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The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults
Schizophrenia Bulletin ( IF 5.3 ) Pub Date : 2024-08-08 , DOI: 10.1093/schbul/sbae136
Suzanne E Gerritsen 1 , Koen Bolhuis 1 , Larissa S van Bodegom 1, 2 , Athanasios Maras 3 , Mathilde M Overbeek 3, 4, 5 , Therese A M J van Amelsvoort 6, 7 , Dieter Wolke 8, 9 , Giovanni de Girolamo 10 , Tomislav Franić 11, 12 , Jason Madan 13 , Fiona McNicholas 14, 15 , Moli Paul 9, 16 , Diane Purper-Ouakil 17, 18 , Paramala Santosh 19, 20, 21 , Ulrike M E Schulze 22 , Swaran P Singh 9 , Cathy Street 9 , Sabine Tremmery 23 , Helena Tuomainen 9 , Gwen C Dieleman 1 , Esther Mesman 1
Affiliation  

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.

中文翻译:


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保健连续性之间的关联



背景和假设 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) 的连续性护理非常重要。在这里,我们调查了自我报告的持续性 PE 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,采用访谈和问卷调查的方式评估了 8 个欧洲国家 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体育、心理健康和服务使用情况。使用生长混合模型 (GMM) 确定从基线到 24 个月随访的自我报告 PE 轨迹(3 项)。使用辅助变量和混合模型评估关联性。研究结果。基线时,56.7% 的 YP 报告了 PE。 GMM 确定了 24 个月内的 5 条轨迹:中度增长 (5.2%)、中度稳定 (11.7%)、中度下降 (6.5%)、高度下降 (4.2%) 和低度稳定 (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 持续存在或增加与随访结果较差相关。结论 当达到 CAMHS 年龄上限时,PE 在 CAMHS 使用者中很常见。 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。
更新日期:2024-08-08
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