Sex-specific diagnostic trajectories and time to transition from non-SMI to severe mental illness in Chinese adolescent inpatients

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The study analyzed transitions from non-severe mental illness (non-SMI) to severe mental illness (SMI) among 884 Chinese adolescent inpatients over a median follow-up of 4.60 years.
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High diagnostic stability was observed, with 81% of schizophrenia spectrum disorders and 74% of bipolar disorders remaining unchanged during the follow-up period.
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Approximately 39.2% of patients experienced at least one diagnostic change, with depressive disorders frequently preceding bipolar disorder conversions.
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Males had a 90% higher risk of transitioning to SMI compared to females, and each additional year of age increased the risk of conversion by 38%.
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The findings highlight the importance of monitoring adolescent psychiatric presentations, particularly in older males with severe or atypical non-SMI symptoms.

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