[Transitional psychiatric needs and identity development of adolescents in Tyrol]

BACKGROUND

Due to the structural separation of child and adolescent psychiatric treatment and adult psychiatric treatment, a switch between these two systems upon the age of 18 is necessary. Considering the importance of an organized transition, patients from an age of 17 were asked about their transition needs and aspects of their identity development. Thus future improvements in the treatment structures in this sensitive phase should derive.

METHODS

With the help of the Transition Readiness and Appropriateness Measure (TRAM), the transition-specific needs of 17 to 24-year-old patients (N = 42) at the Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Hall in Tirol were surveyed. In addition, the connection between identity development and transition was examined using the Assessment of Identity Development in Adolescence (AIDA).

RESULTS

Almost 80% of the patients stated that they needed further care. 'Patient-related factors' and 'family support' were described as barriers to the willingness to transition. A significant connection was found between identity development and the willingness or need for transition (r = 0.431, p < 0.01), although this was more pronounced in relation to the need for transition (r = 0.821 p < 0.01). In addition, those affected stated that they were frequently and severely burdened by stress, 45% reported self-injurious behavior, 48% suicidal thoughts or behavior in the last six months. In terms of psychopathology, anxiety and depression were among the most common symptoms. In terms of functional impairment, the 'relationships' area was the most affected.

CONCLUSIONS

The study provides initial insights into the transition-specific characteristics and needs of patients in transition age. The integration of standardized measuring instruments in institutional care systems, which individually record the transition-related needs, the willingness and need of young people in transition age, can facilitate targeted and needs-based treatment or transition. Interdisciplinary cooperation between child and adolescent psychiatry and adult psychiatry as well as a continuous transfer of the therapeutic relationships in the transition process should also be guaranteed.