OBJECTIVE: This study investigated whether (i) young adults’ mental health problems change when starting career work, (ii) potential changes in mental health problems differ by psychosocial work quality, and (iii) mental health problems during adolescence moderate potential changes in mental health by psychosocial work quality. METHODS: We used data from the TRracking Adolescents’ Individual Lives Survey (TRAILS) cohort. Follow-up time was 2–4 years. Mental health was measured with the youth and adult self-report scales. Longitudinal fixed-effects regression analyses were applied to estimate within-person changes in mental health of young adults entering career work with good, moderate, or poor psychosocial work quality (N=850) and model adolescent mental health as effect modifier of this change (N=766). RESULTS: When psychosocial job quality of the first career job was ignored, mental health problems did not significantly change among young adults after having entered career work compared with not having career work. Taking psychosocial job quality into account, mental health problems increased among young adults starting career work in poor psychosocial quality compared with not having career work (adjusted mean score increase 0.12, 95% confidence interval 0.03−0.21). No significant changes in mental health problems were found for young adults entering work with moderate-to-good psychosocial work quality. We found no evidence for adolescent mental health problems as moderator. CONCLUSION: Psychosocial work quality potentially plays a role for young workers’ mental health. Improving poor psychosocial work quality of young adults might contribute to a mentally healthier start of one’s working life.

BACKGROUND:Little is known about whether and how the timing and duration of work-family experiences are associated with subsequent mental health outcomes in the current generation of young adults. Such information may inform the development of timely interventions to promote better mental health. In this study, we use two complementary approaches to examine the complex relationship between work, family and mental health in young Dutch adults born around 1990. First, we examine the association between work-family trajectories and mental health. Second, we examine which timing and duration features of work-family trajectories are related to subsequent mental health. METHODS:Sequences of monthly work-family states from ages 18 to 28 years were constructed in a sample of Dutch young adults participating in the TRAILS cohort study (N = 992). Mental health was operationalised as experiencing internalising or externalising problems at age 29. We created a typology of work-family trajectories by clustering individual sequences and used regression analysis to examine the association between work-family trajectories and mental health. Next, we used the Boruta feature selection algorithm to identify timing and duration features of work-family trajectories related to mental health at age 29 and conducted a regression analysis to examine the associations between the identified features and mental health. All regression analyses were controlled for mental health problems between ages 11 and 16. RESULTS:Women in the work-family trajectories long education and inactive were most likely to experience internalising problems at age 29. Women in the work-family trajectory inactive were also most likely to experience externalising problems. In line, the feature selection analysis showed that both being inactive and being in education in the first stage of young adulthood, being a parent and in work in the last stage of young adulthood and the total duration of inactivity were associated with internalising problems. Being inactive in the first and the last stages of young adulthood and being inactive and a parent in the third stage of young adulthood were associated with externalising problems. Men in the work-family trajectory inactive were most likely to experience both internalising and externalising problems. Additionally, men in the work-family trajectory continuous education and work were most likely to report externalising problems. The feature selection analysis showed that being in education in the last stage of young adulthood was associated with internalising problems. Similar to women, inactivity in the first stage of young adulthood was associated with internalising and externalising problems at age 29. CONCLUSION:Work-family trajectories in young adulthood are associated with mental health problems at age 29, even when controlling for early-life mental health problems. In particular, the timing and duration of inactivity and education were found to be associated with subsequent mental health problems. Combining sequence analysis and feature selection provides a more nuanced understanding of the dynamics between work-family experiences and mental health.

The present study examines the relationship between the quality of partner relationships and work engagement and burnout, considering the satisfaction and frustration of basic psychological needs within that private relationship. We argue that basic psychological needs mediate between the partner relationship and work, serving as an explanatory mechanism in that relationship. We hypothesized that when things go well at home and a person's basic needs in the partner relationship are fulfilled, it positively associates with work engagement and negatively with burnout. In contrast, we expected that when basic psychological needs are frustrated, it would have a negative relationship with work engagement and a positive relationship with burnout. We analyzed data collected from 317 Dutch residents in committed partner relationships using structural equation modeling in a parallel mediation model. As hypothesized, the results indicate that a supportive partner relationship is associated with higher satisfaction of basic needs, which in turn enhances work engagement and decreases the risk of burnout. Contrary to our hypothesis, we found that the frustration of a partner's basic psychological needs in the partner relationship was positively associated with increased energy for work (work engagement) and lower levels of exhaustion (burnout). Individuals may channel their energy into work when their partner relationship compromises their basic needs. Implications for practice and future research are discussed.

Purpose Work-family life courses have been associated with mental health at various time points in life but little is known about how mental health develops during these work-family life courses. The aim of this study was to examine mental health trajectories from adolescence to young adulthood in women and men with different work-family life courses. Methods Data from 992 young adults participating in the 18-year follow-up TRacking Adolescents' Individual Lives Survey (TRAILS) were used. Work-family life courses from ages 18 to 28 years were previously constructed using sequence analysis. For each work-family life course, trajectories of internalising and externalising problems from ages 11 to 29 years were estimated using a multi-group random intercept growth model. Differences in mental health trajectories were examined across work-family life courses. Results For women, trajectories of internalising and externalising problems in young adulthood differed significantly between work-family life courses (p = 0.037 and p < 0.001, respectively). Women in the inactive work-family life course reported the highest scores of internalising and externalising problems during the entire young adulthood but the differences in mental health scores became most pronounced at age 29. Trajectories of internalising and externalising problems of men did not significantly differ between the work-family life courses. Conclusion Mental health trajectories differed between women depending on their work-family life course. In men, differences between work-family life courses were less pronounced. Future studies should examine which work-family events and transitions captured in work-family life courses are associated with subsequent mental health problems during longer follow-up.

OBJECTIVES: Return to work (RTW) of workers with mental disorders is often a process of gradually increasing work hours over time, resulting in a RTW trajectory. This study aimed to investigate 2-year RTW trajectories by mental disorder diagnosis, examining the distribution of age, sex and contracted work hours across the diagnosis-specific RTW trajectories. METHODS: Sickness absence episodes diagnosed within the ICD-10 chapter V (mental and behavioral disorders) and ICD-10 Z73.0 (burnout) were retrieved from a Dutch occupational health service register, together with age, sex and contracted work hours. Sickness absence episodes due to adjustment disorders (N=25 075), anxiety disorders (N=1335), burnout (N=3644), mood disorders (N=5076), and post-traumatic stress disorders (N=2393) were most prevalent and included in latent class growth analysis (LCGA) to estimate 23-month RTW trajectories. RESULTS: Four main RTW trajectories were identified for all mental disorder diagnoses: fast full RTW [range 82.4% (mood disorders) to 92.0% (adjustment disorders) of the study population], slow full RTW [3.5% (burnout) to 6.1% (mood disorders)], slow partial RTW [0.6% (adjustment disorders) to 1.6% (mood disorders)] and no RTW [2.2% (adjustment disorders) to 9.7% (mood disorders)]. Trajectories with a late onset of fast full RTW included higher percentages of women and lower percentages of full-time workers. CONCLUSIONS: RTW trajectories were similar for different mental disorder diagnoses although the distribution differed across diagnoses, with more partial and no RTW trajectories among workers with mood disorders. To better guide workers back to work, more knowledge is needed of factors associated with late, partial, or no RTW.

BACKGROUND:Labor market inactivity is common among young adults with a history of childhood abuse, which might be attributable to elevated psychopathology in adolescence. OBJECTIVE:We examined and decomposed the effect of adolescent psychopathology in the association between frequent or severe childhood abuse and labor market inactivity in young adulthood. PARTICIPANTS AND SETTING:This study used data from the population and high-risk samples of the Dutch prospective TRacking Adolescents' Individual Lives Survey (N = 2172). METHODS:Childhood abuse included measures of emotional, physical and sexual abuse. We operationalized adolescent psychopathology using the broadband emotional and behavioral problem scales. Labor market inactivity in young adulthood was defined as being neither in education, employment nor training or receiving benefits. We applied causal mediation analysis combined with a four-way decomposition approach to estimate our effects of interest. RESULTS:Individuals who reported frequent or severe childhood abuse were 1.51 (95 % CI: 1.13 to 2.22) times more likely to report labor market inactivity, constituting an excess relative risk (ERR) of 0.51. Most of this excess relative risk is due to mediation by psychopathology at 64.7 % (ERR: 0.33, 95 % CI: 0.16 to 0.50). We found no evidence for a mediated interactive effect (ERR: -0.04, 95 % CI: -0.24 to 0.24). CONCLUSIONS:Adolescent psychopathology largely explains the association between frequent and severe childhood abuse and labor market inactivity in young adulthood. Intervening in the occurrence of adolescent psychopathology following frequent and severe childhood abuse may reduce the risk of subsequent labor market inactivity.

Abstract Background Promoting a sustainable return to work (RTW) and work participation (WP) for employees with common mental disorders (CMDs) is a crucial challenge for mental healthcare, organisations, and society at large. To date, work-related factors have only very rarely been examined within RTW trajectory studies. The present study aims to examine 30-month WP trajectories and associated individual, health- and work-related factors of employees on sickness absence due to CMDs in Germany. Methods In a prospective cohort study with N = 259 participants, five measurements were conducted at baseline (during the last week of inpatient treatment), and 6, 12, 18 and 30 months later. WP was defined as the proportion of weeks being present at work between two measurement points (self-reported). WP trajectories over 30 months were estimated with Latent Class Growth Analysis (LCGA), and were described according to associated individual, health- and work-related factors. Results We extracted four trajectory classes: Class 1 ‘slowly increasing WP’ (19.6%) with a slow but constantly increasing WP over time, and finally reaching nearly 60% of WP; Class 2 ‘high maintaining WP’ (30.3%) with a maintaining high WP of over 80% after RTW until 30 months; Class 3 ‘highest maintaining WP’ (34.7%) with the highest maintaining WP throughout follow-up and reaching nearly 100% WP after RTW; and Class 4 ‘decreasing WP’ (15.4%) with a positive development of WP until 12 months, reaching of about 90% WP, but then decreasing below 60% WP until 30 months. Participants with persistent high WP (Classes 2 and 3, 65.0%) reported better individual-, health- and work-related characteristics at baseline, and more realized work accommodations during RTW. Conclusions For the majority of the employees, returning to work resulted in sustainable WP during the 30 months study period. However, about one third of the employees should be given more attention in their complete RTW process from treatment to workplace support. Key messages • Sustainable work participation after returning to work with common mental disorders is a long and complex journey. • Employees with a better individual, health- and work-related situation at baseline seem to be more likely to achieve a sustainable work participation.

We applied network analysis combined with community detection algorithms to examine how adverse experiences (AEs) (e.g., abuse, bullying victimization, financial difficulties) are, individually and conjunctively, associated with emotional and behavioral problems at age fourteen in the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS, N = 1880, 52.2% female). We found that bullying victimization, peer rejection, parental mental health problems, emotional abuse, and sexual abuse were the only AEs directly contributing to risk of emotional problems. Parental divorce and emotional abuse were the only AEs directly contributing to risk of behavioral problems. Most AEs (e.g., parental employment, parental physical illness) were not conditionally associated with emotional and behavioral problems but may nevertheless contribute to emotional and behavioral problems via associations with other AEs (e.g., parental unemployment and emotional abuse). Community detection algorithms suggested that many of the AEs cluster together (e.g., physical abuse, emotional abuse, and sexual abuse; financial difficulties and parental unemployment), sometimes with emotional and behavioral problems (e.g., bullying victimization, peer rejection and emotional problems). Our findings shed light on how individual AEs contribute to risks of emotional and behavioral problems directly, and indirectly through associations with other AEs.

Background Cumulative exposure to childhood adversity is associated with a variety of labour market outcomes in young adulthood. It remains largely unclear whether the type of adversity matters in this association. This prospective study examined the differences in exposure to 14 adverse experiences among groups of young adults aged 22 characterised by distinct labour market participation states and employment conditions. Methods We used data from the TRacking Adolescents’ Individual Lives Survey, a Dutch prospective cohort study with 15 years of follow-up (N=1524). We included 14 adverse experiences (ages 0–16) across five domains: peer influences, loss or threat of loss, material deprivation, family dynamics and maltreatment. Labour market participation states and employment conditions were assessed at age 22. We used latent class analysis to derive labour market outcome groups, which we subsequently compared on exposure to adverse experiences using pairwise comparisons. Results Inactive individuals (n=85, 5.6%), often neither in education (77.4%) nor employment (98.6%) and on benefits (94.4%), were more likely to be exposed to many distinct types of adverse experiences (eg, parental addiction, bullying victimisation) as compared with all other groups. Early workers (n=413, 27.1%), often on temporary contracts and low monthly incomes, were more likely to be exposed to parental divorce (22.7%) compared with students with side jobs (12.9%). Conclusions Different adverse experiences are not equally associated with labour market outcomes. Researchers and stakeholders in policy and practice should be aware of the differences between adverse experiences in their importance for labour market outcomes in young adults.

Background: Work and family lives interact in complex ways across individuals' life courses. In the past decade, many studies constructed work-family trajectories, some also examined the relation with health. The aims of this systematic review were to summarise the evidence from studies constructing work-family trajectories, and to synthesise the evidence on the association between work-family trajectories and health. Methods: We searched MEDLINE, EMBASE, PsycINFO, SocINDEX and Web of Science databases. Key search terms related to work, family and trajectories. Studies that built combined work-family trajectories or examined the relationship between work and family trajectories were included. Risk of bias was assessed independently by two authors. The identified work-family trajectories were summarised and presented for men and women, age cohorts and contexts. The evidence on the association with health as antecedent or consequence was synthesised. Results: Forty-eight studies, based on 29 unique data sources, were included. Thirty-two studies (67%) were published in 2015 or later, and sequence analysis was the primary analytic technique used to construct the trajectories (n = 43, 90%). Trajectories of women were found to be more diverse and complex in comparison with men. Work-family trajectories differed by age cohorts and contexts. Twenty-three studies (48%) examined the association between work-family trajectories and health and most of these studies found significant associations. The results indicate that work-family trajectories characterised by an early transition to parenthood, single parenthood, and weak ties to employment are associated with worse health outcomes. Conclusions: Work-family trajectories differed greatly between men and women, but differences seemed to decrease in the youngest cohorts. Given the current changes in labour markets and family formation processes, it is important to investigate the work and family lives of younger cohorts. Work-family trajectories were associated with health at different life stages. Future research should examine longitudinal associations of work-family trajectories with health and focus on elucidating why and under which circumstances some trajectories are associated with better or worse health compared with other trajectories.

Mental health problems in the workforce present a major public and occupational health challenge and come with significant costs for the individuals, families, employers and society at large. It has been estimated that, globally, the 12-month prevalence of common mental health problems – such as depressive disorders, anxiety disorders, and stress-related disorders – is on average 17.6%, with often serious implications for employment, productivity, and wages (2, 3). The recent OECD report “Fitter Minds, Fitter Jobs” showed that in 2018, across OECD countries, people with mental health problems have 20% lower employment rates, are almost three times more likely to be unemployed, and almost one and a half times more likely to receive disability benefits as those without these problems (2). These key figures barely differ from those presented in 2013 (2). During the past decades, research on the highly complex phenomenon of (return to) work participation of people with common mental health problems has come a long way: many barriers and facilitators to (return to) working have been identified and interventions have been developed and tested for people with common mental health problems to participate in work (eg, 4, 5). To illustrate, facilitating factors concern, for example, an individual’s active coping style (keep a daily rhythm, exercise, stay in contact with work), high self-efficacy, and a supportive family context and social network (5-8); while the severity of mental health problems or the existence of other health problems are known barriers (5). A safe organizational climate (such as openness about mental health) and good psychosocial working conditions, including support from supervisors and colleagues, having decision authority, and no high workload, have been identified as facilitating workplace factors (5, 7, 8). Also, health and social systems may act as a barrier or facilitator with, eg, waiting lists for mental health treatment or the availability of integrative mental health and occupational rehabilitation/employment services (7, 9). It comes as no surprise that Corbière et al (10) identified 11 different stakeholder groups from the work, health and insurance systems and close to 200 relevant stakeholder actions in the return-to-work process of workers with common mental health problems. Despite extensive progress and a large body of evidence on factors to facilitate the (return to) work participation of workers with common mental health problems (for systematic reviews and meta-analyses, covering more than two decades of research, see, eg, 5, 9, 11), we must acknowledge that meta-analyses of intervention studies to date only have shown small effect sizes for sick leave reduction (4, 12–14) and no substantial effects for improved return-to-work (13) or being at work (14) rates. So, how to move the research field forward? Although people with common mental health problems have lower employment rates, the majority (60% on average across OECD countries) is working (OECD 2021), but knowledge about maintaining and improving at-work participation among this group is lacking. We see a great need for a focus shift towards a deeper understanding of at-work participation of people with common mental health problems. In the following, we focus on two challenges and avenues to move forward: (i) measuring at-work outcomes and (ii) examining the complex, interdependent relationship between common mental health problems and at-work participation with more intense, longitudinal real-time designs and a life course lens. Challenges and avenues to support people with common mental health problems at work Challenge 1: Measurement of at-work outcomes The first challenge concerns the measurement of how people with common mental health problems participate or function at work and what their needs are to enter and stay at work. To better support workers with common mental health problems at work, it is critical to further deepen our understanding of the strategies, work accommodation needs and functioning of these workers. To illustrate, in a qualitative study among workers suffering from common mental health problems, Danielsson et al (15) explored “strategies to keep working”. The authors showed that workers` strategies differed depending on the illness phase; ie, more reactive strategies to avoid strain were used in early phases and more reflective, solution-focused strategies were used in later phases. This knowledge on phase-specific work strategies may be used to better inform and tailor supportive interventions and work accommodation to help workers to maintain working. De Groot et al (16) recently provided first insights about how young adults with a history of mental health problems function at work. It was shown that young adults with both persistent high and elevated levels of mental health problems during childhood and adolescence, compared with those with low-level mental health problems, experience difficulties in meeting their work demands for more than one day a week given a full-time work week at age 29. Moreover, Arends et al (17) showed that many workers who returned to work after being absent with common mental health problems still experience impaired work functioning for up to 12 months. This study also demonstrated that workers recover at a different pace and at a different level in terms of mental health and work functioning. These findings highlight the importance of focusing on at-work strategies and functioning to support workers with common mental health problems as we need to capture early signs of maladaptive strategies or reduced functioning that may inform work accommodations to prevent a further decline in functioning or even more severe consequences as sick leave or work disability. Accommodating work for workers with (common) mental health problems may be especially challenging, as opposed to other health conditions, given the strong stigma attached to mental ill-health (18, 19). As discussed by LaMontagne et al (20), an integrated intervention approach to workplace mental health, combining knowledge from various disciplines (eg, occupational medicine, psychiatry, public health, -positive- psychology) and focusing on both protecting and promoting mental health as well as addressing mental health problems is essential (20). To assess and monitor the abilities to accomplish the work role, it is vital to consider at-work outcomes, such as health-related work functioning, work limitations, work instability, and work capabilities (21–24). Ideally, such outcomes – existing or to be developed – are at the intersection of a persons’ health and work performance, reflect the ability and/or need of a person to meet the work demands given the available personal and/or environmental resources, and provide information for the content and timing of work accommodations. We strongly encourage future research to (further) rigorously test the measurement properties of existing and to be developed at-work measures, in particular the responsiveness to change, within the population of workers with common mental health problems. Challenge 2: Examination of the complex, interdependent relationship between common mental health problems and at-work participation: novel designs and a life course lens The second challenge concerns the need to better understand the complex, interdependent relationship between common mental health problems and at-work participation. To provide adequate and timely support for workers with common mental health problems at work, it is critical to further unravel the underlying mechanisms and (environmental) conditions of this complex, dynamic relationship, as different support policies and programs need to be in place at different time periods to address either common mental health problems or at-work participation. We would like to encourage future longitudinal studies to not shy away from complexity but to use approaches that capture the dynamics of both common mental health problems and at-work participation by, eg, repeatedly and more intensively assessing both concepts over time. Not new, but to be considered in occupational health research and practice, may be the use of intensive, longitudinal real-time designs, as recently applied in single-subject time-series studies in psychiatry, addressing psychopathology as a complex system (eg, 25, 26). For example, to detect personalized early warning signals preceding the occurrence of a major depressive symptom transition, Wichers et al (26) conducted six single-subject time-series studies over a 3–6-month period, prospectively collecting frequent observations of momentary affective states (reported up to three times a day) during a time period when participants were at increased risk of a depressive symptom transition (reported weekly). The results showed (and replicated) the presence of rising early warning signals a month before the symptom transition occurred. To improve personalized support of workers with common mental health problems at work, this type of information is highly needed. What makes the relationship between common mental health problems and at-work participation even more complex is the fact that a person’s mental health does not start when work begins; ie, what happens before a person enters the workforce affects both the health resources a person brings to work and the work opportunities (27). As most research so far measured common mental health problems during working adults’ life, and not across the life course, knowledge on the impact of early life mental health experiences on at-work participation in later life is almost absent. Again, the findings of de Groot et al (16) highlight the importance of adopting a life course perspective by considering the concept of ‘accumulation of health risk or health advantages’ when connecting early life mental health experiences with work functioning. A life course perspective may also help advance future studies on the dynamics between different life domains (7), eg, the interplay between work and private life, as it recognizes an individual’s life course as a multi-level developmental process shaped by the social context. A focus shift towards supporting workers with common mental health problems at work also requires all key stakeholders in the healthcare system, the legal/administrative system, the work system and the personal and family system to work together – which may be a challenge in itself. However, in view of more inclusive workplaces and labor markets, we need to take the next steps to enable, maintain and improve at-work participation of workers with common mental health problems. References 1. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J of Epidemiol 2014; 476-493. https://doi.org/10.1093/ije/dyu038 2. OECD. Fitter Minds, Fitter Jobs: From awareness to change in integrated mental health, skills and work policies. Paris: OECD Publishing, 2021. https://doi.org/10.1787/a0815d0f-en 3. Campbell D, Green MJ, Davies N, Demou E, Howe LD, Harrison S, et al. Effects of depression on employment and social outcomes: a Mendelian randomization study. J Epidemiol Community Health 2022;76:563-71. https://doi.org/10.1136/jech-2021-218074 4. Salomonsson S, Hedman-Lagerlöf E, Öst LG. Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders. Psychol Med 2018;48:1954-1965. https://doi.org/10.1017/S0033291718000065 5. van Hees SGM, Carlier BE, Vossen E, Blonk RWB, Oomens S. Towards a better understanding of work participation among employees with common mental health problems: a systematic realist review. Scand J Work Environ Health 2022 Apr 1;48(3):173-189. https://doi.org/10.5271/sjweh.4005 6. Black O, Keegel T, Sim MR, Collie A, Smith P. The effect of self-efficacy on return-to-work outcomes for workers with psychological or upper-body musculoskeletal injuries: A review of the literature. J Occup Rehabil 2018;28:16-27. https://doi.org/10.1007/s10926-017-9697-y 7. Nielsen K, Yarker J, Munir F, Bültmann U. IGLOO: An integrated framework for sustainable return to work in workers with common mental disorders. Work Stress 2018;32(4):400-417. https://doi.org/10.1080/02678373.2018.1438536 8. Joosen MCW, Lugtenberg M, Arends I, van Gestel HJAWM, Schaapveld B, Terluin B, et al. Barriers and facilitators for return to work from the perspective of workers with common mental disorders with short, medium and long term sickness absence: A longitudinal qualitative study. J Occup Rehabil 2021; Sep 27. https://doi.org/10.1007/s10926-021-10004-9 9. Andersen MF, Nielsen KM, Brinkmann S. Meta-synthesis of qualitative research on return to work among employees with common mental disorders. Scand J Work Environ Health 2012;38(2):93-104. https://doi.org/10.5271/sjweh.3257 10. Corbière M, Mazaniello Chézol M, Bastien M, Wathieu E, Bouchard R, et al. Stakeholders’ role and actions in the return to work process of workers on sick leave due to common mental disorders: A scoping review. J Occup Rehab 2020;30:381-419. https://doi.org/10.1007/s10926-019-09861-2 11. Lagerveld SE, Bültmann U, Franche RL, Van Dijk FJH, Vlasveld C, Van Der Feltz-Cornelis CM, et al. Factors associated with work participation and work functioning in depressed workers: a systematic review. J Occup Rehabil 2010;20:275-92. https://doi.org/10.1007/s10926-021-09978-3 12. Joyce S, Modini M, Christensen H, Mykletun A, Bryant R, Mitchell PB, et al. Workplace interventions for common mental disorders: a systematic meta-review. Psychol Med 2016;46(4):683-697. https://doi.org/10.1017/S0033291715002408 13. Nigatu YT, Liu Y, Uppal M, McKinney S, Rao S, Gillis K, et al. Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials. Psychol Med 2016;46:3263-3274. https://doi.org/10.1017/S0033291716002269 14. Nieuwenhuijsen K, Verbeek JH, Neumeyer-Gromen A, Verhoeven AC, Bültmann U, Faber B. Interventions to improve return to work in depressed people. Cochrane Database of Systematic Reviews 2020;(10). Art. No.: CD006237. https://doi.org/10.1002/14651858.CD006237.pub4 15. Danielsson L, Elf M, Hensing G. Strategies to keep working among workers with common mental disorders - a grounded theory study. Disabil Rehabil 2019;41(7):786-795. https://doi.org/10.1080/09638288.2017.1408711 16. de Groot S, Veldman K, Amick BC 3rd, Bültmann U. Work functioning among young adults: the role of mental health problems from childhood to young adulthood. Occup Environ Med 2022;79(4):217-223. https://doi.org/10.1136/oemed-2021-107819 17. Arends I, Almansa J, Stansfeld SA, Amick BC 3rd, van der Klink JJL, Bültmann U.One-year trajectories of mental health and work outcomes post return to work in patients with common mental disorders. J Affect Disord 2019;257:263-270. https://doi.org/10.1016/j.jad.2019.07.018 18. Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma, help seeking, and public health programs. Am J Public Health 2013;103(5):777-80. https://doi.org/10.2105/AJPH.2012.301056 19. Janssens KME, van Weeghel J, Dewa C, Henderson C, Mathijssen JJP, Joosen MCW, et al. Line managers’ hiring intentions regarding people with mental health problems: a cross-sectional study on workplace stigma. Occup Environ Med 2021;78(8):593-599. https://doi.org/10.1136/oemed-2020-106955 20. LaMontagne AD, Martin A, Page KM, Reavley NJ, Noblet AJ, Milner AJ, et al. Workplace mental health: developing an integrated intervention approach. BMC Psychiatry 2014 May;14:131. https://doi.org/10.1186/1471-244X-14-131 21. Abma FI, Brouwer S, de Vries HJ, Arends I, Robroek SJW, Cuijpers MPJ, et al. The capability set for work: development and validation of a new questionnaire. Scand J Work Environ Health 2016;42(1):34-42. https://doi.org/10.5271/sjweh.3532 22. Walker TJ, Tullar JM, Diamond PM, Kohl HW 3rd, Amick BC 3rd. Validity and reliability of the 8-item work limitations questionnaire. J Occup Rehabil 2017;27(4):576-583. https://doi.org/10.1007/s10926-016-9687-5 23. Abma F, Bjorner JB, Amick BC 3rd, Bültmann U. Two valid and reliable work role functioning questionnaire short versions were developed: WRFQ 5 and WRFQ 10. J Clin Epidemiol 2019;105:101-111. https://doi.org/10.1016/j.jclinepi.2018.09.00 24. Danielsson L, Fornazar R, Holmgren K, Lundgren Nilsson Å, Hensing G. Development and construct validity of the Work Instability Scale for people with common mental sisorders in a sample of depressed and anxious workers: A Rasch analysis. Rehabil Process Outcome 2020;14;9:1179572720936664. https://doi.org/10.1177/1179572720936664 25. Wichers M, Groot PC, Psychosystems, ESM Group, EWS Group. Critical slowing down as a personalized early warning signal for depression. Psychother and Psychosom 2016;85(2):114-116. https://doi.org/10.1159/000441458 26. Wichers M, Smit AC, Snippe E. Early warning signals based on momentary affect dynamics can expose nearby transitions in depression: A confirmatory single-subject time-series study. J Pers Oriented Res 2020;6(1):1-15. https://doi.org/10.17505/jpor.2020.22042 27. Amick BC 3rd, McLeod CB, Bültmann U. Labor markets and health: an integrated life course perspective. Scand J Work Environ Health 2016;42:346-53. https://doi.org/10.5271/sjweh.3567

During young adulthood, several transitions in work and family lives occur, but knowledge of the work-family trajectories of the current generation of young adults, i.e. people born in the 1990s, is lacking. Moreover, lit-tle is known about whether the mental health status before the start of the working life may shape work-family trajectories. We used 18-year follow-up data from the TRAILS cohort study of individuals born between 1989 and 1991 (n = 992; 63.2% women). Internalising and externalising problems were measured with the Youth Self -Report at ages 11, 13 and 16 years. Monthly employment, education and parenthood states were recorded be-tween 18 and 28 years. Applying sequence analysis, we identified six work-family trajectories in women and men. The first five trajectories were labelled: long education, continuous education and work, education and work to work, early work, and inactive. The main difference between trajectories of women and men was in the timing of parenthood, thus the remaining trajectory of women was labelled active with children, and the remaining tra-jectory of men active. Women who experienced externalising problems in adolescence were more likely to belong to the trajectory characterised by parenthood. Men who experienced internalising problems in adolescence were more likely to belong to the trajectory characterised by a long time spent in education. The TRAILS data allowed us to consider timing, duration and ordering of the work and family states in young adulthood, and to use multiple assessments of mental health in adolescence. Further research needs to examine the mechanisms through which early mental health affects later work and family outcomes.

Commonly used methods for modelling early life adversity (e.g., sum-scores, latent class or trajectory ap-proaches, single-adversity approaches, and factor-analytical approaches) have not been able to capture the complex nature of early life adversity. We propose network analysis as an alternative way of modelling early life adversity (ELA). Our aim was to construct a network of fourteen adverse events (AEs) that occurred before the age of 16 in the TRacking Adolescents Individual Lives Survey (TRAILS, N =1029). To show how network analysis can provide insight into why AEs are associated, we compared findings from the resulting network model to findings from tetrachoric correlation analyses. The resulting network of ELA comprised direct re-lationships between AEs and more complex, indirect relationships. A total of fifteen edges emerged in the network of AEs (out of 91 possible edges). The correlation coefficients suggested that many AEs were associated. The network model of ELA indicated, however, that several associations were attributable to interactions with other AEs. For example, the zero-order correlation between parental addiction and familial conflicts (0.24) could be explained by interactions with parental divorce. Our application of network analysis shows that using network analysis for modelling the ELA construct allows capturing the constructs' complex nature. Future studies should focus on gaining more insight into the most optimal model estimation and selection procedures, as well as sample size requirements. Network analysis provides researchers with a valuable tool that allows them as well as policy- makers and professionals to gain insight into potential mechanisms through which adversities are associated with each other, and conjunctively, with life course outcomes of interest

IntroductionMental health problems cause a considerable burden of disease in adolescents, with potential negative consequences on employment later in life. Earlier, five trajectories of internalising and externalising problems (high-stable, moderate-high, decreasing, moderate-low, low-stable) among adolescents from 11 to 19 years were identified and a relationship with employment status at age 19 was found. However, at age 19, many participants were still in education.ObjectivesThis study aims to examine associations of trajectory membership with having paid work and type of employment contract in young adults at age 26.MethodsFifteen-year follow-up data of the longitudinal TRacking Adolescents’ Individual Lives Survey (TRAILS) cohort study (N=1711) were used. Logistic regression analyses were applied to examine associations of trajectory membership of internalising and externalising problems with having paid work and type of employment contract at age 26. The analyses were stepwise adjusted for sex, intelligence, parental education, family composition, physical health, negative life events and mental health comorbidity, all measured at age 11.ResultsFor internalising problems, the high-stable (adjusted OR: 2.19; 95% CI: 1.17–4.11) and moderate-high (adjusted OR: 1.75; 95% CI: 1.14–2.69) trajectories were strongly associated with not having paid work, compared to the low-stable trajectory. No associations were found between the trajectories of externalising problems and having paid work. For both internalising and externalising trajectories, no associations were found between trajectory membership and having a permanent or temporary employment contract.ConclusionThis study expands current knowledge about the impact of internalising problems on employment of young adults. To prevent the effects of mental health problems on work, a life course perspective is needed taking into account the development of mental health problems in childhood and adolescence. In the transition from school to work, integrating youth- and occupational healthcare may be key to prevent negative employment outcomes due to internalising problems.

Background Little is known about the timing and duration of mental health problems (MHPs) on young adults’ labour market participation (LMP). This life-course study aims to examine whether and how the timing and duration of MHPs between childhood and young adulthood are associated with LMP in young adulthood. Methods Logistic regression analyses were performed with data from the Tracking Adolescents’ Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up (N=874). Internalising and externalising problems were measured by the Youth/Adult Self-Report at ages 11, 13, 16, 19 and 22. Labour market participation (having a paid job yes/no) was assessed at age 26. Results Internalising problems at all ages and externalising problems at age 13, 19 and 22 were associated with an increased risk of not having a paid job (internalising problems ORs ranging from 2.24, 95% CI 1.02 to 4.90 at age 11 to OR 6.58, CI 3.14 to 13.80 at age 22; externalising problems ORs from 2.84, CI 1.11 to 7.27 at age 13 to OR 6.36, CI 2.30 to 17.56 at age 22). Especially a long duration of internalising problems increased the risk of not having a paid job in young adulthood. Conclusion The duration of MHPs during childhood and adolescence is strongly associated with not having paid work in young adulthood. This emphasises the necessity of applying a life-course perspective when investigating the effect of MHPs on LMP. Early monitoring, mental healthcare and the (early) provision of employment support may improve young adult’s participation in the labour market.

Purpose Although common mental disorders (CMDs) highly impact individuals and society, a knowledge gap exists on how sickness absence can be prevented in workers with CMDs. This study explores: (1) workers' perceived causes of sickness absence; (2) perceived return to work (RTW) barriers and facilitators; and (3) differences between workers with short, medium and long-term sickness absence. Methods A longitudinal qualitative study was conducted involving 34 workers with CMDs. Semi-structured interviews were held at two time-points during their RTW process. The 68 interviews were audio-taped, transcribed and thematically analyzed to explore workers' perspective on sickness absence causes, RTW barriers and facilitators, and compare data across the three sub-groups of workers. Results Workers reported various causes for their absence, including: (1) high work pressure; (2) poor work relationships; (3) unhelpful thoughts and feelings, e.g. lacking self-insight; and (4) ineffective coping behaviors. According to workers, RTW was facilitated by work adjustments, fulfilling relationships with supervisors, and adequate occupational health guidance. Workers with short-term leave more often reported favorable work conditions, and proactive coping behavior. In contrast, the long-term group reported reactive coping behavior and dissatisfaction with their work. Conclusion Supporting workers with CMDs in gaining self-awareness and regaining control, discussing the value of their work, and creating work conditions that enable workers to do valuable work, seem central for successful RTW and might prevent sickness absence. Supervisors play a key role in enabling workers to do valuable work and further research should focus on how supervisors can be supported in this task.

ObjectiveGeneration Y has to earn a living in a new world of work in changing labor markets. To date, little is known about the working lives of todays’ young adults and how early life factors impact their working lives. The aim of this study is to examine how educational and work factors cluster in young workers and to assess the impact of mental health problems from childhood to young adulthood on the work-life clusters.MethodsLongitudinal data of N=1235 participants of the Tracking Adolescents Individual Life Study (TRAILS), a prospective cohort study from age 11 to 26, was used. To examine the participants’ clusters regarding educational attainment, employment status, social benefits, type of contract, and working hours at age 26, latent class analysis was performed. Trajectories of mental health problems measured at ages 11, 13.5, 16, 19 and 26 were identified with latent class growth models. Multinomial logistic regression analyses were used to examine the associations between mental health and work-life clusters.ResultsFive clusters were identified: 1) high educated fulltime workers (30.6%), 2) medium educated part-time and fulltime workers (21.6%), 3) students and medium educated workers with small jobs (26.0%), 4) fulltime students (15.7%), and 5) social benefit recipients (6.0%). Participants with high-stable trajectories of internalizing and externalizing problems had an increased risk of receiving social benefits (OR 9.80, 95%CI 4.26–22.5 and OR 13.9, 95%CI 4.15–46.9, respectively).ConclusionAt age 26, five work-life clusters were identified, showing the diversity of the working lives of today’s young adults. The results of this study also show the long-term consequences of early mental health problems on the working lives of young adults. During the presentation, conceptual and analytical challenges will be discussed, for example: ‘When does employment begin’ and ‘How can we best capture the new world of work?’