Disability is already pronounced in young people with early stages of affective disorders: Data from an early intervention service

Background: Although there is growing recognition that disability emerges early in the course of psychotic disorders, it is unclear whether young people with early stages of anxiety or affective disorders are similarly affected. This study examined patient self-reported disability in young people attending a designated early intervention service. Methods: Cross-sectional study comparing new headspace patients on self-reported measures of disability and distress (Kessler-10, Work and Social Adjustment Scale, and Brief Disability Questionnaire) with clinician-rated diagnosis and clinical stage. Results: Data from 330 participants with an average age of 16.8 years (50.0% male) was analysed and demonstrated high levels of psychological distress and disability in the overall group. Higher levels of self-reported psychological distress and disability were associated with affective disorder diagnosis and increased with advancing clinical stage. Female gender and younger age also predicted affective disorder diagnosis. Limitations: Clinician-rated participant disability was obtained via a single global measure (SOFAS) and not a systematic assessment. Additionally, data collected was cross-sectional and collected at intake only. Longitudinal assessment of clinical features and disability is required to map changes in disability over time. Conclusions: Surprisingly high levels of psychological distress and disability are apparent in young people presenting to early intervention services. Data suggests that distress and disability in those with anxiety is less than for affective disorder. Results also suggest that clinical staging approaches capture the increasing disability associated with illness progression. The obtained results highlight the need for interventions that specifically target disability, rather than just symptoms of mental health problems. (C) 2010 Elsevier B.V. All rights reserved.