Kunczicky Kerstin, Jahnke-Majorkovits Ann-Christin, Sevecke Kathrin
Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, A.ö. Landeskrankenhaus Hall, Milser Straße 10, Haus 6, 6060, Hall in Tirol, Österreich.
Neuropsychiatr. 2024 Sep;38(3):111-122. doi: 10.1007/s40211-023-00477-w. Epub 2023 Aug 3.
Due to the structural separation of child and adolescent psychiatric treatment and adult psychiatric treatment, a switch between these two systems upon the age of 18 is necessary. Considering the importance of an organized transition, patients from an age of 17 were asked about their transition needs and aspects of their identity development. Thus future improvements in the treatment structures in this sensitive phase should derive.
With the help of the Transition Readiness and Appropriateness Measure (TRAM), the transition-specific needs of 17 to 24-year-old patients (N = 42) at the Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Hall in Tirol were surveyed. In addition, the connection between identity development and transition was examined using the Assessment of Identity Development in Adolescence (AIDA).
Almost 80% of the patients stated that they needed further care. 'Patient-related factors' and 'family support' were described as barriers to the willingness to transition. A significant connection was found between identity development and the willingness or need for transition (r = 0.431, p < 0.01), although this was more pronounced in relation to the need for transition (r = 0.821 p < 0.01). In addition, those affected stated that they were frequently and severely burdened by stress, 45% reported self-injurious behavior, 48% suicidal thoughts or behavior in the last six months. In terms of psychopathology, anxiety and depression were among the most common symptoms. In terms of functional impairment, the 'relationships' area was the most affected.
The study provides initial insights into the transition-specific characteristics and needs of patients in transition age. The integration of standardized measuring instruments in institutional care systems, which individually record the transition-related needs, the willingness and need of young people in transition age, can facilitate targeted and needs-based treatment or transition. Interdisciplinary cooperation between child and adolescent psychiatry and adult psychiatry as well as a continuous transfer of the therapeutic relationships in the transition process should also be guaranteed.
由于儿童和青少年精神科治疗与成人精神科治疗在结构上相互分离,18岁时在这两个系统之间进行转换是必要的。考虑到有组织的过渡的重要性,对17岁及以上的患者询问了他们的过渡需求以及身份发展方面的问题。因此,应该在这个敏感阶段对治疗结构进行未来的改进。
借助过渡准备和适宜性测量(TRAM),对蒂罗尔州哈尔儿童、青少年精神病学、身心医学和心理治疗诊所的17至24岁患者(N = 42)的特定过渡需求进行了调查。此外,使用青少年身份发展评估(AIDA)检查了身份发展与过渡之间的联系。
近80%的患者表示他们需要进一步的护理。“与患者相关的因素”和“家庭支持”被描述为阻碍过渡意愿的因素。在身份发展与过渡意愿或需求之间发现了显著的联系(r = 0.431,p < 0.01),尽管这种联系在过渡需求方面更为明显(r = 0.821,p < 0.01)。此外,受影响者表示他们经常承受严重的压力负担,45%的人报告在过去六个月中有自我伤害行为,48%的人有自杀念头或行为。在精神病理学方面,焦虑和抑郁是最常见的症状。在功能损害方面,“人际关系”领域受影响最大。
该研究为过渡年龄患者的特定过渡特征和需求提供了初步见解。在机构护理系统中整合标准化测量工具,单独记录过渡年龄年轻人的过渡相关需求、意愿和需求,可以促进有针对性的、基于需求的治疗或过渡。儿童和青少年精神病学与成人精神病学之间的跨学科合作以及在过渡过程中治疗关系的持续传递也应得到保证。