Mental Disorders In Young Adults Research Articles

3.4 Developmental Pathways From Adverse Childhood Experiences to Substance Use and Other Mental Disorders in Young Adulthood: Religiosity and Social Resilience Factors

3.4 Developmental Pathways From Adverse Childhood Experiences to Substance Use and Other Mental Disorders in Young Adulthood: Religiosity and Social Resilience Factors

Young Adult Outcomes Associated With Adolescent Suicidality: A Meta-analysis.

Suicide is one of the leading causes of death among adolescents worldwide. Adolescents who present with suicidality may be at an increased risk for future mental illness and suicidality in young adulthood. The objective of this study was to systematically assess the relationship between adolescent suicidal ideation and suicide attempts (suicidality) and young adult psychopathological outcomes. Medline, Embase, and PsychInfo (OVID Interface) were searched for articles published before August 2021. Included articles were prospective cohort studies that compared young adult (19-30 years) psychopathological outcomes between suicidal and nonsuicidal adolescents. We extracted data related to suicidality in adolescence, mental health outcomes in young adulthood, and covariates. Outcomes were analyzed via random-effect meta-analyses and reported using odds ratios. Of 9401 references screened, we included 12 articles comprising over 25 000 adolescents. Four outcomes were meta-analyzed: depression, anxiety, suicidal ideation, and suicide attempt. Adjusted meta-analyses showed that adolescent suicidal ideation was associated with young adult suicide attempt (odds ratio [OR] = 2.75, 95% confidence interval [CI]:1.70-4.44), depressive disorders (OR = 1.58, 95% CI: 1.20-2.08), and anxiety disorders (OR = 1.41, 95% CI: 1.01-1.96), whereas adolescent suicide attempts were associated with young adult suicide attempt (OR = 5.71, 95% CI: 2.40-13.61), and young adult anxiety disorders (OR = 1.54, 95% CI: 1.01-2.34). Results for young adult substance use disorders were mixed. Significant heterogeneity between studies was observed because of differences in timing, method of assessments, and covariate adjustment. Adolescents experiencing suicidal ideation or with a history of suicide attempt may have increased odds of further suicidality or mental disorders in young adulthood.

Robbery Victimization in Early Adulthood, and Depression and Anxiety at Age 30 Years: Results From the 1982 Pelotas (Brazil) Birth Cohort Study.

Robbery is one of the most common urban crimes, but little is known about its relationship with mental disorders in young adults. This study aimed to assess the relationship between robbery victimization and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and comorbidity between MDD and GAD at 30 years of age. A birth cohort study has followed all children born in the city of Pelotas, southern Brazil, since 1982. At ages 23 and 30 years, participants were interviewed and asked about lifetime and recent experiences of robbery. Covariates were measured in interviews between birth and age 30 years. MDD and GAD were measured using the MINI-International Neuropsychiatric Interview. Adjusted prevalence ratio (aPR) and corresponding 95% confidence interval (CI) for associations between robbery and mental disorders were calculated using Poisson regression with robust standard error. Of 3,701 cohort members interviewed at age 30 years, 42% reported robbery victimization during their lifetime. Victimization across three periods (lifetime, past 10 years, past 12 months) was associated with increased occurrence of MDD, GAD, as well as the MDD and GAD comorbidity. The strongest associations were found to robbery occurring in the previous 12 months with the MDD and GAD comorbidity, both for burglary at home (aPR 2.52; 95% CI 1.52–4.22) or community family victimization (aPR 2.10; 95% CI 1.34–3.27). These findings highlight the importance of community violence for mental health in young adulthood, and the need for public policies to prevent violence as well as support services for victims to mitigate its adverse health consequences.

Abstract 10143: Rising Burden Of Cardiovascular Disease Risk Factors And Acute Cardiac Events In Young Adults With Comorbid Depression: A Comparison Of Two Nationwide US Cohorts Hospitalized 10-years Apart

Background: Previous literature suggests an association between depression and cardiovascular diseases. Due to the paucity of data in the young, we aimed to investigate the prevalence of cardiovascular disease (CVD) risk factors and associated major adverse cardiac and cerebrovascular events (MACCE) in young adults hospitalized with comorbid depression a decade apart. Methods: We conducted a retrospective analysis of the National Inpatient Sample database for the years 2007 and 2017. Young adults (18-44 years) hospitalized with comorbid depression were identified using ICD-9 CM/ICD-10 codes. Frequency and trends in demographics and comorbidities including cardiovascular disease risk factors and MACCE were compared between the 2017 vs. 2007 cohort. Results: A total of 1,274,118 (median age 34 [27-40] yrs, 68.7% females) young admissions were recorded with comorbid depression. When the 2007 cohort was compared with the 2017 cohort, a rising trend in depression was observed (5.5% vs. 8.2%) (p <0.001). The 2017 cohort of young adults with depression more often consisted of male, non-white patients . Burden of CVD risk factors (hypertension, diabetes with chronic complications, smoking and obesity) was also greater in the 2017 cohort.. Although the all-cause mortality remained comparable (0.3%) in both cohorts, there was a significantly higher rate and risk of MACCE including acute myocardial infarction (aOR 1.18, 95%CI:1.10-1.26), atrial fibrillation/ flutter (aOR 1.47, 95%CI:1.40-1.54) and stroke (aOR 1.33, 95%CI: 1.26-1.40) (p <0.001) in the 2017 cohort (Table 1) . Conclusion: This nationwide study reveals alarmingly increased prevalence of CVD risk factors and increase in the rate and risk of MACCE in two cohorts of young adults with comorbid depression studied a decade apart. Burden of mental disorders in young adults has been rising in the last decade and warrants extra vigilance by clinicians to curtail CVD risk and improve MACE-associated outcomes.

Associations between Adolescents\u2019 Social Leisure Activities and the Onset of Mental Disorders in Young Adulthood

The association of leisure time activities with specific mental disorders has mainly remained unclear because of lack of such research. This study analyzed the association of different levels of social leisure time activity during adolescence (ages 15–16 years) with the incidence of mental disorders during adolescence and young adulthood between the ages of 16–33 years. The study population consisted of 6838 (females 51.5%) participants from the longitudinal follow-up study, the Northern Finland Birth Cohort 1986, covering 72% of the total 1986 birth cohort. Psychiatric morbidity of the participants was followed through nationwide health registers until the end of the year 2018 when the participants were 33 years old. High social leisure time activity in adolescence associated with lower incidence of psychiatric disorders in general, and specifically, with affective, anxiety, and substance use disorders. Low social leisure time activity was related to increased incidence of any psychiatric disorder in general, and particularly to anxiety and behavioral disorders. In terms of prevention of mental disorders, these study findings encourage families, schools and other communities to continue to enhance and develop community-based social leisure time activities for children and adolescents.

An Online Cultural Experience for Mental Health in People Aged 16-24 Compared to a Typical Museum Website: A Randomised Controlled Trial

Background: The mental health of young people is a major public health concern that has been exacerbated during the COVID-19 pandemic. There is growing interest in cultural assets such as museums to improve mental health. However, there is a dearth of experimental research regarding the impact of cultural assets on common mental disorders in young adults, and in online experiences, which may improve accessibility.Methods/design: The O-ACE POP (Online Active Community Engagement Proof of Principle) study is a randomised controlled trial of a co-produced online museum experience named Ways of Being (WoB) compared with the Ashmolean Website (Ash) on negative affect, positive affect and symptoms of anxiety and depression (K10) over a 3-day intervention phase followed by a 6-week follow up assessment.Findings: 463 people aged 16-24 were randomised: 231 to WoB and 232 to Ash and 349 (74%) completed to 6 weeks. Negative affect was lower over the intervention phase in those allocated to WoB than Ash (WoB-Ash n=448, NA -0.158, p=0·010). For males (179, 39%), those aged 18-24 (422, 91%), non-white ethnic groups (88, 19%), regular users of online culture (238, 51%), those not on antidepressants (363, 78%), and individuals without probable moderate-severe mental health problems (327, 71%) at baseline, negative affect was significantly lower in those allocated to WoB compared to the Ash. Mean K10 reduced over the trial period, from 27·1 (95% CI= 26·6-27·7) to 23·3 (95% CI= 22·5-24·1), as did negative affect whereas positive affect remained relatively stable. Trial recruitment was rapid and feedback positive with broad geographical, occupational and ethnic diversity.Interpretation: Cultural interventions may improve MH outcomes in a measurable way. Populations that are underserved, both clinically and in research such as non-white ethnic groups, non-students and males and were reached in this study. This demonstrates the importance of measuring psychometric outcomes and the potential for co-produced community cultural resources to support mental health.Trial Registration: Trial Registration: NCT04663594Funding: This study is sponsored by the University of Oxford COVID-19 Research Response Fundand supported by the NIHR Oxford Health Biomedical Research Centre, The WestminsterFoundation and the Huo Family FoundationDeclaration of Interest: AKP and MV were supported by a grant provided by the Huo Family Foundation. All other authors have nothing to declare. Ethical Approval: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All procedures involving human subjects were approved by the University of Oxford Central University Research Ethics Committee (CUREC), approval reference number R70187/RE007.

Socioeconomic deprivation in early life and symptoms of depression and anxiety in young adulthood: mediating role of hippocampal connectivity.

Experience of early-life socioeconomic deprivation (ELSD) may increase the risk of mental disorders in young adulthood. This association may be mediated by structural and functional alterations of the hippocampus. We conducted a prospective cohort study on 122 participants of the European Longitudinal Study of Pregnancy and Childhood. Information about ELSD was collected via questionnaire from mothers during the first 18 months of participants' lives. At age 23-24, participants underwent examination by structural magnetic resonance imaging, resting-state functional connectivity and assessment of depressive symptoms (Mood and Feelings Questionnaire) and anxiety (Spielberger State-Trait Anxiety Inventory). The association of ELSD with brain outcomes in young adulthood was assessed with correlations, linear regression (adjusting for sex, socioeconomic position and mother's mental health) and moderated mediation analysis. Higher ELSD was associated with greater depressive symptoms (B = 0.22; p = 0.001), trait anxiety (B = 0.07; p = 0.02) and lower global connectivity of the right hippocampus (B = -0.01; p = 0.02). These associations persisted when adjusted for covariates. In women, lower global connectivity of the right hippocampus was associated with stronger trait anxiety (B = -4.14; p = 0.01). Global connectivity of the right hippocampus as well as connectivity between the right hippocampus and the left middle temporal gyrus mediated the association between ELSD and trait anxiety in women. Higher ELSD correlated with a lower volume of the right hippocampus in men, but the volume of the right hippocampus was not related to mental health. Early preventive strategies targeted at children from socioeconomically deprived families may yield long-lasting benefits for the mental health of the population.

Adverse childhood experiences (ACEs) on mental disorders in young adulthood: Latent classes and community violence exposure

Adverse childhood experiences (ACEs) have significant impacts on mental health outcomes. There is a growing interest in expanding the scope of ACEs beyond household environments. To date, few studies examine multidimensional ACEs with community violence. This study aims to (1) identify underlying ACE classes including exposure to community violence, and (2) investigate the associations of ACE classes with mental disorders in adulthood: depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). We employed Latent Class Analysis (LCA) and logistic regression analyses using the data from the National Longitudinal Study of Adolescent and Adult Health (Add Health). The LCA identified four heterogeneous ACE classes: (1) child maltreatment (17.47%), (2) household dysfunction (14.39%), (3) community violence (5.36%), and (4) low adversity (62.79%). Three logistic analyses showed that the “child maltreatment” class was more likely to report a depression (OR = 1.56, CI = 1.26–1.92), anxiety (OR = 1.31, CI = 1.06–1.62), and PTSD (OR = 1.97, CI = 1.35–2.87) in adulthood compared to the “low adversity” class. Also, the “community violence” class was more likely to have PTSD (OR = 2.15, CI = 1.14–4.06) in adulthood, compared to the “low adversity” class. However, the “household dysfunction” class was not significantly different in all three mental disorders from the “low adversity” class. Findings supported the differences in mental disorders in young adulthood by types of exposures to ACEs. The study highlights the importance of considering types of ACEs exposure for promoting mental health of young adults.

Mental Disorders in Young Adults from Families with the Presenilin-1 Gene Mutation E280A in the Preclinical Stage of Alzheimer's Disease.

Background:There are forms of Alzheimer’s disease (AD) that have an autosomal dominant inheritance pattern; one of them is caused by the E280A mutation in the gene that codes for Presenilin-1 (PSEN1). Studying families of people with this mutation allows the evaluation of characteristics of the subjects before cognitive decline begins.Objective:To determine whether having the mutation E280A in PSEN1 increases the risk of presenting mental disorders in adults under 30 years old who are in the preclinical stage of AD and may be eligible for primary prevention studies of AD.Methods:A psychiatric evaluation was made to 120 people belonging to families with a history of early onset AD. Of these, 62 carried the E280A mutation in PSEN1. The occurrence of mental disorders between carriers and non-carriers of the mutation was compared.Results:No statistically significant differences were found in the frequency of any mental disorder between the group of carriers and non-carriers of the mutation (Hazard Ratio: 0.80, 95% CI 0.49 to 1.31); nor were differences observed when evaluating specific disorders.Conclusion:The E280A mutation does not increase the risk of mental disorders before the age of 30 in the relatives of people affected by familial AD. Studies with larger sample sizes are required to assess the risk of low incidence mental disorders.

WITHDRAWN: Mental Disorders in Young Adults from Families with the Presenilin-1 Gene Mutation E280A in the Preclinical Stage of Alzheimer's Disease.

Ahead of Print article withdrawn by publisher.

Effectiveness of cognitive behavioral therapy on generalized anxiety disorder in college and graduate students: Literature review

There has been a significant increase in the incidence of mental disorders in young adults and often been neglected due to social stigma. However, due to the increased awareness, there has been increased demand for services and counseling centers which often have long waiting lists. Due to the limited resources available, the effectiveness of the therapy method to provide “best” available treatment is needed. In this literature review, the effectiveness of cognitive behavioral therapy (CBT) on generalized anxiety disorder in college and graduate students, a systematic review and meta-analysis of randomized controlled trials (RCTs) and two RCTs are included. The selected studies suggested significant improvement in general anxiety disorder in college or graduate students by providing CBT. The literature reviewed indicates improvement in generalized anxiety in graduate students' population by CBT, limited studies have been conducted specifically to this population, and since young adults constitute majority of the world population suggesting economic growth, there is a need for more research on the effectiveness of the therapy in this specific population per se.

Effect of Childhood Poverty and Trauma on Adult Depressive Symptoms Among Young Men in Peri-Urban South African Settlements

PurposeDepressive disorders contribute to health declines among young men, but little is known about how childhood trauma alongside poverty alters depressive symptoms in young adulthood. These life-course dynamics are particularly under-researched in African settings. MethodsWe assessed how childhood trauma and poverty were associated with depressive symptomology among young men (aged 18–30 years). Data were collected through community-based surveys in two peri-urban, South African settlements. Validated measures assessed childhood abuse, depressive symptomology, and food insecurity. Markers of childhood poverty and young adult socioeconomic predictors were also assessed. ResultsA total of 2,427 young men reported low levels of income, food security, and education. One-third of the sample (39.2%) reported symptoms consistent with probable depression. The majority (76.9%) reported one or more forms of childhood abuse, which was predicted by childhood hunger. Compared with counterparts without childhood trauma, those with physical, sexual, or psychological childhood abuse had a higher risk of later depressive symptoms (adjusted odds ratio [AOR]=2.37,2.42,2.39, respectively). A fully saturated linear mixed model showed each form of childhood trauma predicted increased depressive symptomology in adulthood, with the combination of physical, sexual, and psychological abuse strongly predicting increased depressive symptoms (coef=6.78, 95%CI=5.78–8.17). In all models, childhood poverty and adult poverty independently predicted young adult depressive symptoms. ConclusionHousehold poverty may be a key reason that children experience abuse and, in turn, common mental disorders in young adulthood. Structural interventions for food security, employment, and parenting are essential to break the intergenerational nexus of poverty, trauma, and health in peri-urban settings.

Prevalence and stability of mental disorders among young adults: findings from a longitudinal study

BackgroundMental disorders often have onset early in life, contribute substantially to the global disease burden, and may interfere with young people’s ability to complete age-relevant tasks in important developmental periods. However, knowledge about prevalence and course of mental disorders in young adulthood is sparse. The aim of the current study was to estimate prevalence and stability of mental disorders from the twenties to the thirties/forties.MethodsDSM-IV mental disorders were assessed with the Composite International Diagnostic Interview in two waves (1999–2004 and 2010–2011) in 1623 young adult Norwegian twins (63.2% women, aged 19–29 years in wave 1).ResultsIn wave 1, the 12-month prevalence of any mental disorder among people in the twenties was 19.8% (men) and 32.4% (women), anxiety disorders: 9.6% (men) and 26.7% (women), anxiety disorders excluding specific phobias: 2.5% (men) and 6.9% (women), major depressive disorder (MDD): 4.4% (men) and 7.2% (women), and alcohol use disorder (AUD): 8.7% (men) and 4.4% (women). The prevalence of any mental disorder decreased from the twenties to the thirties/forties. This was due to a decrease in AUD and specific phobias. Anxiety disorders in the twenties predicted anxiety disorders and MDD ten years later, even when controlling for the association between these disorders in the twenties. MDD in the twenties predicted MDD ten years later. At both ages, two-week and 12-month prevalence estimates differed markedly for MDD - indicating an episodic course.ConclusionsCommon mental disorders are highly prevalent among young adults in the twenties, and somewhat less prevalent in the thirties/forties. Those who suffer from one mental disorder in the twenties are at considerably increased risk for suffering from a disorder ten years later as well. This may have significant implications for young people’s ability to attain education, establish a family, and participate in occupational life.

Efficacy of a Web-Based Guided Recommendation Service for a Curated List of Readily Available Mental Health and Well-Being Mobile Apps for Young People: Randomized Controlled Trial.

BackgroundMental disorders are highly prevalent for the people who are aged between 16 and 25 years and can permanently disrupt the development of these individuals. Easily available mobile health (mHealth) apps for mobile phones have great potential for the prevention and early intervention of mental disorders in young adults, but interventions are required that can help individuals to both identify high-quality mobile apps and use them to change health and lifestyle behavior.ObjectivesThe study aimed to assess the efficacy of a Web-based self-guided app recommendation service (“The Toolbox”) in improving the well-being of young Australians aged between 16 and 25 years. The intervention was developed in collaboration with young adults and consists of a curated list of 46 readily available health and well-being apps, assessed and rated by professionals and young people. Participants are guided by an interactive quiz and subsequently receive recommendations for particular apps to download and use based on their personal goals.MethodsThe study was a waitlist, parallel-arm, randomized controlled trial. Our primary outcome measure was change in well-being as measured by the Mental Health Continuum-Short Form (MHC-SF). We also employed ecological momentary assessments (EMAs) to track mood, energy, rest, and sleep. Participants were recruited from the general Australian population, via several Web-based and community strategies. The study was conducted through a Web-based platform consisting of a landing Web page and capabilities to administer study measures at different time points. Web-based measurements were self-assessed at baseline and 4 weeks, and EMAs were collected repeatedly at regular weekly intervals or ad hoc when participants interacted with the study platform. Primary outcomes were analyzed using linear mixed-models and intention-to-treat (ITT) analysis.ResultsA total of 387 participants completed baseline scores and were randomized into the trial. Results demonstrated no significant effect of “The Toolbox” intervention on participant well-being at 4 weeks compared with the control group (P=.66). There were also no significant differences between the intervention and control groups at 4 weeks on any of the subscales of the MHC-SF (psychological: P=.95, social: P=.42, emotional: P=.95). Repeat engagement with the study platform resulted in a significant difference in mood, energy, rest, and sleep trajectories between intervention and control groups as measured by EMAs (P<.01).ConclusionsThis was the first study to assess the effectiveness of a Web-based well-being intervention in a sample of young adults. The design of the intervention utilized expert rating of existing apps and end-user codesign approaches resulting in an app recommendation service. Our finding suggests that recommended readily available mental health and well-being apps may not lead to improvements in the well-being of a nonclinical sample of young people, but might halt a decline in mood, energy, rest, and sleep.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000710628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366145 (Archived by WebCite at http://www.webcitation.org/ 6pWDsnKme)

Common mental disorders in young adults born late-preterm.

Results of adulthood mental health of those born late-preterm (34 + 0-36 + 6 weeks + days of gestation) are mixed and based on national registers. We examined if late-preterm birth was associated with a higher risk for common mental disorders in young adulthood when using a diagnostic interview, and if this risk decreased as gestational age increased. A total of 800 young adults (mean = 25.3, s.d. = 0.62 years), born 1985-1986, participated in a follow-up of the Arvo Ylppö Longitudinal Study. Common mental disorders (mood, anxiety and substance use disorders) during the past 12 months were defined using the Composite International Diagnostic Interview (Munich version). Gestational age was extracted from hospital birth records and categorized into early-preterm (<34 + 0, n = 37), late-preterm (34 + 0-36 + 6, n = 106), term (37 + 0-41 + 6, n = 617) and post-term (⩾42 + 0, n = 40). Those born late-preterm and at term were at a similar risk for any common mental disorder [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.67-1.84], for mood (OR 1.11, 95% CI 0.54-2.25), anxiety (OR 1.00, 95% CI 0.40-2.50) and substance use (OR 1.31, 95% CI 0.74-2.32) disorders, and co-morbidity of these disorders (p = 0.38). While the mental disorder risk decreased significantly as gestational age increased, the trend was driven by a higher risk in those born early-preterm. Using a cohort born during the advanced neonatal and early childhood care, we found that not all individuals born preterm are at risk for common mental disorders in young adulthood - those born late-preterm are not, while those born early-preterm are at a higher risk. Available resources for prevention and intervention should be targeted towards the preterm group born the earliest.

The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey.

IntroductionAlthough substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population.MethodsData were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates. Data from a subset (n = 1766; aged 18 to 30 years) of the SASH sample of 4351 individuals were analysed. The Composite International Diagnostic Interview Version 3 (CIDI 3.0) was used to elicit basic demographic details and information regarding mental illness and substance use. Multiple regression analyses, adjusted for age and gender, were used to identify associations between mental disorders and substance use.ResultsSignificant associations were found between substance use and mood and anxiety disorders, with a particularly strong relationship between cannabis use and mental disorder.ConclusionThe results are consistent with those from previous studies, and reinforce the argument that comorbid substance use and mental disorders constitute a major public health burden.

Common adolescent mental disorders: transition to adulthood

Mental disorders are common, although reported rates differ according to developmental stage. 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar The prevalence of common mental disorders such as depression increases in adolescence, 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar , 2 Kim-Cohen J Caspi A Moffitt TE Harrington H Milne BJ Poulton R Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry. 2003; 60: 709-717 Crossref PubMed Scopus (1476) Google Scholar and many people will experience such a disorder by young adulthood. 3 Copeland W Shanahan L Costello EJ Angold A Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry. 2011; 50: 252-261 Summary Full Text Full Text PDF PubMed Scopus (198) Google Scholar Mental disorder in adolescence increases the risk of later adult disorder, 4 Clark C Rodgers B Caldwell T Power C Stansfeld S Childhood and adulthood psychological ill health as predictors of midlife affective and anxiety disorders. Arch Gen Psychiatry. 2007; 64: 668-678 Crossref PubMed Scopus (129) Google Scholar , 5 Fergusson DM Boden JM Horwood LJ Recurrence of major depression in adolescence and early adulthood, and later mental health, educational and economic outcomes. Br J Psychiatry. 2007; 191: 335-342 Crossref PubMed Scopus (201) Google Scholar , 6 Pine DS Cohen P Gurley D Brook J Ma J The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry. 1998; 55: 56-64 Crossref PubMed Scopus (1316) Google Scholar and adults with mental disorder often have their first episode in adolescence. 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar , 7 Newman DL Moffitt TE Caspi A Magdol L Silva PA Stanton WR Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. J Consult Clin Psychol. 1996; 64: 552-562 Crossref PubMed Scopus (492) Google Scholar Therefore, adolescence is potentially an important time for mental health interventions to reduce both present and long-term impairment. However, there is little detailed knowledge about the prognosis of common adolescent mental disorders during the transition to adulthood. A greater understanding of the course and prognosis of adolescent-onset common mental disorders is needed to identify those at highest risk of later problems, to inform decisions about when to intervene, and to help allocate clinical resources efficiently. The prognosis of common mental disorders in adolescents: a 14-year prospective cohort studyEpisodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life. Full-Text PDF

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study

Most adults with common mental disorders report their first symptoms before 24 years of age. Although adolescent anxiety and depression are frequent, little clarity exists about which syndromes persist into adulthood or resolve before then. In this report, we aim to describe the patterns and predictors of persistence into adulthood. We recruited a stratified, random sample of 1943 adolescents from 44 secondary schools across the state of Victoria, Australia. Between August, 1992, and January, 2008, we assessed common mental disorder at five points in adolescence and three in young adulthood, commencing at a mean age of 15.5 years and ending at a mean age of 29.1 years. Adolescent disorders were defined on the Revised Clinical Interview Schedule (CIS-R) at five adolescent measurement points, with a primary cutoff score of 12 or higher representing a level at which a family doctor would be concerned. Secondary analyses addressed more severe disorders at a cutoff of 18 or higher. 236 of 821 (29%; 95% CI 25-32) male participants and 498 of 929 (54%; 51-57) female participants reported high symptoms on the CIS-R (≥12) at least once during adolescence. Almost 60% (434/734) went on to report a further episode as a young adult. However, for adolescents with one episode of less than 6 months duration, just over half had no further common mental health disorder as a young adult. Longer duration of mental health disorders in adolescence was the strongest predictor of clear-cut young adult disorder (odds ratio [OR] for persistent young adult disorder vs none 3.16, 95% CI 1.86-5.37). Girls (2.12, 1.29-3.48) and adolescents with a background of parental separation or divorce (1.62, 1.03-2.53) also had a greater likelihood of having ongoing disorder into young adulthood than did those without such a background. Rates of adolescent onset disorder dropped sharply by the late 20s (0.57, 0.45-0.73), suggesting a further resolution for many patients whose symptoms had persisted into the early 20s. Episodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life. Australia's National Health and Medical Research Council.

The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey

BACKGROUND: Although substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population. METHODS: Data were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates. Data from a subset (n=1766; aged 18 to 30 years) of the SASH sample of 4351 individuals were analysed. The Composite International Diagnostic Interview Version 3 (CIDI 3.0) was used to elicit basic demographic details and information regarding mental illness and substance use. Multiple regression analyses, adjusted for age and gender, were used to identify associations between mental disorders and substance use. RESULTS: Significant associations were found between substance use and mood and anxiety disorders, with a particularly strong relationship between cannabis use and mental disorder. CONCLUSION: The results are consistent with those from previous studies, and reinforce the argument that comorbid substance use and mental disorders constitute a major public health burden.

Attempted suicide in mental disorders in young adulthood

Nationwide general population study establishes the prevalence of suicide attempts in different mental disorders among young adults and their sociodemographic correlates. Current psychiatric symptoms are also examined. A random sample of 1,894 young Finnish adults aged 20-34 years were approached to participate in a questionnaire containing several screens for mental health interviews. All screen positives and random sample of screen negatives were invited to an SCID interview. Altogether 546 subjects participated in the interview. Diagnostic assessment and lifetime history of suicide attempts were based on all available systematically evaluated information from the questionnaire, the interview and/or case records. The lifetime prevalence of suicide attempts was 5.6% in men and 6.9% in women. Both mental disorders and poor educational and occupational functioning were associated with lifetime suicide attempts. Lifetime history of suicide attempts was associated with current psychological distress, problems related to substance use and other psychiatric symptoms, even after taking current Axis I disorder into account. Suicide attempts were most common in persons with psychotic disorders (41%). These results suggest that continued efforts are needed to outreach and treat effectively young adults with serious mental disorders. Young people who make a suicide attempt should be offered treatment. It seems also important to prevent psychosocial alienation of young people by providing them with adequate education and work possibilities.