Journal article
The temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis
Epidemiology and Psychiatric Sciences, Vol.32, pp.1-9
2023
PMCID: PMC10539737
PMID: 37680185
Appears in Thompson Institute Research Collection
Abstract
Aims:
The needs of young people attending mental healthcare can be complex and often span multiple domains (e.g., social, emotional and physical health factors). These factors often complicate treatment approaches and contribute to poorer outcomes in youth mental health. We aimed to identify how these factors interact over time by modelling the temporal dependencies between these transdiagnostic social, emotional and physical health factors among young people presenting for youth mental healthcare.
Methods:
Dynamic Bayesian networks were used to examine the relationship between mental health factors across multiple domains (social and occupational function, self-harm and suicidality, alcohol and substance use, physical health and psychiatric syndromes) in a longitudinal cohort of 2663 young people accessing youth mental health services. Two networks were developed: (1) ‘initial network’, that shows the conditional dependencies between factors at first presentation, and a (2) ‘transition network’, how factors are dependent longitudinally.
Results:
The ‘initial network’ identified that childhood disorders tend to precede adolescent depression which itself was associated with three distinct pathways or illness trajectories; (1) anxiety disorder; (2) bipolar disorder, manic-like experiences, circadian disturbances and psychosis-like experiences; (3) self-harm and suicidality to alcohol and substance use or functioning. The ‘transition network’ identified that over time social and occupational function had the largest effect on self-harm and suicidality, with direct effects on ideation (relative risk [RR], 1.79; CI, 1.59–1.99) and self-harm (RR, 1.32; CI, 1.22–1.41), and an indirect effect on attempts (RR, 2.10; CI, 1.69–2.50). Suicide ideation had a direct effect on future suicide attempts (RR, 4.37; CI, 3.28–5.43) and self-harm (RR, 2.78; CI, 2.55–3.01). Alcohol and substance use, physical health and psychiatric syndromes (e.g., depression and anxiety, at-risk mental states) were independent domains whereby all direct effects remained within each domain over time.
Conclusions:
This study identified probable temporal dependencies between domains, which has causal interpretations, and therefore can provide insight into their differential role over the course of illness. This work identified social, emotional and physical health factors that may be important early intervention and prevention targets. Improving social and occupational function may be a critical target due to its impacts longitudinally on self-harm and suicidality. The conditional independence of alcohol and substance use supports the need for specific interventions to target these comorbidities.
Details
- Title
- The temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis
- Authors
- Frank Iorfino (Corresponding Author) - The University of SydneyMathew Varidel (Author) - The University of SydneyRoman Marchant (Author) - University of Technology SydneySally Cripps (Author) - University of Technology SydneyJacob Crouse (Author) - The University of SydneyAnte Prodan (Author) - Western Sydney UniversityRafael Oliveria (Author) - The University of SydneyJoanne S. Carpenter (Author) - The University of SydneyDaniel F. Hermens (Author) - University of the Sunshine Coast, Queensland, Thompson InstituteAdam Guastella (Author) - The University of SydneyElizabeth Scott (Author) - The University of SydneyJai Shah (Author) - McGill UniversityKathleen Merikangas (Author) - National Institute of Mental HealthJan Scott (Author) - Newcastle UniversityIan B. Hickie (Author) - The University of Sydney
- Publication details
- Epidemiology and Psychiatric Sciences, Vol.32, pp.1-9
- Publisher
- Cambridge University Press
- Date published
- 2023
- DOI
- 10.1017/S2045796023000616
- ISSN
- 2045-7979
- PMID
- 37680185; PMC10539737
- Copyright note
- © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 99967598702621
- Output Type
- Journal article
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- Domestic collaboration
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- Psychiatry
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