Assessing racial/ethnic differences in the social consequences of early-onset psychiatric disorder

Abstract

Individuals with early onset of psychiatric disorder have worse social outcomes than individuals with adult onset. It is unknown whether this association varies by racial/ ethnic group. Identifying groups at risk for poor social outcomes is important for improving clinical and policy interventions. We compared unemployment, high school dropout, arrest, and welfare participation by race/ethnicity and time of onset using a nationally representative sample of Whites, Blacks, Asians, and Latinos with lifetime psychiatric disorder. Early onset was associated with worse social outcomes than adult onset. Significant Black-White and Latino-White differences in social outcomes were identified. The association between early onset and negative social outcomes was similar across Whites, Latinos, and Blacks. For Asians, the association between unemployment and early onset was opposite that of Whites. Increasing early detection and treatment of psychiatric illness should be prioritized. Further study will clarify the association between onset and social outcomes among sub-ethnic populations.

Figure 1. Predicted Rates of Social Indicators by Age of Onset

**All differences by age of onset are significant at p<.05 level. Error bars represent 95% confidence intervals Source: Collaborative Psychiatric Epidemiology Surveys (includes NLAAS, NSAL, and NCS-R) ^†Predicted rates are generated by “recycled predictions” that apply model coefficients to different data populations after standardization for covariates.

Figure 2. Assesing the Effect of Age of onset on Minority-White Differences in Negative Social Outcomes

**Difference in age of onset within racial/ethnic category is significant at p<.05 level ^†Difference in age of onset for Asians is significantly different than difference in age of onset for Whites