A transdiagnostic study of education, employment, and training outcomes in young people with mental illness

Lee, R. S. C.; Hermens, Daniel F.; Scott, Jan; O’Dea, Bridianne; Glozier, Nick; Scott, Elizabeth

doi:10.1017/s0033291717000484

Cited by 32 publications

(37 citation statements)

References 40 publications

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“…A substantial proportion (27%) of studies did not acknowledge using any psychometric interview to establish their gold standard diagnoses. Several studies (16%) did not refer to a gold standard diagnostic manual, but speculated on comparative benefits of the transdiagnostic approach over specific diagnoses.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies reported non‐existent (e.g., DSM‐IV‐TR bipolar II disorder with psychotic features) or incorrect diagnoses (e.g., suicidality, marijuana abuse/dependence, late onset schizophrenia‐like psychosis, social anxiety disorder and social phobia as two distinct DSM‐IV disorders). Other studies included health anxiety within mental disorders, confusingly defined either as not relating to a specific diagnosis, as hypocondriasis, or as “health‐based anxiety predominant in individuals with illness anxiety disorders and somatic symptom disorders”.…”

Section: Resultsmentioning

confidence: 99%

“…Only a minority (35%) of studies explicitly acknowledged their primary outcome measure, which may be suggestive of suboptimal study quality. There was also a high variability in the number of primary outcome measures, ranging from one to thirteen (median: two measures) per study.…”

Section: Resultsmentioning

confidence: 99%

“…Less than half (44%) of the studies performed a statistical comparative assessment of the transdiagnostic approach versus a specific‐diagnostic approach. This problem was particularly relevant for interventional studies, half of which lacked a comparative specific‐diagnostic group.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Transdiagnostic psychiatry: a systematic review

et al. 2019

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The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Transdiagnostic psychiatry: a systematic review

et al. 2019

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“…b n = 86, engaged in education is coded as 0, and disengaged from education is coded as 1. c n = 77, employed is coded as 0, and unemployed is coded as 1. education is open to everyone of school age. The finding that educational attainment was associated with unemployment and NEET status in a mixed diagnostic sample is novel (Lee et al, 2017;O'Dea et al, 2014). Previous FEP research has reported that poor educational attainment was associated with unemployment and NEET status Dewa et al, 2012;Goulding, Chien, & Compton, 2010;Norman et al, 2007;Tapfumaneyi et al, 2015).…”

Section: Educationmentioning

confidence: 82%

Factors associated with vocational disengagement among young people entering mental health treatment

Caruana¹,

Allott

Farhall³

et al. 2018

Early Intervention Psych

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The likelihood of vocational disengagement did not differ across disorder groups, implying that intervention should be "transdiagnostic" and might best target education first, specifically post-secondary qualifications. Other domains or variables not measured in this study are also likely to be important, and this might include young people's support systems and symptom severity. Qualitative studies may be useful for exploring further factors relevant to vocational engagement.

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A NEET distinction: youths not in employment, education or training follow different pathways to illness and care in psychosis

Iyer

Mustafa

Gariépy

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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PurposeThe early phases of psychosis, including the prodrome, often feature educational/occupational difficulties and various symptoms and signs, that can render or keep youths “Not in Employment, Education or Training” (NEET). Conversely, NEET status itself may increase risk for illness progression and impaired functioning, and impede access to appropriate services for psychosis. As these issues have not been investigated, we aimed to examine differences in the illness and care pathways and characteristics of youths with psychosis who are NEET and non-NEET.MethodsYouths entering a catchment-based Canadian early intervention service for psychosis (N = 416) were assessed as being NEET or non-NEET and compared on symptomatology, premorbid adjustment, prodrome and duration of untreated psychosis (DUP).ResultsThirty-nine percent of the sample was NEET. Compared to non-NEET youths, NEET youths had 34% higher negative symptoms scores, longer prodromes (median of 52 weeks vs. 24 weeks), and were more often continuously ill after their first psychiatric change until the onset of psychosis (62% vs. 45%). Both groups had similar premorbid adjustment scores until late adolescence when scores were significantly worse for NEET youths. Accounting for other predictors, NEET youths had 23% longer DUPs on average, despite having made more help-seeking attempts.ConclusionsDespite being more narrowly defined, NEET status was thrice as prevalent in our sample as in the Canadian population. The NEET group followed a distinct trajectory of persistent symptoms and functional decline before presenting with a psychotic disorder. The systemic delays that NEET youths encountered indicate a need for better-targeted early identification efforts.

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A transdiagnostic study of education, employment, and training outcomes in young people with mental illness

Cited by 32 publications

References 40 publications

Transdiagnostic psychiatry: a systematic review

Transdiagnostic psychiatry: a systematic review

Factors associated with vocational disengagement among young people entering mental health treatment

A NEET distinction: youths not in employment, education or training follow different pathways to illness and care in psychosis

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