Childhood-onset neuropsychiatric conditions and the risk of labor market marginalization in adulthood: Focusing on etiologic mechanisms and putative developmental pathways

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.