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在意大利运营一家过渡年龄青年心理健康门诊诊所的经验教训:青少年医学早期干预(PRIMA)经验

Lessons Learnt From Running a Transition-Age Youth Mental Health Outpatient Clinic in Italy: The PRecocity of Intervention in Adolescent Medicine (PRIMA) Experience.

作者信息

Colizzi Marco, Basaldella Marta, Candolo Anna, Garzitto Marco, Palermo Andrea, Scipioni Claudia, Tavian Giovanna, Balestrieri Matteo, Bortoletto Riccardo, Comacchio Carla

机构信息

Unit of Psychiatry, Department of Medicine (DMED), University of Udine, Udine, Italy.

Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Early Interv Psychiatry. 2025 Jan;19(1):e13604. doi: 10.1111/eip.13604. Epub 2024 Aug 20.

Abstract

AIM

This study assessed whether transition age between adolescence and young adulthood poses a challenge for both patients and mental health services.

METHODS

We retrospectively examined the baseline characteristics, diagnoses and treatments of 99 individuals aged 16-35 presenting to the PRecocity of Intervention in Adolescent Medicine (PRIMA) transition-age mental health outpatient clinic, Italy, over a 24-month period.

RESULTS AND DISCUSSION

Most patients were female, aged 20 or younger, employed and did not experience impairment in daily autonomies. About half patients were referred by general practitioners or self-referred, often as initial contact with any adult mental health services, complaining with multiple symptoms (88%), mainly including anxiety, affective disturbances and insomnia. Most of them received a single diagnosis (68%), one out of three being diagnosed with a neurodevelopmental disorder. Patients presenting with anxiety (63% vs. 32%; OR = 3.55, p = 0.01) and affective symptoms (56% vs .23%; OR = 4.26, p = 0.01) and receiving multiple diagnoses (30% vs. 9%; χ (2) = 19.7, p < 0.01) were more likely to be prescribed with psychopharmacological medication at the first visit. At a 6-month follow-up, one in two patients remained in PRIMA, while the others required different services tailored to their specific conditions, especially neurodevelopmental disorders.

CONCLUSION

Findings from this study warrant the need for specialised mental healthcare facilities ensuring timely and high-quality interventions for adolescents transitioning into young adulthood.

摘要

目的

本研究评估了从青春期到青年期的过渡阶段是否对患者和心理健康服务都构成挑战。

方法

我们回顾性研究了意大利青少年医学干预早熟(PRIMA)过渡年龄心理健康门诊在24个月期间接诊的99名年龄在16 - 35岁患者的基线特征、诊断和治疗情况。

结果与讨论

大多数患者为女性,年龄在20岁及以下,有工作,日常生活自理能力未受损害。约一半患者由全科医生转诊或自行就诊,通常是首次接触成人心理健康服务,主诉多种症状(88%),主要包括焦虑、情感障碍和失眠。他们中的大多数(68%)得到单一诊断,三分之一被诊断患有神经发育障碍。首次就诊时,出现焦虑症状(63%对32%;OR = 3.55,p = 0.01)、情感症状(56%对23%;OR = 4.26,p = 0.01)以及接受多种诊断(30%对9%;χ(2)=19.7,p < 0.01)的患者更有可能被开具精神药物。在6个月的随访中,二分之一的患者仍留在PRIMA,而其他患者则需要根据其具体情况提供不同的服务,尤其是针对神经发育障碍的服务。

结论

本研究结果表明,需要有专门的精神卫生保健设施,为从青春期过渡到青年期的青少年确保及时、高质量的干预措施。

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