Abstract
Background
The potential for early interventions to reduce the later prevalence of common mental disorders (CMD) first experienced in adolescence is unclear.
Aims
To examine the course of CMD and evaluate the extent to which the prevalence of CMD could be reduced by preventing adolescent CMD, or by intervening on young adult mediating processes.
Methods
Prospective cohort study of 1943 Australian participants assessed repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Causal mediation analysis was undertaken to evaluate the extent to which the prevalence of CMD at age 35 years in those with adolescent CMD could be reduced by either preventing adolescent CMD, or by intervening on four
young adult mediating processes.
Results
At age 35, 19.2% of participants reported CMD; a quarter of these cases experienced CMD during both adolescence and young adulthood. Forty-nine percent of those with CMD during both adolescence and young adulthood went on to report CMD at age 35 years. Preventing adolescent CMD reduced the population prevalence at age 35 years by 3.9%. Intervening on all four young adult processes among those with adolescent CMD, reduced this prevalence by 1.6%.
Conclusions
In this Australian cohort, a large proportion of adolescent CMD resolved by adulthood, and by age 35 years, the largest proportion of CMD emerged among individuals without prior CMD. Time-limited, early intervention in those with earlier adolescent disorder is unlikely to substantially reduce the prevalence of CMD in midlife.
The potential for early interventions to reduce the later prevalence of common mental disorders (CMD) first experienced in adolescence is unclear.
Aims
To examine the course of CMD and evaluate the extent to which the prevalence of CMD could be reduced by preventing adolescent CMD, or by intervening on young adult mediating processes.
Methods
Prospective cohort study of 1943 Australian participants assessed repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Causal mediation analysis was undertaken to evaluate the extent to which the prevalence of CMD at age 35 years in those with adolescent CMD could be reduced by either preventing adolescent CMD, or by intervening on four
young adult mediating processes.
Results
At age 35, 19.2% of participants reported CMD; a quarter of these cases experienced CMD during both adolescence and young adulthood. Forty-nine percent of those with CMD during both adolescence and young adulthood went on to report CMD at age 35 years. Preventing adolescent CMD reduced the population prevalence at age 35 years by 3.9%. Intervening on all four young adult processes among those with adolescent CMD, reduced this prevalence by 1.6%.
Conclusions
In this Australian cohort, a large proportion of adolescent CMD resolved by adulthood, and by age 35 years, the largest proportion of CMD emerged among individuals without prior CMD. Time-limited, early intervention in those with earlier adolescent disorder is unlikely to substantially reduce the prevalence of CMD in midlife.
| Original language | English |
|---|---|
| Pages (from-to) | 558-566 |
| Number of pages | 9 |
| Journal | British Journal of Psychiatry |
| Volume | 221 |
| Issue number | 3 |
| Early online date | 7 Feb 2022 |
| DOIs | |
| Publication status | Published - 1 Sept 2022 |
Bibliographical note
Funding Information:Data collection for this study was supported by NHMRC Australia and the Victorian Government's Operational Infrastructure Support Program. M.M.-B. is the recipient of an Australian Research Council Discovery Early Career Award (project number DE190101326) funded by the Australian Government. P.M. is part-funded by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol and also receives salary support from Avon & Wiltshire Mental Health Partnership NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
P.M. is part-funded by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol and also receives salary support from Avon & Wiltshire Mental Health Partnership NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2022 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.