Investigating the Role of Life Events on Youth Mental Health Outcomes: A Population-Based Follow-Up Study.
Background: To address a lack of systematic epidemiological research on youth mental health in Ireland, the first large-scale cross-sectional school-based study (The Challenging Times Study) was carried out eight years ago to determine the prevalence rates of psychiatric disorders in a population of 212 urban Irish adolescents aged 12-15 years. Baseline results showed that 15.6% of the study population met criteria for a current psychiatric disorder. Eight years later the present study identified 169 of the 212 (80%) young people now aged 19-23 years.
The aims of the study were to examine: 1) the mental health outcomes and social and occupational functioning of a cohort of young people (now aged 19-23 years), 2) the association between life stresses such as poor family functioning, parental separation / divorce and peer relations, substance use and anti-social behaviour and mental health outcomes in young adulthood.
Method: Two hundred and twelve young people, who participated in the original Challenging Times Study, were invited to participate in an assessment interview. Mental health outcomes and social and occupational functioning were assessed using the Structured Clinical Interview for DSM-IV psychiatric diagnoses (SCID I), the Achenbach Adult Self Report and Achenbach Adult Behaviour Checklist (parental questionnaire).The Me Master Family Assessment Device was used as a measure of family functioning whilst the Global Assessment of Functioning (GAF) scale measured quality of life and general functioning. The Stressful Life Events Schedule for Children and Adolescents a semi-structured interview was used to identify factors associated with mental ill-health.
Results: Using a weighted population prevalence analysis, 24.3% (22.4 - 28.9) of the young people met the criteria for a psychiatric disorder at follow-up, including 5.4% (4.1 - 7.6) with a mood disorder, 11.2% (9.5 -14.3) with an anxiety disorder, 8.2% (6.7 -11.0) with a substance use disorder and 7.7% (6.2 -10.4) with alcohol disorders. Logistic regression revealed that an adolescent diagnosis of being “at risk” of a psychiatric disorder at the Challenging Times original study was not predictive of poor mental health outcomes at follow-up. Specific stressful life events were identified as factors associated with poor mental health outcomes.
Conclusion: This study offers an understanding of the prevalence rates and psychosocial factors associated with psychiatric disorders in young adulthood in an Irish context. It emphasises the need for youth mental health Intervention and prevention programmes that equip young people with the necessary coping skills to deal with life’s many challenges.