Background and HypothesisYoung 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 DesignIn 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.ConclusionsPE 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.

中文翻译：

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青少年和年轻人纵向队列中自我报告的精神病经历轨迹与心理健康护理连续性之间的关联


背景和假设 患有精神病经历 （PE） 的年轻人 （YP） 患精神疾病的风险增加。因此，了解与 PE 相关的从儿童和青少年 （CAMHS） 到成人心理健康服务 （AMHS） 的护理连续性很重要。在这里，我们调查了持续性 PE 的自我报告轨迹是否与过渡到 AMHS 的可能性和心理健康结果相关。研究设计在这项前瞻性队列研究中，访谈和问卷用于评估 763 名达到服务年龄上限的儿童和青少年心理健康服务使用者的 PE、心理健康和服务使用情况，这些用户来自 8 个欧洲国家。使用生长混合物模型 （GMM） 确定自我报告的 PE （3 项） 从基线到 24 个月随访的轨迹。使用辅助变量和混合模型评估关联。研究结果。在基线时，56.7% 的 YP 报告 PE。GMM 在 24 个月内确定了 5 个轨迹：中度增加 （5.2%）、中等稳定 （11.7%）、中度下降 （6.5%）、高下降 （4.2%） 和低稳定 （72.4%）。PE 轨迹与专科护理的连续性或向 AMHS 的过渡无关。总体而言，患有 PE 的 YP 在基线时报告了更多的心理健康问题。PE 的持续存在或增加与随访时较差的结局相关。结论达到 CAMHS 年龄上限时，PE 在 CAMHS 使用者中常见。PE 的持续或增加与较差的心理健康结果、较差的预后和功能受损相关，但对护理连续性的歧视性较小。