Factors associated with the transition of adolescent inpatients from an intensive residential ward to adult mental health services.


Journal

European child & adolescent psychiatry
ISSN: 1435-165X
Titre abrégé: Eur Child Adolesc Psychiatry
Pays: Germany
ID NLM: 9212296

Informations de publication

Date de publication:
May 2022
Historique:
received: 13 04 2020
accepted: 30 12 2020
pubmed: 26 1 2021
medline: 1 6 2022
entrez: 25 1 2021
Statut: ppublish

Résumé

Transition of young people from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is a complex process. Transition rates are heterogeneously reported, with wide definitions and ranges. Few data are available regarding predictive factors of a successful transition. We explored factors associated with transition in a cohort of former inpatients of a Children and Adolescents Intensive Treatment Ward (CAITW). Socio-demographic and clinical features of patients previously admitted to CAITW were matched to AMHS data for those patients having reached age requirements. We built multiple logistic regression models to identify factors associated with transfer to AMHS (either inpatient or outpatient) and with successful retention in treatment (RIT) at six (short RIT), 12 (intermediate RIT) and 24 months after transfer (long RIT). From a cohort of 322 inpatients, 126 reached the age threshold for transfer to AMHS in the study period. The transfer rate was 50%. Two years after transition-age boundary, CAMHS-AMHS continuity of care was found in 40% and disengagement in 6% of cases. Longer and multiple hospitalizations, atypical antipsychotics prescription and a diagnosis of psychotic disorders were factors associated with short and intermediate RIT. A positive psychiatric family history was negatively associated with successful short and intermediate RIT. Diagnosis of psychosis and learning-supported school attendance were associated with long RIT. Young adults with a history of psychiatric inpatient admission as children or adolescents have a relatively high rate of transition to AMHS. A diagnosis of psychosis seems to be the strongest predictor for transition in these patients. Further research should focus on patients' schooling needs and on children of parents with mental health problems to enhance family and educational system engagement.

Identifiants

pubmed: 33491124
doi: 10.1007/s00787-020-01717-y
pii: 10.1007/s00787-020-01717-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

805-818

Informations de copyright

© 2021. Springer-Verlag GmbH, DE part of Springer Nature.

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Auteurs

Giancarlo Pontoni (G)

Psychiatry Section, Psychophysiological Selection Office, Italian Army National Recruitment and Selection Center, 06034, Foligno, PG, Italy.

Elena Di Pietro (E)

Private Accredited Hospital Villa Igea, 41126, Saliceta San Giuliano, MO, Italy.

Tommaso Neri (T)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy.

Giorgio Mattei (G)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy.
Marco Biagi Department of Economics and Marco Biagi Foundation, University of Modena and Reggio Emilia, 41121, Modena, Italy.

Fedora Longo (F)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy.

Vittoria Neviani (V)

Private Accredited Hospital Villa Igea, 41126, Saliceta San Giuliano, MO, Italy.

Giovanni Neri (G)

Private Accredited Hospital Villa Igea, 41126, Saliceta San Giuliano, MO, Italy.

Paolo Stagi (P)

Child and Adolescent Mental Health Service Empoli, Azienda USL Toscana Centro, 50053, Empoli, FI, Italy.

Ernesto Caffo (E)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy.

Fabrizio Starace (F)

Department of Mental Health and Drug Abuse, Azienda USL Modena, 41124, Modena, Italy.

Gian Maria Galeazzi (GM)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy. gianmaria.galeazzi@unimore.it.

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