Psychiatric disorders diagnosed in adolescence and subsequent long-term exclusion from education, employment or training: longitudinal national birth cohort study

Abstract

Background Long-term ‘not in education, employment or training’ (NEET) status is an important indicator of youth marginalisation. Aims To carry out a comprehensive overview of the associations between different psychiatric illnesses and long-term NEET status. Method We used the register-based 1987 Finnish Birth Cohort study, which includes all live births in Finland during that year. The analyses comprised 55 273 individuals after exclusions for intellectual disability, death or emigration. We predicted that psychiatric disorders, diagnosed by specialist services between 1998 and 2007 when the cohort were 10–20 years of age, would be associated with subsequent long-term NEET (defined as NEET for at least 5 years between 2008 and 2015, when they were 20–28 years of age). Results In total, 1438 individuals (2.6%) were long-term NEET during follow-up and the associations between long-term NEET and the 11 diagnostic categories we studied were statistically significant (P < 0.001). In multivariate models we included sociodemographic characteristics and upper secondary education as covariates, and the highest effect sizes, measured by odds ratios (OR) with 95% confidence intervals (CI), were found for psychosis (OR = 12.0, 95% CI 9.5–15.2) and autism spectrum disorder (OR = 17.3, 95% CI 11.5–26.0). If individuals had not successfully completed this education, 70.6% of those with autism spectrum disorder and 48.4% of those with psychosis were later long-term NEET. Conclusions Adolescents who receive treatment for psychiatric disorders, particularly autism spectrum disorder or psychosis, need support to access education and employment. This could help to prevent marginalisation in early adulthood.

Teachers With Special Needs. De-Psychiatrization of Children in Schools

“…While diagnosis can promote social identification and acceptance, and children themselves sometimes actively engage in their own psychiatrization, it can also lead to social alienation, invalidation and stigmatization (O'Connor et al, 2018;Beeker et al, 2020). In the long term, psychiatric diagnoses in youth are associated with social exclusion in later life (Ringbom et al, 2021). A final drawback of diagnostic inflation is that expansive diagnostic procedures and specialized treatments for mild problems, result in problematically high youth care costs, and draw resources away from severely troubled children and families who need it the most.…”

Transdiagnostic inflammatory subgroups among psychiatric disorders and their relevance to role functioning: a nested case-control study of the ALSPAC cohort

“…In this study, the subgroup with higher levels of inflammatory markers had a greater proportion of individuals who had psychotic experiences in the past year and a greater proportion of individuals who were not in employment, education or training, the latter finding being the strongest. Social and role functioning are increasingly recognised as important outcomes [ 55 – 59 ], and psychiatric disorders have been associated with future long-term exclusion from education, employment or training while adjusting for sociodemographic confounders [ 60 ]. In line with this, it has previously been highlighted that those with psychotic experiences represent the more severe end of a continuum of ‘common mental distress’ [ 61 ].…”

Sick or Sad? A Qualitative Study on How Dutch GPs Deal With Sadness Complaints Among Young Adults

“…Recommendations for further research would be to gain more information about the definition and prevalence of the different GP types. Another recommendation is to gain more information on the “recognized illness” with a semi-legitimized sick role that is introduced in this study, for example, by applying the constructs on recent research showing that adolescents who had received a mental health disorder diagnosis were often excluded from the labor market and education as young adults ( Ringbom et al, 2021 ). By using the semi-legitimized sick role, contributions can be made to better understand how individuals are affected by diagnoses through the legitimizing of the sick role and how subsequently society is.…”