/disorder even after adjustment for prospectively assessed confounding factors. However, exposure to interparental violence during childhood was not related to increased risk of later panic attack/disorder after adjustment. These data suggest the need for clinicians to be aware that patients with histories of childhood physical and sexual abuse may be at increased risk for panic during young adulthood.

Adolescent↗

Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood.

BACKGROUND: The aim of this study was to examine the linkages between suicidal ideation and attempt in adolescence and subsequent suicidal behaviours and mental health in young adulthood. METHOD: Data were gathered during the course of a 25-year longitudinal study of a birth cohort of 1265 New Zealand children. The information collected included: (a) measures of suicidal thoughts and attempts in adolescence (< 18 years); (b) measures of suicidal ideation, suicide attempt, major depression, anxiety disorders, and substance use disorders in young adulthood (18-25 years); and (c) measures of childhood and family background, individual characteristics, and mental disorders in adolescence. RESULTS: After statistical adjustment for confounding factors, suicide attempt in adolescence was associated with increased risks of subsequent suicidal ideation (OR 5.7) suicide attempt (OR 17.8) and major depression (OR 1.5). Those reporting suicidal ideation without suicide attempt showed moderate increases in risks of later suicidal ideation (OR 2.5), suicide attempt (OR 2.0) and major depression (OR 1.6). In addition, there was evidence of an interactive relationship in which suicidal behaviour in adolescence was associated with increased risks of later substance use disorders in females but not males. CONCLUSIONS: Young people reporting suicidal ideation or making a suicide attempt are an at-risk population for subsequent suicidal behaviour and depression. Further research is needed into the reasons for suicidal adolescent females being at greater risk of later substance use disorder.

Adolescent↗

Sexual orientation and mental health in a birth cohort of young adults.

BACKGROUND: This paper sought to examine the relationship between sexual orientation and mental health in a New Zealand birth cohort studied to age 25 years. METHOD: The analysis is based on a sample of 967 participants (469 males; 498 females) in the Christchurch Health and Development Study. As part of this study information was gathered on: (a) measures of sexual orientation, same-sex behaviour and sexual attraction obtained at ages 21 and 25 years; (b) measures of mental disorders and suicidal behaviours over the interval 21-25 years; (c) measures of childhood and family background. RESULTS: Latent class analysis was used to combine indicators of sexual orientation, same sex behaviour and attraction to form an empirically based classification of sexual orientation. The best-fitting model classified the sample into three groups: exclusively heterosexual orientation (87.6%); predominantly heterosexual but with same-sex inclinations or experience (9.6%); predominantly homosexual (2.8%). Proportionately more women than men were classified as predominantly heterosexual (14.2% v. 4.8% respectively) or predominantly homosexual (3.9% v. 1.5% respectively). Cohort members with a predominantly homosexual orientation had rates of mental disorder and suicidal behaviours that were between 1.5 and 12 times higher than for those with an exclusively heterosexual orientation. These associations persisted after adjustment for confounding. The associations between sexual orientation and mental health were more marked for males than females. CONCLUSIONS. The findings suggest a continuum of sexual preferences amongst young adults. Variations in sexual orientation were clearly associated with mental health. These associations tended to be stronger for males.

Adult↗

Tests of causal linkages between cannabis use and psychotic symptoms.

AIM: To examine possible causal linkages between cannabis use and psychosis using data gathered over the course of a 25-year longitudinal study. DESIGN: A 25-year longitudinal study of the health, development and adjustment of a birth cohort of 1265 New Zealand children (635 males, 630 females). SETTING: The Christchurch Health and Development Study, a general community sample. PARTICIPANTS: A total of 1055 participants from the Christchurch Health and Development Study (CHDS) cohort for whom data on cannabis use and psychotic symptoms were available on at least one occasion from 18, 21 and 25 years. MEASUREMENTS: As part of this study, data were gathered on frequency of cannabis use and psychotic symptoms at ages 18, 21 and 25 years. FINDINGS: Regression models adjusting for observed and non-observed confounding suggested that daily users of cannabis had rates of psychotic symptoms that were between 1.6 and 1.8 times higher (P < 0.001) than non-users of cannabis. Structural equation modelling suggested that these associations reflected the effects of cannabis use on symptom levels rather than the effects of symptom levels on cannabis use. CONCLUSIONS: The results of the present study add to a growing body of evidence suggesting that regular cannabis use may increase risks of psychosis. The present study suggests that: (a) the association between cannabis use and psychotic symptoms is unlikely to be due to confounding factors; and (b) the direction of causality is from cannabis use to psychotic symptoms.

Adolescent↗

Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood.

BACKGROUND: This paper seeks to extend research into the adult sequelae of childhood conduct problems by investigating the associations between conduct problems in middle childhood and psychosocial outcomes in adulthood. METHOD: Data were gathered during the course of a 25-year longitudinal study of a birth cohort of New Zealand young people. Information was collected on: a) parent and teacher reports of child conduct problems at ages 7, 8 and 9 years; b) measures of crime, substance use, mental health, sexual/partner relationships, education/employment; c) confounding factors, including childhood, family and educational characteristics. RESULTS: There were statistically significant associations between childhood conduct problems from 7-9 years and risks of adverse outcomes across all domains of functioning. After control for confounding factors the associations between conduct problems and education/employment outcomes became statistically non-significant. Associations persisted for other outcomes (crime, substance dependence, mental health and sexual/partner relationships). Children in the most disturbed 5% of the cohort had rates of these outcomes that were between 1.5 and 19 times higher than rates for the least disturbed 50% of the cohort. The associations between conduct problems and adult outcomes were similar for males and females. CONCLUSIONS: Childhood conduct problems were associated with a wide range of adverse psychosocial outcomes (crime, substance use, mental health, sexual/partner relationships) even after control for confounding factors. The results reinforce the need for greater investment into interventions to address these problems.

Adaptation, Psychological↗

Show me the child at seven II: Childhood intelligence and later outcomes in adolescence and young adulthood.

BACKGROUND: There has been ongoing interest in the role of intelligence in longer-term educational and occupational achievement and social adjustment. The aims of this study were to examine the extent to which IQ in middle childhood (8-9 years) was prognostic of future outcomes when due allowance was made for confounding personal and social factors. METHODS: Data were gathered on (WISC-R) IQ at ages 8-9 years and a range of educational and social adjustment measures over the course of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of 1,265 New Zealand children. RESULTS: IQ assessed at ages 8-9 years was related to a range of outcomes: later crime (offending, arrest/conviction); substance use disorders (nicotine dependence, illicit drug dependence); mental health (anxiety, suicidality); sexual adjustment (number of sexual partners, pregnancy); educational achievement (school leaving qualifications, tertiary qualifications); and occupational outcomes (unemployment, income). However, intelligence was largely unrelated to many of these outcomes: crime, mental health, sexual behaviours, and illicit substance dependence after statistical adjustment for early behaviour problems and family background. Strong relationships remained between childhood intelligence and later educational and occupational outcomes. CONCLUSIONS: Much of the association between early intelligence and later social adjustment is mediated by childhood conduct problems and family social circumstances. However, strong relationships exist between early intelligence and later academic achievement and income independently of these factors.

Achievement↗

Familial transmission of suicidal ideation and suicide attempts: evidence from a general population sample.

The goals of the study were (1) to determine the association between parental and offspring suicidal ideation and suicide attempts among adult offspring in a general community sample, and (2) to examine the extent to which this association can be explained by mediating processes of mental disorders. Data were drawn from the National Comorbidity Survey (n=8098), a representative household sample of adults aged 15-54 in the United States. The relationships between suicidal ideation and suicide attempts among adult offspring and suicidal ideation and suicide attempt in their parents, compared with those in parents not characterized by suicidal ideation or suicide attempts, were calculated using multiple logistic regression analyses. Analyses were adjusted for differences in sociodemographic characteristics and for mental disorders. Results showed that parental suicidal ideation was associated with a significantly increased likelihood of suicidal ideation [OR=1.7 (1.2, 2.5)] and suicide attempt [OR=1.4 (0.9, 2.1)] among offspring. Parental suicide attempt was associated with increased odds of suicidal ideation [OR=2.0 (1.4, 2.9)] and suicide attempt [OR=2.2 (1.4, 3.4)] among offspring. Comorbid mental disorders contributed to the strength of these associations, but with the exception of the link between parental suicidal ideation and offspring suicide attempt, all remained statistically significant even after adjustment. These data provide initial evidence of familial linkages (parent-offspring) of suicidal ideation and behavior among a sample of adults representative of the US population. The data suggest that comorbid mental disorders contribute to these associations but do not completely account for them. The findings are consistent with and extend results from family, clinical, and high-risk studies suggesting that a familial risk of suicidal ideation and suicide behavior occurs in the general population. Implications for prevention and future research are discussed.

Adolescent↗

Asthma and depressive and anxiety disorders among young persons in the community.

BACKGROUND: The objectives of the study were to examine linkages between asthma and depressive and anxiety disorders in a birth cohort of over 1000 young persons studied to the age of 21 years. Specifically, the study aimed to ascertain the extent to which associations between asthma and depressive and anxiety disorders could be explained by non-observed fixed confounding factors. METHOD: Asthma and depressive and anxiety disorders were measured prospectively over the course of a 21-year longitudinal study. Fixed effects logistic regression models were used to determine the relationship between asthma and depressive and anxiety disorders, adjusting for potentially confounding factors. RESULTS: Asthma in adolescence and young adulthood was associated with increased likelihood of major depression (OR 1.7, 95 % CI 1.3-2.3), panic attacks (OR 1.9, 95 % CI 1.3-2.8), and any anxiety disorder (OR 1.6, 95% CI 1.2-2.2). Associations between asthma and depressive and anxiety disorders were adjusted for confounding factors using a fixed effects regression model which showed that, after control for fixed confounding factors, asthma was no longer significantly related to major depression (OR 1.1), panic attacks (OR 1.1), or any anxiety disorder (OR 1.2). Additional post hoc analyses suggested that exposure to childhood adversity or unexamined familial factors may account for some of the co-morbidity of asthma and depressive and anxiety disorders. CONCLUSIONS: These results confirm and extend previous findings by documenting elevated rates of depressive and anxiety disorders among young adults with asthma, compared with their counterparts without asthma, in the community. The weight of the evidence from this study suggests that associations between asthma and depressive and anxiety symptoms may reflect effects of common factors associated with both asthma and depressive and anxiety disorders, rather than a direct causal link. Future research is needed to identify the specific factors underlying these associations.

Adolescent↗

Knowledge and attitudes about suicide in 25-year-olds.

OBJECTIVE: To examine knowledge and attitudes about suicide in a New Zealand sample of young people aged 25 years. METHOD: The sample was a birth cohort of 1265 young people born in New Zealand in 1977 who have been followed in a longitudinal study for 25 years. At age 25, participants were asked a series of questions designed to assess their knowledge and attitudes about suicide. RESULTS: Young people had poor knowledge about youth suicide. They overestimated the number of youth suicide deaths, with a quarter believing that the number of deaths was at least 10x higher than the actual number. They overestimated the fraction of all suicides accounted for by youth suicides with two-thirds believing that 50% or more of all suicides occurred among young people. The most common source of information about suicide was the media. Young people tended to hold mixed attitudes toward suicide, having both liberal and conservative views. Those with lifetime histories of suicidal ideation or suicide attempt and those with family histories of suicide or suicide attempt tended to hold more liberal attitudes. Attitudes toward suicide were unrelated to gender and to knowledge about suicide. CONCLUSIONS: Young people over-estimate the prevalence of youth suicide and the fraction of suicides accounted for by youth deaths, and hold both conservative and liberal attitudes toward suicide. Their primary source of information about suicide is the media. These findings raise concerns about the potential for media coverage of youth suicide issues to normalize suicide as a common, and thereby acceptable, response among young people, and suggest the need for careful dissemination of accurate information about suicide by knowledgeable, respected and reputable sources.

Adolescent↗

Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood.

AIMS: To describe the pattern of drinking at age 16 and to relate this to outcomes at 16-21 years and 21-25 years across a number of psychosocial domains. DESIGN: A prospective birth cohort study with annual follow-up until age 16 then at 18, 21 and 25 years. SETTING: Christchurch, New Zealand. PARTICIPANTS: Of 1265 subjects, 953 were interviewed at age 16. MEASUREMENTS: Multiple measures of family background were collected from birth to 16 years. Alcohol consumption was measured in terms of frequency, usual or last quantity drunk and most drunk per occasion. Problems were also recorded. Questions about psychiatric symptoms enabled Diagnostic and Statistical Manual (DSM) criteria to be applied. Detailed reports on educational outcomes, employment, sexual behaviours and offending were collected. FINDINGS: Four latent classes were required to describe drinking at age 16, but these appeared to lie along a single dimension which strongly predicted outcomes at ages 16-21 and 21-25 across all domains (alcohol-related, substance dependence, mental health, education, sexual relationships and offending). After controlling for background and correlates only a small number of outcomes were still related consistently to drinking at age 16 over both periods: most alcohol-related outcomes, the number of sexual partners and the extent of violent offending. CONCLUSIONS: Drinking at age 16 is a clear indicator of future life-course over most domains in late adolescence and early adulthood. Many of these associations are due to other covariates. Outcomes specific to drinking at age 16 are alcohol outcomes, number of sexual partners and violence.

Adolescent↗

Early anxious/withdrawn behaviours predict later internalising disorders.

BACKGROUND: The aim of the study was to examine the association between anxious/withdrawn behaviours at age 8 and the development of internalising disorders in adolescence and young adulthood (ages 16-21). METHODS: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of over 1,000 New-Zealand-born young people. Over the course of the study, data were gathered on: (a) anxious/withdrawn behaviour at age 8; (b) anxiety disorders and major depression at ages 16-18 and 18-21; (c) a range of potential confounding factors, including measures of adversity and family factors during childhood. RESULTS: Increasing anxious/withdrawn behaviour at age 8 was associated with increasing risks of social phobia; specific phobia; panic/agoraphobia; and major depression during adolescence and young adulthood. These associations persisted after adjustment for a series of confounding social, childhood, and family factors. CONCLUSIONS: Anxious/withdrawn behaviour in childhood is associated with elevated rates of anxiety disorders and major depression during adolescence and young adulthood. These data are consistent with, and extend, previous clinical and epidemiologic findings, by showing consistent linkages between childhood anxious/withdrawn behaviours at age 8 and increased risk for anxiety disorders and depression at ages 16-18 and 18-21 among young persons in the community. These results may point to the need to provide support and possibly intervention to children showing early anxious or withdrawn behaviours.

Adolescent↗

Panic attacks and psychoticism.

OBJECTIVE: The authors sought to determine the association between panic attacks and psychoticism among young adults in the community. METHOD: Data were drawn from a 21-year longitudinal birth cohort study (N=1,265). Negative binomial regression models were used to determine the association between panic attacks in adolescence (age 15-21) and psychoticism during young adulthood. RESULTS: Having a panic attack in the preceding 3 years was associated with elevated rates of psychoticism at ages 18 (rate ratio=2.81, 95% CI=1.92-4.13) and 21 (rate ratio=3.01, 95% CI=2.10-4.33). These associations were adjusted for differences in previous psychoticism, comorbid anxiety, depression, and substance use disorders and a range of other potential confounding factors by using a generalized estimating equation model. This analysis showed that after adjustment for confounding factors, having a panic attack was still associated with an increased rate of psychoticism (rate ratio=1.51, 95% CI=1.14-2.02). CONCLUSIONS: Panic attacks during adolescence are associated with significantly increased levels of psychoticism among young adults in the community compared with young persons with no history of panic attacks. Much of the relationship between panic attacks and psychoticism appears to be explained by common risk factors and psychiatric comorbidity, yet these data provide evidence of an independent association between panic attacks in adolescence and psychoticism during young adulthood in the community. Replication of these findings is needed, as are future studies that further investigate the mechanism of this association.

Adolescent↗

Early reactions to cannabis predict later dependence.

CONTEXT: While there is a growing literature on the linkages between early subjective responses to nicotine and alcohol and later risks of nicotine or alcohol dependence, to date there has been no study of this issue in relation to cannabis. OBJECTIVE: To examine the extent to which subjective responses to early (prior to the age of 16 years) cannabis use were associated with subsequent cannabis dependence in a birth cohort studied to the age of 21 years. DESIGN: Data on early (prior to the age of 16 years) subjective reactions to cannabis use and subsequent cannabis dependence were gathered over the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of children born in Christchurch, New Zealand. SETTING: General community sample. PARTICIPANTS: Members of a population-based birth cohort (86.5% white, 11.3% New Zealand Maori, and 2.2% Pacific Island). Main Outcome Measure Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition cannabis dependence (for those aged 16-21 years). RESULTS: Of the cohort, 198 (20%) had used cannabis prior to the age of 16 years. Among this high-risk group, rates of dependence were high with 21.7% meeting DSM-IV criteria for cannabis dependence by the age of 21 years. There were clear tendencies for rates of cannabis dependence to increase with increasing reports of positive responses to early cannabis use: those reporting 5 positive responses had odds of cannabis dependence that were 28.5 (95% confidence interval, 6.3-133.8) times higher than those not reporting positive reactions to cannabis. The association held (odds ratio, 23.4; 95% confidence interval, 4.0-135.9) after control for potentially confounding factors including the extent of use of cannabis prior to age 16 years. The extent of early negative reactions to cannabis was unrelated to later cannabis dependence. CONCLUSIONS: Early subjective responses to cannabis are prognostic of later cannabis dependence. These findings may suggest the presence of genetically mediated individual differences in early responsiveness to cannabis. Clinicians should be aware that young people who report positive reactions to early use of cannabis are at increased risks of later cannabis dependence.

Adolescent↗

Deviant peer affiliations and depression: confounding or causation?

Data gathered from 2 longitudinal studies (the Christchurch Health and Development study of a birth cohort of 1,265 New Zealand participants studied to 21 years and the Quebec Study of 240 Canadian participants studied to 13 years) was used to examine the linkages between deviant peer affiliations and depression in adolescence. Both studies produced similar conclusions: a) increasing peer affiliations were associated with significant (p < .0001) increases in depressive symptoms; b) the associations between peer affiliations and depression could not be fully explained by confounding factors; and c) peer affiliations and depressive symptoms were linked by a causal chain process in which deviant peer affiliations led to increased externalizing behaviors with the negative consequences of these behaviors leading to depression.

Adolescent↗