The associations between adolescent psychiatric disorders and adulthood payment problems: A Norwegian register study of complete birth cohorts of 1995-1997

Abstract

Background: Psychiatric disorder diagnoses are linked to long-term socio-economic “shadows” into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway, and whether these associations are moderated by parental and area characteristics.

Methods: We combine Norwegian registry data with payment problem records from the public debt enforcement agency for the 1995-1997 birth cohorts (n=173,750). We ascertain behavioural, neurotic, mood, and substance use disorder diagnoses from specialised care at ages 13-17. Payment problems are defined as any records of mandatory deductions in wages or benefits up to age 23. Causal forests are used to explore the potential moderating role of socio-demographic variables.

Results: Some 6% of the sample have payment problems, but the share is higher among men and among people with low childhood socio-economic status. After adjusting for background characteristics, behavioural problem diagnoses are linked to a 4.6 percentage point higher risk of payment problems (95% confidence intervals 4.1–5), mood disorder diagnoses to a 2.2 percentage point higher risk (1.5–2.9), neurotic disorder diagnoses to a 2.5 percentage point higher risk (2–3.1), and substance use disorder diagnoses to a 9.3 percentage point higher risk (7.6–10.9). The associations between substance use and behavioural diagnoses and payment problems are stronger for people with low childhood socio-economic status.

Conclusion: The associations between adolescence substance and behavioural diagnoses and adulthood payment problems are particularly strong among people with low childhood socio-economic status. Reducing these associations is critical for preventing the accumulation of disadvantages.