title: Distress and disability in young adults presenting to clinical services with mood disorders.
abstract: BACKGROUND
  Distress and/or dysfunction are well established as key reasons for help-seeking. We explore the characteristics of groups defined by high or low distress or disability in young people with unipolar depression (UP) or bipolar disorder (BD).
  
  
  METHODS
  Individuals aged 12 to 25 years presenting to youth mental health services for the first time with a primary diagnosis of UP or BD were assessed using the Kessler Psychological Distress Scale (Kessler-10) and the Work and Social Adjustment Scale (WSAS). Four groups with high or low distress or impairment were defined (according to scores above or below the group medians for the Kessler-10 and WSAS). Multinomial logistic regression (MNLR) was used to examine how cases with high levels of distress and disability (reference group) differed from the other three groups.
  
  
  CONCLUSIONS
  The sample comprised 1,746 cases (90% UP, 56% female) with a median age of 17.5 years. Median scores on the Kessler-10 and WSAS were both high (30 and 20, respectively) and were significantly inter-correlated (r = 0.62); the high impairment/distress group was the largest sub-group (39% of cases). The MNLR analysis demonstrated that younger age was associated with lower impairment groups (irrespective of distress level), whilst male gender was associated with lower distress (irrespective of impairment). Compared to the low impairment/distress cases, the high impairment/distress group was significantly more likely to use cannabis and/or alcohol. Age, substance use and possibly gender are probably better predictors of distress/impairment sub-group than mood disorder sub-type in youth.
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia ; School of Medicine, The University of Notre Dame, 160 Oxford Street, Darlinghurst, Sydney, New South Wales 2010 Australia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Scott
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hermens
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Naismith
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Guastella
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Django
authors.initials: D
authors.lastname: White
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Whitwell
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Jim
authors.initials: J
authors.lastname: Lagopoulos
authors.affiliation: Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE1 7RU UK ; Centre for Affective Disorders, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, 100 Mallett Street, Camperdown, New South Wales 2050 Australia.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
keywords: Alcohol and substance misuse; Bipolar; Co-morbidity; Unipolar; Youth