There is limited knowledge on how age at onset relates to long-term employment in psychosis, accounting for premorbid employment. We examined whether onset age is associated with employment over a 40-year follow-up, as well as employment status two years before psychosis onset, five years after onset, and at the end of follow-up (age 57). We used national register data to identify participants of the Northern Finland Birth Cohort 1966 (NFBC1966) with psychosis (n = 225) and categorized them into three onset age groups. We analyzed 40-year employment data (1983–2023) and compared the proportion of time in employment across the follow-up period between onset age groups using nonparametric tests. We used binary logistic regression to examine whether onset after age 21 was associated with employment at selected time points, adjusting for covariates including premorbid employment. Individuals with earlier onset spent a lower proportion of time in employment during the follow-up. Later onset was associated with being employed at the 5-year follow-up, but this association became nonsignificant after adjustment. Having children was associated with being employed at all time-points. Those with earlier onset were less often employed before psychosis onset. Being employed before psychosis onset increased the odds of being employed at follow-up. Later onset is associated with a higher proportion of time in employment during a 40-year follow-up and being employed before psychosis onset. Being employed before psychosis onset emerged as a strong predictor of later employment outcomes.
Reducing longer hospital stays of acute mental health admissions is an urgent priority across psychiatric hospitals. However, there are limited risk prediction tools to identify prolonged admissions to support timelier treatment and discharge planning. We developed and validated a pragmatic risk prediction tool—the Risk of Prolonged Psychiatric Admission Score (R-PPAS)—to identify adult psychiatric admissions likely to exceed 59 days. We derived a population-based cohort using electronic health records of 4208 adult acute psychiatric admissions (aged 18–65) across six wards in two English counties (January 2016 -March 2021). We developed a prediction model from 31 candidate predictors in a derivation cohort (four wards), and converted estimates into a simplified 0–7 scoring tool. We validated the final risk-scoring tool in a validation cohort involving two different wards in a different county. Overall, 977 (23.2
Borderline personality disorder (BPD) is a severe mental illness associated with emotional and functional impairment, elevated suicide risk, and high individual and societal costs. BPD is under-researched in the general population, especially among males, and from a developmental perspective. We examined the prevalence and development of BPD symptoms in young men and explored the longitudinal associations with risk-taking behaviors. Data came from the prospective-longitudinal Cohort Study on Substance Use Risk Factors (C-SURF), a population sample of young men. Participants were screened for BPD risk using the McLean Screening Instrument (MSI-BPD) at mean age 25 (2016–2018; n = 5,516) and again at mean age 28 (2019–2020; n = 5,367). Risk-taking behaviors (e.g., interpersonal violence, gambling, substance use) were self-reported at both time points. Multilevel regression models examined within-person changes in BPD symptoms, including self-harm, and risk-taking behaviors over time. 7.4
This study examines mental health complaints among adolescents in Germany over 20 years and investigates intensive electronic media communication (EMC), problematic social media use (PSMU), and their associations with mental health complaints in 2018 and 2022. We used data from six waves (2002–2022) of the German Health Behaviour in School-aged Children (HBSC) study, comprising repeated cross-sectional samples of 11-, 13-, and 15-year-olds (N = 34,712). Mental health complaints were assessed across all waves; intensive EMC and PSMU were assessed in 2018 and 2022. Weighted multilevel regression models accounted for the hierarchical sampling structure. Mental health complaints were highest in 2022, with increases particularly pronounced among girls and older adolescents. In 2022, 46.1
The dual responsibilities of informal care for sick family members and work may increase risk of burnout. We examine sex-specific risk of mental disorders among working caregivers of children, adolescents, and young adults with versus without mental disorders. Adverse psychosocial working conditions were evaluated as effect modifiers. This longitudinal matched cohort-study analyzed register data on 596,048 female and 723,318 male caregivers according to child mental disorders commencing between 2000 and 2016 (baseline). Job-exposure matrices provided baseline psychosocial data on emotional demands and job influence. Caregiver cases (n = 219,561) and controls (n = 1,097,805) were randomly matched 1:5 based on age, sex (child/caregiver), occupation, part-/full-time employment, and baseline week. Cox models with robust standard errors estimated sex-specific hazard ratios (HR) and 95
