A Ten-Year Cohort Study on the Stability and Trajectories of Psychiatric Diagnosis in Adolescents and Young Adults in Lazio, Italy

Introduction

We aimed to evaluate the diagnostic stability of a large spectrum of psychiatric diagnoses in adolescents and young adult patients attending specialised facilities in the Lazio Region (Italy).

Methods

A total of 3871 subjects (11–35 years) at their first hospitalisation with a psychiatric diagnosis were selected and followed up for 10 years on subsequent hospital admissions to psychiatric care.

Results

A total of 1145 patients were readmitted to a hospital for a psychiatric disorder in the following 10 years. Among these subjects, the concordance between the first and last diagnosis was 57.8% with a weighted kappa of 0.47 (95% CI: 0.42–0.51); the repeated stability (the same diagnosis in at least 75% of admissions) was 31.2%. The diagnostic categories with the highest values of prospective concordance and kappa were schizophrenia spectrum and other functional psychoses (70%, kappa 0.53), substance use disorders (54%, kappa 0.57), and eating disorders (80.9%, kappa 0.76).

Conclusions

In a population study, the stability over time of the first psychiatric diagnosis in a hospital varied according to the specific diagnostic categories, and overall, it was lower than previously reported. The trajectories were disorder-specific, and the stability was influenced by several factors, including the individuals' characteristics, the disorder's severity, and the diagnostic setting.