Pediatric Research Center, New Children's Hospital, Helsinki, Finland
Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
BMJ Paediatr Open. 2023 Feb;7(1). doi: 10.1136/bmjpo-2022-001605.
To investigate disease control, psychiatric comorbidity, substance use and their possible associations in adolescents with chronic medical conditions before transfer to adult healthcare.
We collected clinical data from the year preceding transfer of care and psychiatric data from the records of the paediatric hospital in Helsinki, Finland (population base 1.7 million). Participants were grouped into three disease and/or adherence control categories (good, some evidence of concern, poor) based on clinical data from the medical records of the year preceding the transfer of care. Participants completed the Adolescent's Substance Use Measurement Questionnaire before transfer of care and were divided into four risk subgroups accordingly.
In total, 253 adolescents (mean age 17.3 years, SD 1.2) from six paediatric subspecialties participated in this study. Disease control and/or adherence were rated as good in 28% (n=70), moderate in 42% (n=105) and poor in 30% (n=76) in the year before participants transferred to adult health services. A quarter of participants had at least one psychiatric diagnosis during adolescence. Adolescents with concomitant psychiatric diagnoses more often had poor disease control of their chronic medical condition than adolescents with only a medical condition (44% vs 26%; n=25 of 59 vs 51 of 194, respectively). More than half of adolescents (56%) were abstinent or used substances infrequently; 10% (n=26) reported hazardous substance use.
Psychiatric comorbidity in adolescents with chronic medical conditions is common. Its negative association with disease control and possible substance use should be considered in the transition process to adult health services.
为了调查患有慢性疾病的青少年在转入成人医疗保健之前的疾病控制、精神共病、物质使用及其可能的关联。
我们从芬兰赫尔辛基儿科医院的记录中收集了临床数据（人口基数为 170 万），并在转入护理前一年收集了精神科数据。参与者根据转入护理前一年的医疗记录中的临床数据分为三组疾病和/或依从性控制类别（良好、有一定关注迹象、不良）。参与者在转入护理前完成了青少年物质使用测量问卷，并据此分为四个风险亚组。
共有 253 名（平均年龄 17.3 岁，SD1.2）来自六个儿科亚专科的青少年参与了这项研究。在转入成人健康服务前一年，28%（n=70）的参与者疾病控制和/或依从性良好，42%（n=105）中度，30%（n=76）不良。四分之一的参与者在青少年时期至少有一个精神科诊断。患有精神共病的青少年其慢性疾病的控制情况比只有单一疾病的青少年更差（44% vs 26%；n=25 例/59 例与 n=51 例/194 例，分别）。超过一半的青少年（56%）保持禁欲或很少使用物质；10%（n=26）报告有危险物质使用。
患有慢性疾病的青少年中常见精神共病。在向成人健康服务过渡的过程中，应考虑其与疾病控制和可能的物质使用之间的负面关联。
