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European Child & Adolescent Psychiatry

, Volume 24, Issue 12, pp 1535–1541 | Cite as

Continuity of care from child and adolescent to adult mental health services: evidence from a regional survey in Northern Italy

  • Paolo Stagi
  • Simona Galeotti
  • Stefano Mimmi
  • Fabrizio Starace
  • Augusto C. Castagnini
Original Contribution

Abstract

To examine clinical and demographic factors associated with continuity of care from child–adolescent (CAMHS) to adult mental health services (AMHS), we undertook a record-linkage study to the Adult Mental Health Information System including all those 16 years old and over who were listed between 2010 and 2013 in the Child and Adolescent Neuropsychiatry Information System in Emilia-Romagna, an Italian region of nearly 4.5 million residents. From a cohort of 8239 adolescents attending CAMHS (population at risk about 144,000), 821 (19.4 %) moved to AMHS, excluding cases with specific developmental disorders, whose conditions were not managed by adult psychiatrists, and those with mental retardation who attended usually social services. Young people referred for treatment to AMHS were more likely to receive a discharge diagnosis of schizophrenia and related disorders (Odds Ratio [OR] 3.92; 95 % confidence interval [CI] 2.17–7.08), personality disorders (OR 2.69; 95 % CI 1.89–3.83), and pervasive developmental disorders (OR 2.13; 95 % CI 1.51–2.99). Further factors predicting transfer to AMHS were not living with parents, inpatient psychiatric admission, and being on medication in the previous 24 months. These findings suggest that a relatively small number of adolescents moved to AMHS and are likely to reflect the configuration of local mental health services and alternative care available, mainly for those with less-severe mental disorders.

Keywords

Adolescent Epidemiology ICD-10 Mental health care Psychiatric services Transition 

Notes

Acknowledgements

This study was funded by Regione Emilia-Romagna Innovation Fund, Italy, (DGR grant no. 1165–2012).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. Dr. Augusto C. Castagnini acted as external supervisor (Modena AUSL grant no. 547–2013); he devised the study and wrote and revised the paper.

Ethical standards

Data comply with appropriate standards of protection for anonymity, and no ethical approval for this study is required.

References

  1. 1.
    Patel V, Flisher AJ, Hetrick S, McGorry P (2007) Mental health of young people: a global public-health challenge. Lancet 369(9569):1302–1313CrossRefPubMedGoogle Scholar
  2. 2.
    Kessler RC, Berglund PMBA, Demler O et al (2005) Lifetime prevalence and age-of-onset distribution of DSM-IV disorder in the National Comorbidity Study Replication. Arch Gen Psychiatry 62:593–602CrossRefPubMedGoogle Scholar
  3. 3.
    Kim-Cohen J, Caspi A, Moffit TE, Harrington H, Milne BJ, Poulton R (2003) Pro juvenile diagnoses in adult with mental disorder. JAMA Psychiatry 60:709–719Google Scholar
  4. 4.
    Reef J, Diamantopoulou S, van Meurs I, Verhulst F, van der Ende J (2009) Child to adult continuities of psychopathology: a 24-year follow-up. Acta Psychiatr Scand 120:230–238CrossRefPubMedGoogle Scholar
  5. 5.
    Copeland WE, Adair CE, Smetanin P et al (2013) Diagnostic transitions from childhood to adolescence to early adulthood. J Child Psychol Psychiatry 54:791–799PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Levav I, Jacobsson L, Tsiantis J et al (2004) Psychiatric services and training for children and adolescents in Europe: results from a county survey. Eur Child Adolesc Psychiatry 13:395–401CrossRefPubMedGoogle Scholar
  7. 7.
    Steinhausen H-C (2014) Recent international trends in psychiatric medication prescriptions for children and adolescents. Eur Child Adolesc Psychiatry (published online 8 November 2014)Google Scholar
  8. 8.
    Munoz-Solomando Townley M, Williams R (2010) Improving transition for young people who move from child and adolescent mental health services to mental health services for adults: lessons from research and young people’s experiences. Curr Opin Psychiatry 23:311–317CrossRefPubMedGoogle Scholar
  9. 9.
    Singh SP, Paul M, Ford T et al (2010) Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. Br J Psychiatry 197:305–312CrossRefPubMedGoogle Scholar
  10. 10.
    Lamb C, Murphy M (2013) The divide between child and adult mental health services: points for debate. Br J Psychiatry 202(suppl. 1):s41–s44CrossRefGoogle Scholar
  11. 11.
    Paul M, Ford T, Kramer T, Islam Z, Harley K, Singh SP (2013) Transfers and transitions between child and adult mental health services. Br J Psychiatry 202(suppl. 1):s36–s40CrossRefGoogle Scholar
  12. 12.
    McNamara N, McNicholas F, Ford T et al (2014) Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice. Early Interv Psychiatry 8:291–297CrossRefPubMedGoogle Scholar
  13. 13.
    Treasure J, Schmidt U, Hugo P (2005) Mind the gap: service transition and interface problems for patients with eating disorders. Br J Psychiatry 187:398–400CrossRefPubMedGoogle Scholar
  14. 14.
    Hall CL, Newell K, Taylor J, Saval K, Hollis C (2015) Services for young people with attention deficit/hyperactivity disorder transitioning from child to adult mental health services: a national survey of mental health trusts in England. J Psychopharmacol 29:39–42CrossRefPubMedGoogle Scholar
  15. 15.
    Pottick KJ, Bilder S, Stoep AV et al (2008) US patterns of mental health services utilization for transition-age youth and young adults. J Behav Health Serv Res 35:373–389CrossRefPubMedGoogle Scholar
  16. 16.
    Paul M, Street C, Wheeler, Singh SP (2014) Transition to adult services for young people with mental health needs: a systematic review. Clin Child Psychol Psychiatry. doi: 10.1177/1359104514526603 (published online 7 April 2014) PubMedGoogle Scholar
  17. 17.
    Pedrini L, Colasurdo G, Costa S et al (2012) The characteristics and activities of child and adolescent mental health services in Italy: a regional survey. BMC Psychiatry 12:7PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
  19. 19.
    World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Descriptions and Diagnostic Guidelines. World Health Organization, GenevaGoogle Scholar
  20. 20.
  21. 21.
  22. 22.
  23. 23.
    Frigerio A, Rucci P, Goodman R et al (2009) Prevalence and correlates of mental disorders among adolescents in Italy: the PRISMA study. Eur Child Adolesc Psychiatry 18:217–226CrossRefPubMedGoogle Scholar
  24. 24.
    Wang PS, Aguilar-Gaxiola S, Alonso J et al (2007) Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO World Mental Health Surveys. Lancet 370:841–850PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    De Girolamo G, Polidori G, Morosini P et al (2006) Prevalence of common mental disorders in Italy: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Soc Psychiatry Psychiatr Epidemiol 41:853–861CrossRefPubMedGoogle Scholar
  26. 26.
    De Girolamo G, Bassi M, Neri G et al (2007) The current state of mental health care in Italy: problems, perspectives, and lesson to learn. Eur Arch Psychiatry Clin Neurosci 257:83–91CrossRefPubMedGoogle Scholar
  27. 27.
  28. 28.
    McGorry P, Johanessen JO, Lewis S et al (2010) Early intervention in psychosis: keeping faith with evidence-based health care. Psychol Med 40:399–404CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Paolo Stagi
    • 1
    • 2
  • Simona Galeotti
    • 1
  • Stefano Mimmi
    • 1
  • Fabrizio Starace
    • 1
  • Augusto C. Castagnini
    • 1
  1. 1.Mental Health DepartmentAUSL ModenaModenaItaly
  2. 2.Child and Adolescent Neuropsychiatry Service, Mental Health DepartmentAzienda USLModenaItaly

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