Schraeder Kyleigh E, Reid Graham J
Department of Psychology, The University of Western Ontario, 361 Windermere Rd, Westminister Hall, Room 234E, N6A 3K7, London, ON, Canada.
Departments of Psychology, Family Medicine and Paediatrics, The University of Western Ontario, London, ON, Canada.
J Behav Health Serv Res. 2017 Apr;44(2):316-330. doi: 10.1007/s11414-015-9495-2.
The process of transitioning youth from child to adult mental health services is poorly managed, and many adolescents disengage from services during transfer. The waxing and waning of symptoms over time means that some youth who are asymptomatic prior to transfer (15-17 years) will be at high risk for recurrence during the transition period. There are no clear, evidence-based guidelines about who should transfer to adult care. Objectives were to propose: (1) criteria to define anxious or depressed youth (16-21 years) that should transfer and (2) levels of service needed in young adulthood. Natural history of psychopathology and treatment response for depression and anxiety was reviewed. Risk factors for recurrence and persistence, such as initial severity, comorbidity, and family functioning, can help to identify youth requiring transfer. Few controlled treatment studies have examined predictors of long-term course. Recommendations for follow-up care and ongoing monitoring during young adulthood are discussed.
青少年从儿童心理健康服务过渡到成人心理健康服务的过程管理不善，许多青少年在转诊期间不再接受服务。症状随时间的起伏意味着一些在转诊前（15 - 17岁）无症状的青少年在过渡期复发风险很高。对于谁应该转至成人护理，没有明确的、基于证据的指南。目标是提出：（1）界定应转诊的焦虑或抑郁青少年（16 - 21岁）的标准，以及（2）成年早期所需的服务水平。回顾了抑郁和焦虑的精神病理学自然史及治疗反应。复发和持续存在的风险因素，如初始严重程度、共病和家庭功能，有助于识别需要转诊的青少年。很少有对照治疗研究考察长期病程的预测因素。讨论了成年早期后续护理和持续监测的建议。
