Anxiety at age 15 predicts psychiatric diagnoses and suicidal ideation in late adolescence and young adulthood: results from two longitudinal studies

Sabrina Doering, Paul Lichtenstein, Christopher Gillberg, D. I. Boomsma, Toos C.E.M. Van Beijsterveldt, Lannie Ligthart, Gonneke Willemsen, Eco De Geus, Christel M. Middeldorp, Meike Bartels, Ralf Kuja-Halkola, Sebastian Lundström

Research output: Contribution to JournalArticleAcademicpeer-review


BACKGROUND: Anxiety disorders in adolescence have been associated with several psychiatric outcomes. We sought to describe the prospective relationship between various levels of adolescent anxiety and psychiatric diagnoses (anxiety-, bipolar/psychotic-, depressive-, and alcohol and drug misuse disorders) and suicidal ideation in early adulthood while adjusting for childhood attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental coordination disorder (DCD). Furthermore, we aimed to estimate the proportion attributable to the various anxiety levels for the outcomes.

METHODS: We used a nation-wide population-based Swedish twin study comprising 14,106 fifteen-year-old twins born in Sweden between 1994 and 2002 and a replication sample consisting of 9211 Dutch twins, born between 1985 and 1999. Adolescent anxiety was measured with parental and self-report. Psychiatric diagnoses and suicidal ideation were retrieved from the Swedish National Patient Register and via self-report.

RESULTS: Adolescent anxiety, of various levels, predicted, in the Swedish National Patient Register, anxiety disorders: hazard ratio (HR) = 4.92 (CI 3.33-7.28); depressive disorders: HR = 4.79 (3.23-7.08), and any psychiatric outcome: HR = 3.40 (2.58-4.48), when adjusting for ADHD, ASD, and DCD. The results were replicated in the Dutch data. The proportion of psychiatric outcome attributable to adolescent anxiety over time (age 15-21) was 29% for any psychiatric outcome, 43-40% for anxiety disorders, and 39-38% for depressive disorders.

CONCLUSION: Anxiety in adolescence constitutes an important risk factor in the development of psychiatric outcomes, revealing unique predictions for the different levels of anxiety, and beyond the risk conferred by childhood ADHD, ASD, and DCD. Developmental trajectories leading into psychiatric outcomes should further empirically investigated.

Original languageEnglish
Article number363
Pages (from-to)1-11
Number of pages11
JournalBMC Psychiatry
Issue number1
Publication statusPublished - 14 Nov 2019


This work has been supported by the CAPICE project, funded by the European Union's Horizon 2020 Research and Innovation Programme under the Marie Sklodowska-Curie grant agreement number 721567.

FundersFunder number
European Union's Horizon 2020
Horizon 2020 Framework Programme602768, 721567


    • Adolescence
    • Anxiety disorders
    • Depressive disorders
    • Neurodevelopmental disorders
    • Suicidal ideation
    • Young adulthood

    Cohort Studies

    • Netherlands Twin Register (NTR)


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