The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults

Suzanne E Gerritsen¹, Koen Bolhuis¹, Larissa S van Bodegom^{1

2}, Athanasios Maras³, Mathilde M Overbeek^{3

4

5}, Therese A M J van Amelsvoort^{6

7}, Dieter Wolke^{8

9}, Giovanni de Girolamo¹⁰, Tomislav Franić^{11

12}, Jason Madan¹³, Fiona McNicholas^{14

15}, Moli Paul^{9

16}, Diane Purper-Ouakil^{17

18}, Paramala Santosh^{19

20

21}, Ulrike M E Schulze²², Swaran P Singh⁹, Cathy Street⁹, Sabine Tremmery²³, Helena Tuomainen⁹, Gwen C Dieleman¹, Esther Mesman¹

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
² Yulius Mental Health Organization, Dordrecht, the Netherlands.
³ ARQ National Psychotrauma Centre, Diemen, the Netherlands.
⁴ Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
⁵ Yulius Academy, Yulius Mental Health Organization, Dordrecht, the Netherlands.
⁶ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, the Netherlands.
⁷ Mondriaan Mental Health Care, Heerlen, the Netherlands.
⁸ Department of Psychology, University of Warwick, Coventry, UK.
⁹ Warwick Medical School, University of Warwick, Coventry, UK.
¹⁰ IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
¹¹ University Hospital Split, Split, Croatia.
¹² School of Medicine, University of Split, Split, Croatia.
¹³ Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
¹⁴ School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland.
¹⁵ Lucena CAMHS, SJOG, Dublin, Republic of Ireland.
¹⁶ Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
¹⁷ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France.
¹⁸ INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France.
¹⁹ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
²⁰ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
²¹ HealthTracker Ltd, Kent, UK.
²² Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
²³ Department of Neurosciences, KU Leuven, Leuven, Belgium.

PMID: 39113641
PMCID: PMC12414552
DOI: 10.1093/schbul/sbae136

The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults

Suzanne E Gerritsen et al. Schizophr Bull. 2025.

. 2025 Sep 8;51(5):1282-1295.

doi: 10.1093/schbul/sbae136.

Authors

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
² Yulius Mental Health Organization, Dordrecht, the Netherlands.
³ ARQ National Psychotrauma Centre, Diemen, the Netherlands.
⁴ Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
⁵ Yulius Academy, Yulius Mental Health Organization, Dordrecht, the Netherlands.
⁶ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, the Netherlands.
⁷ Mondriaan Mental Health Care, Heerlen, the Netherlands.
⁸ Department of Psychology, University of Warwick, Coventry, UK.
⁹ Warwick Medical School, University of Warwick, Coventry, UK.
¹⁰ IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
¹¹ University Hospital Split, Split, Croatia.
¹² School of Medicine, University of Split, Split, Croatia.
¹³ Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
¹⁴ School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland.
¹⁵ Lucena CAMHS, SJOG, Dublin, Republic of Ireland.
¹⁶ Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
¹⁷ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France.
¹⁸ INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France.
¹⁹ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
²⁰ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
²¹ HealthTracker Ltd, Kent, UK.
²² Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
²³ Department of Neurosciences, KU Leuven, Leuven, Belgium.

PMID: 39113641
PMCID: PMC12414552
DOI: 10.1093/schbul/sbae136

Abstract

Background and hypothesis: Young people (YP) with psychotic experiences (PE) have an increased risk of developing a psychiatric disorder. Therefore, knowledge on continuity of care from child and adolescent (CAMHS) to adult mental health services (AMHS) in relation to PE is important. Here, we investigated whether the self-reported trajectories of persistent PE were associated with likelihood of transition to AMHS and mental health outcomes.

Study design: In this prospective cohort study, interviews and questionnaires were used to assess PE, mental health, and service use in 763 child and adolescent mental health service users reaching their service's upper age limit in 8 European countries. Trajectories of self-reported PE (3 items) from baseline to 24-month follow-up were determined using growth mixture modeling (GMM). Associations were assessed with auxiliary variables and using mixed models. Study results. At baseline, 56.7% of YP reported PE. GMM identified 5 trajectories over 24 months: medium increasing (5.2%), medium stable (11.7%), medium decreasing (6.5%), high decreasing (4.2%), and low stable (72.4%). PE trajectories were not associated with continuity of specialist care or transition to AMHS. Overall, YP with PE reported more mental health problems at baseline. Persistence of PE or an increase was associated with poorer outcomes at follow-up.

Conclusions: PE are common among CAMHS users when reaching the upper age limit of CAMHS. Persistence or an increase of PE was associated with poorer mental health outcomes, poorer prognosis, and impaired functioning, but were less discriminative for continuity of care.

Keywords: adolescent; mental health services; psychotic disorders; psychotic symptoms; transition to adult care; young adult.

PubMed Disclaimer

Conflict of interest statement

The MILESTONE project is funded by EU FP7 programme under grant number 602442. SPS was part-funded by the NIHR Applied Research Collaboration West Midlands (ARC-WM). The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. PS is the co-inventor of the HealthTracker^TM and is the Chief Executive Officer and shareholder in HealthTracker Ltd and has received funding for clinical trials in Rett Syndrome from Anavex Scientific Corp, Newron Pharma, and GW Pharma (all not related to transition research). AM was a speaker and advisor for Neurim, Shire, Infectopharm, and Lilly (all not related to transition research).

Figures

**Fig. 1.**
Five latent classes representing developmental trajectories of self-reported PE. *Note*: Class 1 (medium increasing): n = 37 (5.2%); class 2 (medium decreasing): n = 46 (6.5%); class 3 (high decreasing): n = 30 (4.2%); class 4 (low stable): n = 515 (72.4%); class 5 (medium stable): n = 83 (11.7%).

See this image and copyright information in PMC

References

1. Reef J, van Meurs I, Verhulst FC, van der Ende J. Children’s problems predict adults’ DSM-IV disorders across 24 years. Journal of the American Academy of Child & Adolescent Psychiatry. 2010;49(11):1117–1124. - PubMed
1. Copeland WE, Shanahan L, Costello EJ, Angold A. Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Arch Gen Psychiatry. 2009;66(7):764–772. - PMC - PubMed
1. Copeland WE, Wolke D, Shanahan L, Costello EJ. Adult functional outcomes of common childhood psychiatric problems: a prospective, longitudinal study. JAMA Psychiatry. 2015;72(9):892–899. doi: 10.1001/jamapsychiatry.2015.0730 - DOI - PMC - PubMed
1. Paul M, Ford T, Kramer T, Islam Z, Harley K, Singh SP. Transfers and transitions between child and adult mental health services. Br J Psychiatry Suppl. 2013;202:s36–s40. doi: 10.1192/bjp.bp.112.119198 - DOI - PubMed
1. Davis M. Addressing the needs of youth in transition to adulthood. Adm Policy Ment Health. 2003;30(6):495–509. - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults

Affiliations

The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical