Cook Judith A, Jonikas Jessica A, Burke-Miller Jane K, Aranda Frances, Mullen Michelle G, Davis Maryann, Sabella Kathryn
Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois Chicago College of Medicine, 1601 West Taylor Street, 4th Floor, M/C 912, Chicago, IL, 60612, USA.
Transitions to Adulthood Center for Research, Department of Psychiatry, UMass Chan Medical Schoo, 222 Maple Avenue, Shrewsbury, MA, 01545, USA.
J Behav Health Serv Res. 2025 Apr;52(2):263-281. doi: 10.1007/s11414-024-09924-0. Epub 2025 Jan 13.
This study sought to understand how young adults (age 18-25) with histories of mental health disorders are coping with disrupted transitions to adulthood during the COVID-19 pandemic. A cross-sectional web survey was conducted in March-June 2021 of 967 US young adults with pre-pandemic psychiatric disability to assess their current psychiatric status, interrupted transitions, and associations with social determinants including income, community participation, and social context. Mental health was assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and PTSD Checklist-Civilian Version. Social determinants were identified with the Epidemic-Pandemic Impacts Inventory. Interrupted transitions were measured with the Young Adult Disrupted Transitions Assessment. Multivariable logistic regression models predicted four types of transition disruptions and associations with current mental health, social determinants, and demographic factors. Disruptions were reported by 81.1% including interrupted education completion (38.3%), employment careers (37.6%), residential independence (27.7%), and intimate partner relationships (22.9%). Many screened positive for major depressive disorder (81.7%), PTSD (85.5%), or GAD (58.6%). Disruption in establishing intimate partner relationships was associated with depression, anxiety, and PTSD. Interrupted residential independence was associated with anxiety. Interrupted education completion was associated with PTSD. Interrupted employment was associated with anxiety. Social determinants significant in these models included social connections, community participation, income, and racial/ethnic identification. Results illuminate ways that current mental health and social determinants affect transition interruptions during the pandemic. Findings suggest the need for interdisciplinary approaches, integrated models of care, and assistance accessing treatment, rehabilitation, and community support services from adult service systems.
本研究旨在了解有心理健康障碍病史的年轻人（18至25岁）在新冠疫情期间如何应对向成年期过渡的中断。2021年3月至6月对967名疫情前有精神疾病残疾的美国年轻人进行了一项横断面网络调查，以评估他们当前的精神状态、过渡中断情况以及与包括收入、社区参与和社会环境在内的社会决定因素之间的关联。使用患者健康问卷（PHQ - 9）、广泛性焦虑障碍量表（GAD - 7）和创伤后应激障碍检查表 - 平民版评估心理健康状况。使用疫情影响量表确定社会决定因素。使用青年成人过渡中断评估量表测量过渡中断情况。多变量逻辑回归模型预测了四种类型的过渡中断以及与当前心理健康、社会决定因素和人口因素之间的关联。81.1%的人报告有过渡中断情况，包括教育完成中断（38.3%）、就业生涯中断（37.6%）、居住独立中断（27.7%）和亲密伴侣关系中断（22.9%）。许多人筛查出患有重度抑郁症（81.7%）、创伤后应激障碍（85.5%）或广泛性焦虑障碍（58.6%）。建立亲密伴侣关系的中断与抑郁、焦虑和创伤后应激障碍有关。居住独立中断与焦虑有关。教育完成中断与创伤后应激障碍有关。就业中断与焦虑有关。这些模型中显著的社会决定因素包括社会联系、社区参与、收入和种族/族裔认同。研究结果揭示了当前心理健康和社会决定因素在疫情期间影响过渡中断的方式。研究结果表明需要采用跨学科方法、综合护理模式，并协助从成人服务系统获得治疗、康复和社区支持服务。
