Incidence and persistence of internalizing disorders from late childhood to young adulthood: an 8-year follow-up analysis of a community-based cohort

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Ribeiro, Sahamia Martins ; Caye, Arthur ; Fitzpatrick, Caroline ; Da Silva-Jr, Francisco ; Haas, Leticia Muller ; de Giusti, Carina ; Salto, Ana Beatriz Ravagnani ; Bressan, Rodrigo Affonseca ; Miguel, Euripedes Constantino ; Rohde, Luis Augusto ; Salum, Giovanni Abrahao ; Pan, Pedro Mario

• Document type: Journal article
• Source: Journal of Affective Disorders; v. 392, p. 10-pg., 2025-09-03.

Abstract

Background: Internalizing disorders are common and impairing in youth, often continuing into adulthood. While clinical samples emphasize their persistence, non-clinical cohorts using dimensional approaches reveal diverse trajectories. However, few population-based studies have examined internalizing disorders as categorical outcomes while identifying clinically relevant predictors. Methods: This study is part of the ongoing community-based Brazilian High-Risk Cohort Study for Mental Conditions, which includes baseline (T0, age 6 to 14 years), 3-year (T1), and 8-year (T2) evaluations (N = 2247). Participants were categorized into four non-overlapping trajectories: incident, persistent, remittent, and no internalizing disorder. Diagnoses were based on DSM-IV criteria, ascertained by clinical psychiatrists using Development and Well-Being Assessment. Baseline predictors included dimensional psychopathology, parental psychiatric disorders, environmental, and sociodemographic variables. Associations between these variables and disorder trajectories were analyzed using logistic regression models. Results: At T0, n = 309 (13.8 %) participants met criteria for an internalizing disorder, from whom 64.4 % experienced a remittent trajectory, while 35.6 % had a persistent trajectory. Among those without baseline internalizing disorders, 25.8 % developed an incident trajectory at T1 or T2. Maternal internalizing disorders, female sex, and child-reported - rather than parent-reported - emotional symptoms at T0 were associated with both persistent and incident trajectories, whereas childhood maltreatment was associated only with the incidence of internalizing disorders. Conclusion: Our findings suggest that these clinical factors may indicate risk for both onset and maintenance of such conditions over time, while emphasizing the need to assess children's and young adolescents' reports in community clinical care. (AU)

• FAPESP's process: 13/08531-5 - High risk cohort study for psychiatric disorders in childhood: 3-year follow-up neuroimaging study
• Grantee: Andrea Parolin Jackowski
• Support Opportunities: Regular Research Grants
• FAPESP's process: 21/12901-9 - National Center for Research and Innovation in Mental Health (CISM)
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Grants - Applied Research Centers Program
• FAPESP's process: 20/06172-1 - Counterproductive behaviors in coping with the SARS-CoV-2 pandemic in Brazil: investigation using a 10-year follow-up cohort and Ecological Momentary Assessment
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Regular Research Grants
• FAPESP's process: 14/50917-0 - INCT 2014: developmental psychiatry for children and adolescents
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/05332-8 - Brazilian high-risk cohort for psychiatric disorders: 10 years follow-up
• Grantee: Rodrigo Affonseca Bressan
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 23/00437-1 - Multi-user equipment approved in grant 2021/05332-8: Biomek i5 Automated Workstation
• Grantee: Rodrigo Affonseca Bressan
• Support Opportunities: Multi-user Equipment Program