TY - JOUR
AU - E. Tonini
AU - J. J. Crouse
AU - M. Shin
AU - J. Scott
AU - J. S. Carpenter
AU - A. Nichles
AU - N. Zmicerevska
AU - F. Iorfino
AU - W. Capon
AU - S. J. Wood
AU - R. Purcell
AU - A. R. Yung
AU - C. Pantelis
AU - B. Nelson
AU - P. D. McGorry
AU - I. B. Hickie
A1 - 
AB - BACKGROUND: The clinical profiles of youth presenting to early intervention mental health services are heterogeneous, with various sub-groups proposed and little information about the longitudinal stability of profiles, especially those associated with bipolarity. METHODS: 802 youth aged 12-25-years (Mean = 18.26; 66 % females) accessing primary-care based mental health clinics were assessed at baseline and 417 were re-assessed after 12-months. An exploratory factor analysis of 62 items from six validated rating scales of the severity of mental and physical ill-health was conducted. Seven factors (anxiety, sleep, depression, restlessness, distress, activation, somatic complaints) were derived and modelled using latent profile analysis. Associations between profile membership, clinical outcomes and functioning were examined. Conditional probabilities of shifting to a different profile longitudinally were computed. RESULTS: Three profiles were revealed which were psychometrically invariant across baseline and follow-up: (1) 'High distress with high activation' (32 % baseline, 25 % follow-up); (2) 'High distress without activation' (31 % baseline, 26 % follow-up); and (3) 'Moderate distress' (37 % baseline, 33 % follow-up). A fourth profile, 'Low distress' (16 %), emerged at follow-up. Profiles did not differ by age at baseline or sex. 'High distress with high activation' was more likely to be impaired longitudinally, and to meet criteria for a full-threshold mental disorder at follow-up. About 39 % of youth retained the same profile longitudinally, while 16 % shifted to lower distress, and 13 % shifted to higher distress. CONCLUSION: These findings suggest that activation is a marker of poorer clinical and functional outcomes in youth presenting for mental health care.
AD - Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: emiliana.tonini@sydney.edu.au.; Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.; Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Institute of Neuroscience, University of Newcastle, Newcastle, UK.; Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; School of Psychology, University of Birmingham, Edgbaston, UK.; Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.; Institute of Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia; School of Health Sciences, University of Manchester, UK.; Department of Psychiatry, University of Melbourne, Western Hospital, Sunshine, St Albans, Vic, Australia; Monash Institute of Pharmaceutical Sciences (MIPS), Monash University, Parkville, Vic, Australia; Florey Institute of Neurosciences and Mental Health, Parkville, Vic, Australia.
AN - 40090388
BT - J Affect Disord
C5 - Healthcare Disparities
DA - Jun 15
DO - 10.1016/j.jad.2025.03.084
DP - NLM
ET - 20250314
JF - J Affect Disord
LA - eng
N2 - BACKGROUND: The clinical profiles of youth presenting to early intervention mental health services are heterogeneous, with various sub-groups proposed and little information about the longitudinal stability of profiles, especially those associated with bipolarity. METHODS: 802 youth aged 12-25-years (Mean = 18.26; 66 % females) accessing primary-care based mental health clinics were assessed at baseline and 417 were re-assessed after 12-months. An exploratory factor analysis of 62 items from six validated rating scales of the severity of mental and physical ill-health was conducted. Seven factors (anxiety, sleep, depression, restlessness, distress, activation, somatic complaints) were derived and modelled using latent profile analysis. Associations between profile membership, clinical outcomes and functioning were examined. Conditional probabilities of shifting to a different profile longitudinally were computed. RESULTS: Three profiles were revealed which were psychometrically invariant across baseline and follow-up: (1) 'High distress with high activation' (32 % baseline, 25 % follow-up); (2) 'High distress without activation' (31 % baseline, 26 % follow-up); and (3) 'Moderate distress' (37 % baseline, 33 % follow-up). A fourth profile, 'Low distress' (16 %), emerged at follow-up. Profiles did not differ by age at baseline or sex. 'High distress with high activation' was more likely to be impaired longitudinally, and to meet criteria for a full-threshold mental disorder at follow-up. About 39 % of youth retained the same profile longitudinally, while 16 % shifted to lower distress, and 13 % shifted to higher distress. CONCLUSION: These findings suggest that activation is a marker of poorer clinical and functional outcomes in youth presenting for mental health care.
PY - 2025
SN - 0165-0327
SP - 680
EP - 689+
ST - Activation differentiates illness trajectories among youth seeking mental health care
T1 - Activation differentiates illness trajectories among youth seeking mental health care
T2 - J Affect Disord
TI - Activation differentiates illness trajectories among youth seeking mental health care
U1 - Healthcare Disparities
U3 - 10.1016/j.jad.2025.03.084
VL - 379
VO - 0165-0327
Y1 - 2025
ER -