Developmental trajectories of common mental health issues such as ADHD symptoms, internalising problems, and externalising problems can often be usefully summarised in terms of a small number of ‘developmental subtypes’ (e.g., ‘childhood onset’, ‘adolescent onset’) that may differ in their profiles or levels of clinically meaningful variables such as etiological risk factors. However, given the strong tendency for symptoms in these domains to co-occur, it is important to consider not only developmental subtypes in each domain individually, but also the joint developmental subtypes defined by symptoms trajectories in all three domains together (e.g., ‘late onset multimorbid’, ‘pure internalising’, ‘early onset multimorbid’). Previous research has illuminated the joint developmental subtypes of ADHD symptoms, internalising problems, and externalising problems that emerge from normative longitudinal data using methods such as group-based trajectory modelling, as well as predictors of membership in these developmental subtypes. However, information on the long-term outcomes of developmental subtype membership is critical to illuminate the likely nature and intensity of support needs required for individuals whose trajectories fit different developmental subtypes. We, therefore, evaluated the relations between developmental subtypes previously derived using group-based trajectory modelling in the z-proso study (n = 1620 with trajectory data at ages 7, 8, 9, 10, 11, 12, 13, 15) and early adulthood outcomes. Individuals with multimorbid trajectories but not ‘pure’ internalising problem elevations showed higher levels of social exclusion and delinquency at age 20. These associations held irrespective of the specific developmental course of symptoms (e.g., early versus late onset versus remitting). There was also some evidence that intimate partner violence acts as a form of heterotypic continuity for earlier externalising problems. Results underline the need for early intervention to address the pathways that lead to social exclusion and delinquency among young people with multiple co-occurring mental health issues.

常见心理健康问题（例如多动症症状、内化问题和外化问题）的发展轨迹通常可以有效地概括为少数可能不同的“发展亚型”（例如“儿童期发病”、“青少年期发病”）。具有临床意义的变量（例如病因学风险因素）的概况或水平。然而，鉴于这些领域的症状同时出现的强烈趋势，重要的是不仅要单独考虑每个领域的发育亚型，还要考虑由所有三个领域的症状轨迹共同定义的联合发育亚型（例如，“晚期”）发病多病”、“纯粹内化”、“早发多病”）。先前的研究已经阐明了 ADHD 症状的联合发展亚型、内化问题和外化问题，这些问题是使用基于群体的轨迹建模等方法以及这些发展亚型成员资格的预测因子从规范纵向数据中出现的。然而，关于发展亚型成员资格的长期结果的信息对于阐明轨迹适合不同发展亚型的个人所需的支持需求的可能性质和强度至关重要。因此，我们评估了之前在 z-proso 研究中使用基于群体的轨迹模型得出的发育亚型之间的关系（n = 1620，轨迹数据为 7、8、9、10、11、12、13、15 岁）和成年早期的结果。具有多种病态轨迹但并非“纯粹”内化问题升高的个体在 20 岁时表现出更高水平的社会排斥和犯罪行为。无论症状的具体发展过程如何（例如，早发型、晚发型、缓解型），这些关联都成立。还有一些证据表明，亲密伴侣暴力是早期外化问题的异型连续性的一种形式。研究结果强调，需要早期干预，以解决导致同时存在多种心理健康问题的年轻人社会排斥和犯罪的途径。