Zurcher Adolescent Screening for Mental Disorder
Condition: Mental Disorders
MeSH terms: Mental Disorders; Psychotic Disorders
Study type: Observational

Summary: 
      Mental disorders are common in youth and adults. Symptoms of mental are aggravated by
      unemployment. Compared to the working population, the unemployed have higher rates of poor
      health, a tendency toward negative emotionality and depression, show symptoms of exhaustion
      more frequently, and experience disturbed sleep or have a sleep disorder. It can be
      reasonably expected that unemployment in adolescents and young adults causes the same
      symptoms and behaviors as in adults. In those youth with a mental disorder, particularly an
      untreated one, the transfer from school to the employment market can be hindered. At the same
      time, the investigators notice an increase in early disability pensions due to mental health
      issues among adolescents. Thus, the early recognition and treatment of mental disorders and
      psychological strain is crucial in promoting the employment of young people and supporting
      their connection to the employment market.With this project the investigators want to
      implement an early intervention and reach out to unemployed youth. The investigators
      identified the period between graduation and first employment as the ideal moment of
      intervention, because this time period is a critical period in which young people are exposed
      to increasing personal challenges. Conducting an intervention before a psychological stress
      transforms into a mental disorder, can prevent harm and suffering to the afflicted person. In
      addition, early intervention could help prevent the need to enroll in the early disability
      pension program.
    

Detailed description: 
      Mental disorders are common. A WHO study shows (Gore, Bloem, Ferguson, Coffey and Mathers,
      2011) that during adolescence; most of the years lost because of illness are due to
      neuropsychiatric disorders such as depression, substance abuse and schizophrenia.
      Steinhausen, Metzke and Kannenberg (1998) found that 22% of the children and adolescents
      living in the canton of Zurich, suffer from mental disorders. The figures are comparable with
      Wittchen, Nelson and Lachner (1998) who fund 27% of the adolescents fitting the DSM IV
      (Diagnostic and Statistical Manual) criteria for mental disorders.

      Mental disorders are particularly stressful in combination with unemployment. Unemployed are
      often in a worse physical condition compared to employed people; they tend to negative
      emotional states and depression, fatigue and sleep disorders. It is to be expected that
      unemployment will have the same effect on adolescents. Fergusson, Horwood and Lynskey (1997)
      showed that in 16 to 25 years old, the increase of the unemployment was correlated with the
      increase of mental distress having consequences like depression, anxiety, substance abuse and
      attempts to suicide.

      The aim of this project is to validate a screening tool for the early recognition of mental
      disorders among young unemployed. The screening tool will be composed by no more than 50
      items.

      The participants will be requested to fill out the screening tool and in a second phase, they
      will be asked to participate in a face to face, standardized clinical Interview, the
      Munich-Composite International Diagnostic Interview (M-CIDI) (Wittchen, Lachner, Wunderlich
      and Pfister, 1998).

      To ensure that the screening tool differentiates between 'at risk' and 'non at risk'
      patients, the sample will be composed by 40 unemployed young adults, Age 16-25 and 40 working
      young adults, age 16-25.

      Statistical Analysis: After the data collection the data from the screening and the clinical
      interview will be tested for sensitivity and specificity. To evaluate both the Receiver
      Operating Characteristic (ROC) and other methods will be used. The prognostic validity of the
      screening tool will be additionally calculated with a logistic regression. The data analysis
      will be executed with SPSS 21.

      Missing data will be excluded from the sample.
    

Intervention name(s): Screening
Intervention type(s): Other
Intervention description(s): Participants will fill out a short screening questionnaire where different aspects of mental health and behavioral problems will be assessed.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Participants will be recruited in Institutions Coaching unemployed Young People.