Objectives Adolescent mental health problems often follow varied courses, including persistence or remission. Early identification of these trajectories is important for timely monitoring and preventive efforts. To identify predictors of symptom persistence across six common mental health problems in youth (attention-deficit/hyperactivity disorder, anxiety, conduct, depressive, oppositional defiant and somatic problems), and to investigate brain differences between persisters and remitters. Design Longitudinal cohort study with baseline and 2-year follow-up assessments. Setting Multisite population-based cohort (Adolescent Brain Cognitive Development Study, USA). Participants A total of 3417 children aged 9–10 years with clinically relevant symptoms based on the Child Behaviour Checklist (CBCL). Main outcome measures Symptom persistence at 2-year follow-up (persisters vs remitters), predictive performance assessed by area under the receiver operating characteristic curve (AUC) and baseline and longitudinal neuroimaging differences (structural MRI, resting-state functional MRI, diffusion tensor imaging). Results Persistence rates ranged from 36% to 50% across problems at 2-year follow-up. CBCL-based models showed acceptable prediction for anxiety (AUC=0.72), while performance for other disorders was lower (AUC=0.55–0.65). Higher baseline CBCL total scores were consistently observed in persisters (p<1×10⁻⁷). Neuroimaging analyses revealed baseline brain differences for anxiety, somatic and oppositional defiant problems, whereas longitudinal differences were observed only for oppositional defiant problems. Conclusions Mental health problems in adolescence frequently persist over 2 years. CBCL measures may help identify individuals at risk for persistent anxiety symptoms, whereas prediction for other problems remains limited. Neuroimaging findings suggest that symptom persistence may be partly associated with pre-existing brain differences.
Hou et al. (Wed,) studied this question.