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Am J Psychiatry 1997; 154:1405-1411
Copyright © 1997 by American Psychiatric Association
Social consequences of psychiatric disorders, II: Teenage parenthood
RC Kessler, PA Berglund, CL Foster, WB Saunders, PE Stang and EE Walters
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115-5899, USA.
OBJECTIVE: The subject of this study was the relation between
retrospectively reported early-onset psychiatric disorders and subsequent
teenage parenthood in the general population. METHOD: The data were from
5,877 respondents aged 15-54 years in the National Comorbidity Survey, a
nationally representative household survey. Information on respondents'
DSM-III-R anxiety disorders, mood disorders, substance abuse disorders, and
conduct disorder, age at the birth of the first child, and teenage sexual
activity was collected in face-to-face interviews. RESULTS: Early-onset
psychiatric disorders were associated with subsequent teenage parenthood
among both females and males, with significant odds ratios of 2.0-12.0 and
population attributable risk proportions of 6.2%-33.7%. Disaggregation
analyses showed that disorders were associated with increased probability
of sexual activity but not with decreased probability of using
contraception. CONCLUSIONS: These results add to a growing body of evidence
that psychiatric disorders are associated with a variety of adverse life
consequences. The current policy debate concerning universal insurance
coverage needs to take this into consideration. Planners of interventions
aimed at preventing teenage pregnancy should consider including a mental
health treatment component in their intervention packages. Mental health
professionals treating adolescents need to be sensitized to their higher
risk of pregnancy, while family doctors and specialists treating teenage
mothers or their children need to be sensitized to the mothers' higher risk
of psychiatric disorder.
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