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Soc Psychiatry Psychiatr Epidemiol. 2018 Dec;53(12):1401-1411. doi: 10.1007/s00127-018-1565-3. Epub 2018 Aug 9.

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

Iyer S1,2,3, Mustafa S4, Gariépy G5, Shah J5,4,6, Joober R5,4,6, Lepage M5,4, Malla A5,4,6.

Author information

1
Department of Psychiatry, McGill University, Montreal, Canada. srividya.iyer@mcgill.ca.
2
Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada. srividya.iyer@mcgill.ca.
3
ACCESS Open Minds (pan-Canadian youth mental health services research network), Douglas Mental Health University Institute, Montreal, Canada. srividya.iyer@mcgill.ca.
4
Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
5
Department of Psychiatry, McGill University, Montreal, Canada.
6
ACCESS Open Minds (pan-Canadian youth mental health services research network), Douglas Mental Health University Institute, Montreal, Canada.

Abstract

PURPOSE:

The 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.

METHODS:

Youths 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).

RESULTS:

Thirty-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.

CONCLUSIONS:

Despite 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.

KEYWORDS:

Early intervention; NEET; Negative symptoms; Pathways to care; Prodrome; Psychosis; Treatment delays

PMID:
30094632
PMCID:
PMC6267132
DOI:
10.1007/s00127-018-1565-3
[Indexed for MEDLINE]
Free PMC Article

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