Anxiety and depression as predictors of NEET in young adulthood: A Swedish national cohort study

Abstract Background Young people not in education, employment, or training (NEET) are a growing concern in European societies. While mental health problems are established risk factors for NEET status, the specific roles of anxiety and depression - and their co-occurrence - remains understudied. This study examines whether symptoms of anxiety, depression, or their co-occurrence at age 21 predict NEET status at age 23, separately for males and females. Methods Data were drawn from Futura01, a Swedish national cohort of individuals born in 2001. We used survey data from waves 3 and 4 (n = 2,619, 59.3% females). NEET status at age 23 was based on current main activity; individuals not studying, working, training, in military service, or on parental leave were classified as NEET. Anxiety and depression symptoms were assessed at age 21 using the Patient Health Questionnaire-4 (PHQ-4). Parental education and migration background were included as covariates. Logistic regression analyses were conducted. Results Among males, experiencing anxiety only (OR = 2.28, p < 0.05), depression only (OR = 2.47, p < 0.01), or their co-occurrence (OR = 2.57, p < 0.01) was associated with higher odds of being NEET. Among females, while neither anxiety only (OR = 0.96, p = 0.924) not depression only (OR = 2.14, p = 0.071) significantly predicted NEET status, the co-occurrence of depression and anxiety symptoms was associated with being NEET (OR = 3.53, p < 0.001). Conclusions Symptoms of anxiety and depression at age 21 are linked to an increased risk of NEET status at age 23, especially the co-occurrence of these symptoms. Experiencing only anxiety symptoms seems to matter solely for males. These findings underscore the importance of distinguishing between mental health disorders, accounting for their co-occurrence, and considering sex-specific patterns when addressing risk factors for being NEET in early adulthood. Targeting youth who display symptoms of mental disorders can be beneficial for reducing NEET prevalence. Key messages • Anxiety, depression, and especially their co-occurrence in early adulthood are linked to a higher risk of being NEET, with distinct patterns by sex. • Sex-specific mental health interventions that identify and support young adults with these symptoms may help reduce NEET prevalence.