Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?

Larissa S van Bodegom^{1

2}, Mathilde M Overbeek^{1

3

4}, Suzanne E Gerritsen², Athanasios Maras^{1

3}, Manon H J Hillegers², Dieter Wolke⁵, Dimitris Rizopoulos^{6

7}, Giovanni Allibrio⁸, Therese A M J van Amelsvoort^{9

10}, Rebecca Appleton¹¹, Marco Armando¹², Tomislav Franić^{13

14}, Giovanni de Girolamo¹⁵, Jason Madan¹⁶, Lidia Manenti⁸, Francesco Margari¹⁷, Fiona McNicholas^{18

19}, Adriana Pastore²⁰, Moli Paul¹⁶, Diane Purper-Ouakil^{21

22}, Francesco Rinaldi²³, Melanie C Saam²⁴, Paramala J Santosh^{25

26

27}, Anne Sartor²⁸, Ulrike M E Schulze²⁴, Giulia Signorini¹⁵, Swaran P Singh¹⁶, Cathy Street¹⁶, Priya Tah^{16

29}, Elena Tanase²⁴, Sabine Tremmery³⁰, Helena Tuomainen¹⁵, Gwendolyn C Dieleman²

Affiliations

¹ Yulius Mental Health Organization, Yulius Academy, Dordrecht, 3300 BA, Netherlands.
² Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
³ ARQ National Pyschotrauma Centre, Diemen, Netherlands.
⁴ Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, Netherlands.
⁵ Department of Psychology, University of Warwick, Coventry CV4 7AL, UK.
⁶ Department of Biostatistics, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
⁷ Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
⁸ Child And Adolescent Neuropsychiatric Service, ASST Spedali Civili, Brescia, Italy.
⁹ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, Netherlands.
¹⁰ Mondriaan Mental Health Care, Heerlen, Netherlands.
¹¹ NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London W1T 7NF, UK.
¹² University Service for Child and Adolescent Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
¹³ Department of Psychiatry, University Hospital Split, Split 21000, Croatia.
¹⁴ School of Medicine, University of Split, Split 21000, Croatia.
¹⁵ Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy.
¹⁶ Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
¹⁷ Child Neuropsychiatric Unit, University of Bari, Bari 70121, Italy.
¹⁸ School of Medicine & Medical Science, University College Dublin, Dublin D04 V1W8, Ireland.
¹⁹ Lucena CAMHS, SJOG, Dublin, Ireland.
²⁰ Unit of Adolescent Psychiatric Emergency, "Policlinico" Hospital, Bari 70121, Italy.
²¹ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier 34090, France.
²² CESP U1018, PsyDev, University Paris Saclay, UVSQ, INSERM, Versailles, France.
²³ Child And Adolescent Neuropsychiatric Service, ASST of Valcamonica, Esine, Italy.
²⁴ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm 89075, Germany.
²⁵ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK.
²⁶ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
²⁷ HealthTracker Ltd., Kent ME7 1AY, UK.
²⁸ Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Josefinum Augsburg, Augsburg 86154, Germany.
²⁹ Rees Centre, Department of Education, University of Oxford, Oxford OX2 6PY, UK.
³⁰ Department of Neurosciences, KU Leuven, Leuven BE-3000, Belgium.

PMID: 40224602
PMCID: PMC11921827
DOI: 10.1155/2023/8495521

Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?

Larissa S van Bodegom et al. Depress Anxiety. 2023.

. 2023 Oct 31:2023:8495521.

doi: 10.1155/2023/8495521. eCollection 2023.

Authors

Affiliations

¹ Yulius Mental Health Organization, Yulius Academy, Dordrecht, 3300 BA, Netherlands.
² Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
³ ARQ National Pyschotrauma Centre, Diemen, Netherlands.
⁴ Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, Netherlands.
⁵ Department of Psychology, University of Warwick, Coventry CV4 7AL, UK.
⁶ Department of Biostatistics, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
⁷ Department of Epidemiology, Erasmus Medical Center, Rotterdam, 3000 CB, Netherlands.
⁸ Child And Adolescent Neuropsychiatric Service, ASST Spedali Civili, Brescia, Italy.
⁹ Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, Netherlands.
¹⁰ Mondriaan Mental Health Care, Heerlen, Netherlands.
¹¹ NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London W1T 7NF, UK.
¹² University Service for Child and Adolescent Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
¹³ Department of Psychiatry, University Hospital Split, Split 21000, Croatia.
¹⁴ School of Medicine, University of Split, Split 21000, Croatia.
¹⁵ Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy.
¹⁶ Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
¹⁷ Child Neuropsychiatric Unit, University of Bari, Bari 70121, Italy.
¹⁸ School of Medicine & Medical Science, University College Dublin, Dublin D04 V1W8, Ireland.
¹⁹ Lucena CAMHS, SJOG, Dublin, Ireland.
²⁰ Unit of Adolescent Psychiatric Emergency, "Policlinico" Hospital, Bari 70121, Italy.
²¹ Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier 34090, France.
²² CESP U1018, PsyDev, University Paris Saclay, UVSQ, INSERM, Versailles, France.
²³ Child And Adolescent Neuropsychiatric Service, ASST of Valcamonica, Esine, Italy.
²⁴ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm 89075, Germany.
²⁵ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 8AF, UK.
²⁶ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
²⁷ HealthTracker Ltd., Kent ME7 1AY, UK.
²⁸ Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Josefinum Augsburg, Augsburg 86154, Germany.
²⁹ Rees Centre, Department of Education, University of Oxford, Oxford OX2 6PY, UK.
³⁰ Department of Neurosciences, KU Leuven, Leuven BE-3000, Belgium.

PMID: 40224602
PMCID: PMC11921827
DOI: 10.1155/2023/8495521

Abstract

Background: Clinicians in Child and Adolescent Mental Healthcare Services (CAMHS) face the challenge to determine who is at risk of persistence of depressive problems into adulthood and requires continued treatment after reaching the CAMHS upper age limit of care-provision. We assessed whether risk factors for persistence were related to CAMHS clinicians' transition recommendations.

Methods: Within the wider MILESTONE cohort study, 203 CAMHS users were classified with unipolar depressive disorder by their clinician, and 185 reported clinical levels of depressive problems on the DSM-oriented Depressive Problems scale of the Achenbach Youth Self Report. Logistic regression models were fitted to both subsamples to assess the relationship between clinicians' transition recommendations and risk factors for persistent depression.

Results: Only clinician-rated severity of psychopathology was related to a recommendation to continue treatment for those classified with unipolar depressive disorder (N = 203; OR = 1.45, 95% CI (1.03-2.03), p = .044) and for those with self-reported depressive problems on the Achenbach DSM-oriented Depressive Problems scale (N = 185; OR = 1.62, 95% CI (1.12-2.34), p = .012).

Conclusion: Transition recommendations and need for continued treatment are based on clinical expertise, rather than self-reported problems and needs.

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Conflict of interest statement

SPS is part-funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (NIHR CLAHRC WM), now recommissioned as NIHR Applied Research Collaboration West Midlands. 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 coinventor of the HealthTrackerTM, 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).

References

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Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?

Affiliations

Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms