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Am Fam Physician. 1998;57(5):1126-1129

The first report of the National Comorbidity Survey revealed that early-onset psychiatric disorders are predictors of truncated educational attainment. The second study was conducted to evaluate whether these disorders are associated with subsequent teenage parenthood. Results indicated that women who give birth as adolescents are more likely to become welfare recipients and to have a difficult time establishing independence from government assistance. Over 50 percent of the Aid to Families with Dependent Children budget goes to families started by adolescents. Kessler and associates evaluated the National Comorbidity Survey to determine the relationship between early-onset psychiatric disorders and subsequent teenage pregnancy.

Researchers surveyed 8,098 persons 15 to 54 years of age. Psychiatric disorders consisting of anxiety, affective and conduct disorders, and addiction were positively related to subsequent teenage pregnancy in females, with addictive disorders being the strongest predictors. Male teenage premarital parenthood was significantly associated with conduct disorder. There was no evidence that history of prior psychiatric disorders predicted subsequent abortion or miscarriage. There was a consistently positive association between prior psychiatric disorders and having at least one sexual partner during the previous 12 months. The association between psychiatric disorders and failure to use consistent contraception was nonsignificant, with the exception of conduct disorder among females.

Results of this study suggest that adolescents with psychiatric disorders are at higher risk of teenage pregnancy. These results have important implications for the policy debate on national health care insurance. Results reported in this study add to the growing body of evidence that early-onset psychiatric disorders are associated with important societal costs.

The authors conclude that these findings also have important implications for mental health professionals treating adolescents with psychopathology; the higher risk for pregnancy in this group should be noted. These results should also alert family physicians who treat adolescent mothers or their children to be aware of possible psychopathology and adverse life consequences in this group. Planners of interventions aimed at preventing adolescent pregnancy should consider including a mental health treatment component in the treatment intervention package.

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Copyright © 1998 by the American Academy of Family Physicians.

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