Kids with psychiatric problems may be more likely to have health, legal, financial and social difficulties as adults even when their mental health issues don’t persist beyond childhood, a study suggests.

Researchers tracked 1,420 kids between ages nine and 16, assessing them on up to six occasions for common psychiatric diagnoses as well as mental health problems that didn’t rise to the level of a full-blown diagnosis.

Then, they followed up with 1,273 of them on three occasions between ages 19 and 26 to see if problems earlier in life were linked to difficulties in adulthood.

Compared with kids who grew up without any mental health challenges, those who were diagnosed with a psychiatric disorder had six times higher odds of facing difficulties as a young adult. Kids with mental health problems that didn’t escalate to a clinical diagnosis still had three times higher odds of experiencing difficulties.

“The effects of childhood problems persist even if the problems themselves do not, and this persistence was seen for problems that don’t meet conventional thresholds for mental illness,” lead study author William Copeland, a researcher at Duke University Medical Center, said by email. “Both primary findings surprised me.”

His team’s subjects were participants of the Great Smokey Mountains Study, representing children in 11 predominantly rural counties in North Carolina.

Common psychiatric disorders assessed by the study team included anxiety, depression, conduct challenges, oppositional defiant disorder, attention deficit or hyperactivity disorders, and substance abuse.

Researchers also assessed adult outcomes for children who didn’t meet the clinical criteria to be diagnosed with a psychiatric disorder but still had some mental health symptoms that impaired day-to-day life.

Overall, 26 percent of the kids in the study met the diagnosis criteria for a common behavioral or emotional disorder at some point during childhood, while another 31 percent without a diagnosis still had symptoms that disrupted their lives.

About 42 percent of children with symptoms that didn’t rise to a full-blown diagnosis, and 60 percent of kids meeting diagnosis criteria, also suffered setbacks in at least one of these areas as an adult.

Health, legal, financial and social difficulties can afflict even young adults with no history of mental health issues, the authors acknowledge. In this study, 19 percent of such kids still faced challenges in at least one of these areas as an adult, the researchers report in JAMA Psychiatry.

But overall, nearly 80 percent of participants with a health, legal, financial or social difficulty in young adulthood had mental health issues as a child. This was true for close to 90 percent of young adults with difficulties in more than one aspect of their lives.

The study isn’t representative of the U.S. population, the researchers acknowledge. Childhood psychiatric cases may also have been missed if kids were diagnosed before they enrolled in the study, for example.

It’s also not clear why or how childhood psychiatric disorders later translate into difficulties for adults, said Benjamin Lahey, a public health researcher at the University of Chicago.

Lahey, the author of an editorial accompanying the study, told Reuters Health by email, “We know now that child mental disorders predict adult mental disorders, crime, lower educational and academic performance, and social instability. We need more research to understand why this happens to intervene in the right way.”