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Gregersen M, Møllegaard Jepsen JR, Rohd SB, Søndergaard A, Brandt JM, Ellersgaard D, Hjorthøj C, Ohland J, Krantz MF, Wilms M, Andreassen AK, Veddum L, Knudsen CB, Greve AN, Bliksted V, Mors O, Clemmensen L, Nordentoft M, Hemager N, Elgaard Thorup AA. Developmental Pathways and Clinical Outcomes of Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder: A Prospective, Longitudinal Cohort Study - The Danish High Risk and Resilience Study, VIA 11. Am J Psychiatry 2022; 179:628-639. [PMID: 36048497 DOI: 10.1176/appi.ajp.21101076] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychotic experiences are common in children and adolescents and are associated with concurrent and subsequent psychopathology. Most findings originate from general population studies, whereas little is known of the clinical outcomes of psychotic experiences in children and adolescents at familial high risk of psychosis. We examined the prevalence of psychotic experiences in middle childhood and whether early childhood psychotic experiences and developmental pathways of psychotic experiences predicted mental disorders in middle childhood in children at familial high risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and a population-based control group. METHODS In a longitudinal population-based cohort study children at FHR-SZ (N=170), FHR-BP (N=103), and the control group (N=174) were assessed for psychotic experiences and axis I disorders with face-to-face interviews in early and middle childhood (at 7 and 11 years of age). RESULTS Psychotic experiences were more prevalent in children at FHR-SZ (31.8%, odds ratio 2.1, 95% CI 1.3-3.4) than in the control group (18.4%) in middle childhood. Early childhood psychotic experiences predicted mental disorders in middle childhood after adjusting for early childhood disorders and familial risk (odds ratio 2.0, 95% CI 1.2-3.1). Having three or more psychotic experiences increased odds the most (odds ratio 2.5, 95% CI 1.1-5.7). Persistent psychotic experiences were associated with increased odds of middle childhood disorders (odds ratio 4.1, 95% CI 2.1-8.4). Psychotic experiences were nondifferentially associated with mental disorders across the three familial risk groups. CONCLUSIONS Early childhood psychotic experiences predict mental disorders in middle childhood. Psychotic experiences index vulnerability for psychopathology nondifferentially in children at familial high risk and the control group. Psychotic experiences should be included in mental health screenings including children at familial high risk.
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Affiliation(s)
- Maja Gregersen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Jens Richardt Møllegaard Jepsen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Sinnika Birkehøj Rohd
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anne Søndergaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Julie Marie Brandt
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Ditte Ellersgaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Jessica Ohland
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Mette Falkenberg Krantz
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Martin Wilms
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anna Krogh Andreassen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Lotte Veddum
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Christina Bruun Knudsen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Aja Neergaard Greve
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Vibeke Bliksted
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Ole Mors
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Lars Clemmensen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Nicoline Hemager
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anne Amalie Elgaard Thorup
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
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Gerritsen SE, van Bodegom LS, Dieleman GC, Overbeek MM, Verhulst FC, Wolke D, Rizopoulos D, Appleton R, van Amelsvoort TAMJ, Bodier Rethore C, Bonnet-Brilhault F, Charvin I, Da Fonseca D, Davidović N, Dodig-Ćurković K, Ferrari A, Fiori F, Franić T, Gatherer C, de Girolamo G, Heaney N, Hendrickx G, Jardri R, Kolozsvari A, Lida-Pulik H, Lievesley K, Madan J, Mastroianni M, Maurice V, McNicholas F, Nacinovich R, Parenti A, Paul M, Purper-Ouakil D, Rivolta L, de Roeck V, Russet F, Saam MC, Sagar-Ouriaghli I, Santosh PJ, Sartor A, Schulze UME, Scocco P, Signorini G, Singh SP, Singh J, Speranza M, Stagi P, Stagni P, Street C, Tah P, Tanase E, Tremmery S, Tuffrey A, Tuomainen H, Walker L, Wilson A, Maras A. Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services. Soc Psychiatry Psychiatr Epidemiol 2022; 57:973-991. [PMID: 35146551 PMCID: PMC9042957 DOI: 10.1007/s00127-022-02238-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS. METHODS Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations. RESULTS Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. CONCLUSION Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.
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Affiliation(s)
- S E Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - L S van Bodegom
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
| | - M M Overbeek
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - D Rizopoulos
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | | | | | - I Charvin
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - D Da Fonseca
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - N Davidović
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - K Dodig-Ćurković
- Faculty for Dental Care and Health, Osijek, Croatia
- University Health Center Osijek, Osijek, Croatia
- Unit for Child and Adolescent Psychiatry, Osijek, Croatia
| | - A Ferrari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- DISM, ULSS 16, SOPROXI Onlus, Padua, Italy
| | - F Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - T Franić
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - C Gatherer
- Warwick Medical School, University of Warwick, Coventry, UK
| | - G de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - N Heaney
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - G Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - R Jardri
- Lille Neurosciences and Cognitions, Plasticity and Subjectivity Team, CURE Platform, Université de Lille, INSERM (U-1172), Fontan Hospital, CHU Lille, Lille, France
| | | | | | - K Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - J Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - M Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - V Maurice
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - F McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland
- Lucena CAMHS, SJOG, Dublin, Republic of Ireland
| | - R Nacinovich
- Child and Adolescent Neuropsychiatry Unit, ASST Monza, Monza, Italy
- Università Degli Studi Milano Bicocca, Milan, Italy
| | - A Parenti
- Centre Hospitalier Universitaire de Lille, Lille, France
| | - M Paul
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - D Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
| | - L Rivolta
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
- Department of Mental Health, Psychiatry Unit, San Gerardo Hospital, Monza, Monza Brianza, Italy
| | - V de Roeck
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Child and Youth Studies, Campus Social School, University Colleges Leuven Limburg, Heverlee, Belgium
| | - F Russet
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - M C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - I Sagar-Ouriaghli
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - P J Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - A Sartor
- Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany
| | - U M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - P Scocco
- Department of Mental Health, ULSS 6 Euganea, Padua, Italy
- SOPROXI Onlus, Padua, Italy
| | - G Signorini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - S P Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - M Speranza
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France
| | - P Stagi
- Child and Adolescent Neuropsychiatry Unit, AUSL Modena, Modena, Italy
| | - P Stagni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Child and Adolescent Neuropsychiatry, Department of Mental Health, Modena, Italy
| | - C Street
- Warwick Medical School, University of Warwick, Coventry, UK
| | - P Tah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - E Tanase
- Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany
| | - S Tremmery
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - A Tuffrey
- Warwick Medical School, University of Warwick, Coventry, UK
| | - H Tuomainen
- Warwick Medical School, University of Warwick, Coventry, UK
| | - L Walker
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Wilson
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
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