Prognostic significance of clinical and psychosocial factors of childhood in the dynamics of mental disorders in adults: a clinical and follow-up study

Mental disorders of childhood are dynamic formations characterized by complex patterns of development with periods of remission, changes in the clinical picture and comorbid stratification. he aim of the study is to establish the prognostic significance of clinical and psychosocial factors of childhood psychiatric disorders for differentiating the dynamics of their course in adulthood. Materials and methods: a prospective cohort clinical and follow-up study of 175 patients of the children’s psychiatric service with a follow-up period of at least 10 years was conducted. An integrated approach was applied, combining a retrospective analysis of medical documentation with a prospective follow-up examination.

Results and discussion: significant heterogeneity of diagnostic pathways was revealed: complete stability of the diagnosis was observed in 56.0% of patients, and a change in the nosological group was observed in 24.0%. The multiple logistic regression model revealed key predictors of a favorable outcome: diagnosis of «adjustment disorder» (OR=6.17), absence of hospitalization (OR=4.26), and complete family (OR=1.97). Cluster analysis revealed three homogeneous groups with different development trajectories corresponding to modern typological models. Conclusions. The study confirms the complex nature of the interaction of clinical and psychosocial factors in shaping the trajectories of mental pathology. The data confirm the need for a differentiated approach to prognosis and early intervention in the conditions of a regional psychiatric service.

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