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Psychiatric Disorders in Adolescence Linked to Absence From School and Jobs

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Adolescent diagnosis of psychiatric disorders, particularly psychosis and autism spectrum disorder (ASD), is associated with long-term absence from education, work, or training (“not in education, employment, or training” = NEET), according to study results published in British Journal of Psychiatry.

The researchers analyzed socioeconomic data and medical history from a longitudinal study of the Finnish Institute of Health and Welfare of children born in Finland in 1987. Individuals (n = 55273) included in the study lived in the country for the duration of the study (2008 to 2015) and did so. Intellectual disabilities have not been diagnosed.

The investigators discovered that 1,438 individuals (2.6%) had been outside employment, education, training, parental leave and job seekers programs for at least 5 years. Of these individuals, 65.1% were male and 65% had not completed secondary school.

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A total of 44% of the group with long-term NEET were diagnosed in adulthood with a psychiatric or neurodevelopmental disorder as an adolescent. Depressive disorders (20.1%) and anxiety disorders (16.6%) were the most common. Disproportionately, individuals with autism spectrum disorder (44%) and psychosis (36.5%) were more likely to experience NEET in the long term.

Failure to complete secondary education had the largest effect size (OR 10.1 95% CI 9.0-11.2). A total of 10% of individuals who did not complete secondary school were subsequently on long-term NEET.

The researchers found that 70.6% of individuals with autism spectrum disorder and 48.4% of individuals with psychosis experienced long-term NEET when they did not complete secondary school.

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They found that a psychiatric or neurodevelopmental diagnosis in adolescence increased the long-term odds of developing NEET in adulthood 7.1 times. ASD (OR 17.3 95% CI 11.5-26.0) and psychosis (OR 12.0 95% CI 9.5-15.2) had the highest long-term NEET effect sizes.

Associations held for Asperger’s syndrome (OR 29.4) and other ASDs (OR 21.3) when analyzed individually. When the researchers excluded individuals with schizophrenia and schizoaffective disorder, the association with other types of psychosis was (OR 14.5). Associations to other diagnostic categories remained when researchers removed individuals diagnosed with substance use disorder, psychosis, or ASD.

Patients who received inpatient treatment when they were less than 10 years old had 7.3 times higher odds of being in the long-term NEET trial. Those who received inpatient treatment between the ages of 10 and 20 had 11.5 times higher odds of a long-term NEET trial.

“Our finding of clear associations between major psychiatric diagnoses in adolescence and long-term NEET in young adults suggests that effective adolescent mental health services, including prevention, early intervention, social services, and occupational rehabilitation, should be considered as important components of a strategy to address these issues,” the researchers said. marginalization of youth.

“Combining comprehensive and targeted strategies can reduce individual suffering and the costs to society from NEET in the long run. The results of this study could serve as a baseline if the number of young people marginalized or experiencing mental disorders increases after the COVID-19 pandemic.”

Disclosure: The study author announced his affiliations with biotechnology, pharmaceutical, and/or device companies. Please see the original reference for a full list of author disclosures


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Ringbom I, Ringbom I, Suvisaari J, Kääriälä A, et al. Diagnosed with mental disorders in adolescence and subsequent long-term exclusion from education, work, or training: a longitudinal study of the national birth cohort. Br J Psychiatry. Published online October 5, 2021. doi: 10.1192 / bjp.2021.146

This article originally appeared on Psychiatry Advisor

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