Iman Alaie

Labour market marginalisation (LMM) remains a major public health concern, especially in young people with psychiatric disorders such as depression and attention-deficit hyperactivity disorder (ADHD). Yet, there is scarce knowledge on the underlying etiologic mechanisms and pathways linking early psychiatric disorders to LMM, in terms of sickness absence (SA), disability pension (DP) and long-term unemployment (LTU). We will study the role of familial factors (ie, genetics and shared environment), comorbidities (eg, depression + ADHD) and social adversities (eg, bullying) for the risk of SA, DP and LTU in young adults with early psychiatric disorders.The project brings together an interdisciplinary team with expertise in epidemiology, insurance medicine and twin studies to conduct groundbreaking research using large-scale epidemiologic cohorts of youths, born 1982-2002, in the total Swedish population (N=1580371) and the Swedish Twin Registry (n=21494). Youths with psychiatric disorders (eg, depression, ADHD), assessed at ages 5-19 years, will be prospectively followed into young adulthood regarding SA, DP and LTU using linkage with nationwide registries. The unique data sources combined with use of advanced statistical methods provide a distinct opportunity to obtain precise estimates with minimal risk of potential bias.The project has clear potential to identify specific and potentially modifiable risk factors for LMM, thereby informing policymaking and healthcare planning.

Labor market marginalization among young people with psychiatric problems has been widely recognized as a major societal challenge. Notably, children with neuropsychiatric conditions such as ADHD are at substantial risk to become young adults facing additional mental health problems, general health issues, social difficulties, and troubles with establishing themselves in the labor market. However, there is a clear lack of knowledge about the underlying mechanisms and pathways leading to future labor market marginalization, in terms of sickness absence (SA), disability pension (DP), and unemployment. This project aims at better understanding the links between childhood-onset neuropsychiatric conditions and adult SA, DP, and unemployment. Specifically, the project addresses the potential role played by familial confounding (ie, genetic and shared environmental factors), the cumulative burden of childhood psychopathology (eg, ADHD + depression), and the effects of exposure to early adverse experiences (eg, bullying) for the subsequent risk of SA, DP, and unemployment.The project builds on unique data sources from the Swedish Twin Registry, including the world´s largest longitudinal twin study of childhood psychiatric problems, with extensive survey data on mental health, physical health, and social situation. Using linkage between surveys and national registries, eligible twins (n=46 990) will be followed prospectively with annual outcome data on SA, DP, and unemployment. To combine surveys with outcome data ascertained from national registries provides a distinct opportunity to obtain objective and precise estimates with minimal risk of potential biases.The project has clear potential to identify specific and potentially modifiable risk factors for labor market marginalization among young people with neuropsychiatric conditions. The gained knowledge may contribute significantly to public health policy, thereby helping to reduce both the individual and societal burden.