van Bodegom Larissa S, Gerritsen Suzanne E, Maras Athanasios, Hillegers Manon H J, Wolke Dieter, Rizopoulos Dimitris, van Amelsvoort Therese A M J, Franić Tomislav, de Girolamo Giovanni, Madan Jason, McNicholas Fiona, Paul Moli, Purper-Ouakil Diane, Santosh Paramala J, Schulze Ulrike, Singh Swaran P, Street Cathy, Tremmery Sabine, Tuomainen Helena, Dieleman Gwendolyn C, Overbeek Mathilde M
Yulius Academy, Yulius Mental Health Organization, Dordrecht 3300 BA, Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam 3000 CB, Netherlands.
Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam 3000 CB, Netherlands.
J Affect Disord. 2025 Dec 15;391:119925. doi: 10.1016/j.jad.2025.119925. Epub 2025 Jul 15.
Identifying young service users whose depressive symptoms persist into adulthood is crucial to avert potential difficulties they may face when transitioning from Child and Adolescent Mental Healthcare Services (CAMHS) to Adult Mental Healthcare Services (AMHS). As depressive symptoms are diverse in severity and stability, it is important to objectively identify those who require continued support. A clinical cohort of 763 young people from eight European countries, reaching the upper age limit of their CAMHS, was studied to identify trajectories of self-reported depressive problems (ASEBA Youth Self-Report and Adult Self-Report) over a 24-month follow-up period, as well as associated risk factors for persistent depression and service use, using growth mixture modeling. Self-reported, parent-reported, and clinician-reported interviews and questionnaires were used to collect information on risk factors for persistent depression and service use. We identified a low, a decreasing, an increasing and a high trajectory of depressive symptoms. The high trajectory could be predicted with almost all risk factors for persistent depression (i.g. higher clinician-rated psychopathology, more suicidality, comorbidity and being a victim of bullying) and these young people were likely to transition to AMHS or require specialist mental health care at a later date. More importantly, young people whose depressive symptoms increase to similar levels as the group with persistent high-levels of depressive symptoms (the increasing trajectory) could not be properly distinguished from other young people based on risk factors, while their needed continuation of treatment (either in AMHS or CAMHS) was equally likely as the end of care.
识别那些抑郁症状持续到成年期的年轻服务使用者，对于避免他们从儿童和青少年心理健康服务（CAMHS）过渡到成人心理健康服务（AMHS）时可能面临的潜在困难至关重要。由于抑郁症状在严重程度和稳定性方面各不相同，客观地识别那些需要持续支持的人很重要。对来自八个欧洲国家的763名达到CAMHS年龄上限的年轻人的临床队列进行了研究，以确定在24个月的随访期内自我报告的抑郁问题轨迹（ASEBA青少年自我报告和成人自我报告），以及使用生长混合模型确定持续性抑郁和服务使用的相关风险因素。通过自我报告、家长报告和临床医生报告的访谈及问卷来收集关于持续性抑郁和服务使用风险因素的信息。我们确定了抑郁症状的低、下降、上升和高轨迹。高轨迹几乎可以用所有持续性抑郁的风险因素来预测（例如临床医生评定的更高精神病理学、更多自杀倾向、共病以及成为欺凌受害者），这些年轻人很可能会过渡到AMHS或在以后需要专科心理健康护理。更重要的是，那些抑郁症状上升到与持续性高水平抑郁症状组相似水平的年轻人（上升轨迹），基于风险因素无法与其他年轻人正确区分，而他们所需的持续治疗（无论是在AMHS还是CAMHS）与护理结束的可能性相同。
