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儿童期起病的神经发育障碍患者从儿童和青少年心理健康服务向成人心理健康服务的转诊过程:来自土耳其的首例病例对照研究。

The transfer process from child and adolescent mental health services to adult mental health services for patients with childhood-onset neurodevelopmental disorders: first case-control study from Türkiye.

作者信息

Karaçam Doğan Melike, Karakuş Aydos Yağmur, Keleş Şükrü, Çak Esen Halime Tuna, Yildiz Mevhibe İrem

机构信息

Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Department of Psychiatry, Kdz Eregli State Hospital, Zonguldak, Turkey.

出版信息

BJPsych Open. 2025 Jun 26;11(4):e128. doi: 10.1192/bjo.2025.59.

Abstract

BACKGROUND

The transfer from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) can be challenging, particularly for adolescents with neurodevelopmental disorders (NDDs) requiring long-term follow-up.

AIMS

To examine the transfer process from CAMHS to AMHS in a university hospital in Türkiye, focusing on challenges, service gaps and barriers to transfer for individuals with NDDs.

METHOD

Hospital records of children with NDDs followed in CAMHS for at least 5 years were reviewed. Children with at least one annual admission until 2017-2018 were included. A total of 211 patients were categorised into two groups: those who transferred to AMHS by 2018-2019 (transferred group, 81 patients) and those who did not transfer (non-transferred group, 130 patients). Clinical features, such as primary diagnosis and treatments, were compared, and parental views on the transfer process were collected via telephone interviews.

RESULTS

The transferred group included 81 patients (38.4%), whereas the non-transferred group had 130 patients (61.6%). Of the total sample, 55 (26.1%) were female, and 156 (73.9%) were male. Primary diagnoses were similar between groups; however, the transferred group had more comorbidities ( < 0.001) and more frequent antipsychotic prescriptions ( = 0.006). Proactive information from CAMHS doctors ( = 2.46, s.e. = 0.68, < 0.001) and psychiatric comorbidities predicted transfer. In addition, attention-deficit hyperactivity disorder diagnoses changed during transfer in the transferred group ( = 0.002).

CONCLUSION

These findings emphasise the need for tailored transition support to enhance mental healthcare for NDD patients and indicate areas where further research is required to address healthcare barriers.

摘要

背景

从儿童及青少年心理健康服务(CAMHS)向成人心理健康服务(AMHS)的过渡可能具有挑战性,尤其是对于需要长期随访的患有神经发育障碍(NDDs)的青少年而言。

目的

在土耳其的一家大学医院中,研究从CAMHS向AMHS的过渡过程,重点关注患有NDDs的个体在过渡过程中面临的挑战、服务差距和障碍。

方法

回顾了在CAMHS接受至少5年随访的患有NDDs儿童的医院记录。纳入了在2017 - 2018年之前每年至少入院一次的儿童。总共211名患者被分为两组:到2018 - 2019年转至AMHS的患者(转组,81例)和未转组(未转组,130例)。比较了临床特征,如主要诊断和治疗情况,并通过电话访谈收集了家长对过渡过程的看法。

结果

转组包括81例患者(38.4%),而未转组有130例患者(61.6%)。在总样本中,55例(26.1%)为女性,156例(73.9%)为男性。两组之间的主要诊断相似;然而,转组有更多的共病(<0.001)和更频繁的抗精神病药物处方(=0.006)。来自CAMHS医生的主动信息(=2.46,标准误=0.68,<0.001)和精神共病可预测转组情况。此外,转组中注意力缺陷多动障碍的诊断在过渡期间发生了变化(=0.002)。

结论

这些发现强调了需要提供量身定制的过渡支持,以加强对NDD患者的精神卫生保健,并指出了需要进一步研究以解决卫生保健障碍的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a50/12247079/2c305f75d84b/S2056472425000596_fig1.jpg

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