Gerritsen Suzanne E, Bolhuis Koen, van Bodegom Larissa S, Maras Athanasios, Overbeek Mathilde M, van Amelsvoort Therese A M J, Wolke Dieter, de Girolamo Giovanni, Franić Tomislav, Madan Jason, McNicholas Fiona, Paul Moli, Purper-Ouakil Diane, Santosh Paramala, Schulze Ulrike M E, Singh Swaran P, Street Cathy, Tremmery Sabine, Tuomainen Helena, Dieleman Gwen C, Mesman Esther
Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands.
Yulius Mental Health Organization, Dordrecht, the Netherlands.
Schizophr Bull. 2024 Aug 7. doi: 10.1093/schbul/sbae136.
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.
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.
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.
有精神病体验（PE）的年轻人患精神疾病的风险增加。因此，了解从儿童和青少年心理健康服务（CAMHS）到成人心理健康服务（AMHS）在PE方面的连续护理情况很重要。在此，我们调查了自我报告的持续性PE轨迹是否与向AMHS过渡的可能性及心理健康结果相关。
在这项前瞻性队列研究中，通过访谈和问卷调查对8个欧洲国家763名达到其所在儿童和青少年心理健康服务机构年龄上限的服务使用者的PE、心理健康及服务使用情况进行评估。使用生长混合模型（GMM）确定从基线到24个月随访期间自我报告的PE（3项）轨迹。通过辅助变量并使用混合模型评估相关性。研究结果。在基线时，56.7%的年轻人报告有PE。GMM识别出24个月内的5种轨迹：中度上升（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，有PE的年轻人在基线时报告有更多心理健康问题。PE的持续存在或增加与随访时较差的结果相关。
在达到CAMHS年龄上限时，PE在CAMHS使用者中很常见。PE的持续存在或增加与较差的心理健康结果、较差的预后及功能受损相关，但对连续护理的区分性较小。
