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Predictors of transfer and prognosis after transfer from child and adolescent mental health services to adult mental health services—a Danish nationwide prospective register-based cohort study.

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Title: Predictors of transfer and prognosis after transfer from child and adolescent mental health services to adult mental health services—a Danish nationwide prospective register-based cohort study.
Authors: Hansen, Christina Østergaard, Thorup, Anne Amalie Elgaard, Nordentoft, Merete, Hjorthøj, Carsten
Source: European Child & Adolescent Psychiatry. Jan2024, Vol. 33 Issue 1, p79-87. 9p.
Subjects: Personality disorders, Confidence intervals, Schizophrenia, Pervasive child development disorders, Patients, Medical care research, Attention-deficit hyperactivity disorder, Hospital admission & discharge, Suicidal behavior, Descriptive statistics, Sociodemographic factors, Odds ratio, Mental illness, Mental health services, Psychiatric emergencies, Adults
Geographic Terms: Denmark
Abstract: Onset of mental health disorder peaks during adolescence making continuity of care during this period of life crucial both to ensure a smooth treatment course and high quality of mental health services for adolescents. We aimed to examine which clinical and sociodemographic features predict transfer from child and adolescent mental health services to adult mental health services and if transfer is associated with prognosis. A Danish register study including all 16–17-year-olds with an outpatient contact in child and adolescent mental health services, who were discharged in the period of 1/1/06–10/05/15. Out of 27,170 Danish adolescents, 16% transferred to adult mental health services. Transfer was predicted by schizophrenia (OR 6.16; 95% CI 5.51–6.90) and personality disorders (OR 2.08; 95% CI 1.84–2.34), while hyperkinetic (OR 0.54; 95% CI 0.49–0.59) and pervasive developmental disorders (OR 0.42; 95% CI 0.31–0.58) decreased likelihood of transfer. Transfer was also substantially predicted by inpatient admission (OR 3.37; 95% CI 3.14–3.61) and psychiatric medication (OR 2.07; 95% CI 1.92–2.23). Transfer was associated with higher rates of inpatient admission to adult mental health services (IRR 5.83; 95% CI 4.37–7.77), more psychiatric emergency contacts (IRR 12.0; 95% CI 10.7–13.4), more convictions (IRR 1.40; 95% CI 1.23–1.59) and suicide attempts (IRR 5.70; 95% CI 4.72–6.90). Policy-makers and clinicians should push for improvements and open a discussion of how to ensure continuity of care for adolescents with psychiatric disorders. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Predictors of transfer and prognosis after transfer from child and adolescent mental health services to adult mental health services—a Danish nationwide prospective register-based cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Hansen%2C+Christina+Østergaard%22">Hansen, Christina Østergaard</searchLink><br /><searchLink fieldCode="AR" term="%22Thorup%2C+Anne+Amalie+Elgaard%22">Thorup, Anne Amalie Elgaard</searchLink><br /><searchLink fieldCode="AR" term="%22Nordentoft%2C+Merete%22">Nordentoft, Merete</searchLink><br /><searchLink fieldCode="AR" term="%22Hjorthøj%2C+Carsten%22">Hjorthøj, Carsten</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Jan2024, Vol. 33 Issue 1, p79-87. 9p.
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  Data: Onset of mental health disorder peaks during adolescence making continuity of care during this period of life crucial both to ensure a smooth treatment course and high quality of mental health services for adolescents. We aimed to examine which clinical and sociodemographic features predict transfer from child and adolescent mental health services to adult mental health services and if transfer is associated with prognosis. A Danish register study including all 16–17-year-olds with an outpatient contact in child and adolescent mental health services, who were discharged in the period of 1/1/06–10/05/15. Out of 27,170 Danish adolescents, 16% transferred to adult mental health services. Transfer was predicted by schizophrenia (OR 6.16; 95% CI 5.51–6.90) and personality disorders (OR 2.08; 95% CI 1.84–2.34), while hyperkinetic (OR 0.54; 95% CI 0.49–0.59) and pervasive developmental disorders (OR 0.42; 95% CI 0.31–0.58) decreased likelihood of transfer. Transfer was also substantially predicted by inpatient admission (OR 3.37; 95% CI 3.14–3.61) and psychiatric medication (OR 2.07; 95% CI 1.92–2.23). Transfer was associated with higher rates of inpatient admission to adult mental health services (IRR 5.83; 95% CI 4.37–7.77), more psychiatric emergency contacts (IRR 12.0; 95% CI 10.7–13.4), more convictions (IRR 1.40; 95% CI 1.23–1.59) and suicide attempts (IRR 5.70; 95% CI 4.72–6.90). Policy-makers and clinicians should push for improvements and open a discussion of how to ensure continuity of care for adolescents with psychiatric disorders. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00787-022-02136-x
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      – Code: eng
        Text: English
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      – SubjectFull: Personality disorders
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Schizophrenia
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      – SubjectFull: Pervasive child development disorders
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      – SubjectFull: Denmark
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      – TitleFull: Predictors of transfer and prognosis after transfer from child and adolescent mental health services to adult mental health services—a Danish nationwide prospective register-based cohort study.
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              Text: Jan2024
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