Srividya Iyer1,2,3, Sally Mustafa3, Jai Shah1,2,3, Ridha Joober1,2,3, Martin Lepage1,3, Ashok Malla1,2,3; 1Department of Psychiatry, McGill University, 2ACCESS Open Minds/Esprits ouverts, Douglas Mental Health University Institute, 3Prevention and Early Intervention Program for Psychosis (PEPP-Montreal)
Among youths presenting at specialised early intervention (SEI) services for psychosis, those Not in Employment, Education or Training (NEET) may have experienced longer periods of functional decline and mental health problems. They may also have difficulties accessing SEIs due to disadvantages associated with being NEET. These issues have not been investigated in first-episode psychosis. Our aims were therefore to document the prevalence of NEET status in a first-episode psychosis sample, and to investigate baseline differences between NEET and non-NEET groups in terms of demographics, symptomatology, pre-psychosis illness course and treatment delays. Data for 416 youths entering a catchment-based Canadian SEI service were analysed. NEET and non-NEET groups were compared on demographics (e.g. gender); symptomatology (e.g., negative symptoms); pre-psychosis course (i.e., premorbid adjustment, prodrome); and duration of untreated psychosis (DUP). NEET individuals (39% of sample) were likelier to be male, have schizophrenia-spectrum psychosis and have higher negative symptom scores than non-NEET individuals. They had longer prodromes and were likelier to remain ill after the first psychiatric change, until the onset of psychosis. Although both groups had similar premorbid adjustment earlier, the NEET group’s adjustment dropped in late adolescence. NEET youths had longer DUPs despite making more help-seeking attempts. In conclusion, NEET status was thrice as prevalent in our sample as in the Canadian populace. The NEET group followed a distinct trajectory of persistent symptoms and functional decline towards an eventual intersection of psychosis and NEET status. The systemic delays that NEET youths encounter indicate a need for better-targeted early identification efforts
