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Girela-Serrano B, Miguélez-Fernández C, Abascal-Peiró S, Peñuelas-Calvo I, Jiménez-Muñoz L, Moreno M, Delgado-Gómez D, Bello HJ, Nicholls D, Baca-García E, Carballo JJ, Porras-Segovia A. Diagnostic trajectories of mental disorders in children and adolescents: a cohort study. Eur Child Adolesc Psychiatry 2024; 33:1481-1494. [PMID: 37422547 DOI: 10.1007/s00787-023-02254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Mental disorders in children and adolescents may follow different trajectories, such as remission, change of diagnosis, or addition of two or more comorbid diagnoses, showing a heterotypic pattern. This study aims to describe the main diagnostic trajectories across a broad range of mental disorder diagnostic categories, from childhood to adolescence and from adolescence to young adulthood in a clinical population. A prospective study was conducted among a clinical sample of children and adolescents who were aged 3-17 years at the face-to-face baseline interview. Electronic health records of these participants were reviewed 10 years later. The diagnostic stability over time was examined using the kappa coefficient, and factors associated with stability were explored using simple logistic regression. The study included a sample of 691 participants. The kappa coefficient for diagnostic stability across all diagnoses was 0.574 for the transition from childhood to adulthood, 0.614 from childhood to adolescence, and 0.733 from adolescence to adulthood. Neurodevelopmental diagnoses had the highest stability. Factors associated with higher diagnostic stability included family history of mental disorders, receiving psychopharmacological treatment, and symptom severity at baseline. We found a variable diagnostic stability across different diagnoses and age categories. The different life transitions represent complex periods that should not be overlooked from a clinical standpoint. An appropriate transition from child and adolescent mental health services to adult mental health services may have a positive impact on children and adolescents with mental disorders.
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Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child and Adolescent Mental Health Service, Central and Northwest London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College London, London, UK
| | | | - Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28911, Leganés, Spain
| | - Hugo J Bello
- Department of Applied Mathematics, Universidad de Valladolid, Valladolid, Spain
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Enrique Baca-García
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alejandro Porras-Segovia
- Division of Psychiatry, Imperial College London, London, UK.
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain.
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McFayden TC, Culbertson S, DeRamus M, Kramer C, Roush J, Mankowski J. Assessing Autism in Deaf/Hard-of-Hearing Youths: Interdisciplinary Teams, COVID Considerations, and Future Directions. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1492-1507. [PMID: 37314896 PMCID: PMC10271818 DOI: 10.1177/17456916231178711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Autism spectrum disorders are more prevalent in children who are Deaf or Hard of Hearing (D/HH) than in the general population. This potential for diagnostic overlap underscores the importance of understanding the best approaches for assessing autism spectrum disorder in D/HH youths. Despite the recognition of clinical significance, youths who are D/HH are often identified as autistic later than individuals with normal hearing, which results in delayed access to appropriate early intervention services. Three primary barriers to early identification include behavioral phenotypic overlap, a lack of "gold-standard" screening and diagnostic tools for this population, and limited access to qualified clinicians. In the current article, we seek to address these barriers to prompt an appropriate identification of autism by providing recommendations for autism assessment in children who are D/HH from an interdisciplinary hearing and development clinic, including virtual service delivery during COVID-19. Strengths, gaps, and future directions for implementation are addressed.
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Affiliation(s)
- Tyler C. McFayden
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Shannon Culbertson
- Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill
| | - Margaret DeRamus
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Christine Kramer
- The Children’s Cochlear Implant Center, University of North Carolina at Chapel Hill
| | - Jackson Roush
- Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill
| | - Jean Mankowski
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
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Holzinger D, Fellinger J, Hofer J. Special Issue "Early Intervention for Hearing Loss in Children: Drafting from Theory to Clinical Practice". J Clin Med 2022; 11:jcm11113166. [PMID: 35683552 PMCID: PMC9181804 DOI: 10.3390/jcm11113166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.F.); (J.H.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
- Correspondence:
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.F.); (J.H.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.F.); (J.H.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Department of Paediatrics I, Innsbruck Medical University, 6020 Innsbruck, Austria
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Hofer J, Tillmann J, Salzmann J, Bölte S, Fellinger J, Holzinger D. Screening for autism spectrum disorder in deaf adults with intellectual disability: Feasibility and accuracy of two autism screening instruments. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 122:104167. [PMID: 34998116 DOI: 10.1016/j.ridd.2021.104167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is a lack of autism screening instruments for deaf or hard of hearing (DHH) adults with intellectual disability. AIMS This study examined the diagnostic validity of the Pervasive Developmental Disorder in Mental Retardation Scale and the Diagnostic Behavioral Assessment for autism spectrum disorder - Revised in this rare population. METHODS AND PARTICIPANTS 56 DHH adults with intellectual disability living in three specialized therapeutic communities were examined, 9 of whom met criteria for autism. OUTCOMES AND RESULTS With minimal adaptions regarding item interpretation, both tools showed good diagnostic and high convergent validity. Items probing for difficulties in reciprocal social interaction and restricted interests were discriminant between individuals with and without autism. CONCLUSION These data suggest that both autism screening tools are feasible and psychometrically sound when used with appropriate adaptations for DHH adults with intellectual disability.
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Affiliation(s)
- J Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - J Tillmann
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
| | - J Salzmann
- Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria
| | - S Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - J Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - D Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Institute of Linguistics, University of Graz, Graz, Austria.
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