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1. Demographic, clinical, and service-use characteristics related to the clinician’s recommendation to transition from child to adult mental health services

Author

Gerritsen, S, van Bodegom, L, Dieleman, G, Overbeek, M, Verhulst, F, Wolke, D, Rizopoulos, D, Appleton, R, van Amelsvoort, T, Bodier Rethore, C, Bonnet-Brilhault, F, Charvin, I, Da Fonseca, D, Davidovic, N, Dodig-Curkovic, K, Ferrari, A, Fiori, F, Franic, 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, M, Sagar-Ouriaghli, I, Santosh, P, Sartor, A, Schulze, U, Scocco, P, Signorini, G, Singh, S, 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, Adams, L, Allibrio, G, Armando, M, Aslan, S, Baccanelli, N, Balaudo, M, Bergamo, F, Bertani, A, Berriman, J, Boon, A, Braamse, K, Breuninger, U, Buttiglione, M, Buttle, S, Schandrin, A, Cammarano, M, Canaway, A, Cantini, F, Cappellari, C, Carenini, M, Carra, G, Ferrari, C, Chianura, K, Coleman, P, Colonna, A, Conese, P, Costanzo, R, Daffern, C, Danckaerts, M, de Giacomo, A, Ermans, J, Farmer, A, Fegert, J, Ferrari, S, Galea, G, Gatta, M, Gheza, E, Goglia, G, Grandetto, M, Griffin, J, Levi, F, Humbertclaude, V, Ingravallo, N, Invernizzi, R, Kelly, C, Killilea, M, Kirwan, J, Klockaerts, C, Kovac, V, Liew, A, Lippens, C, Macchi, F, Manenti, L, Margari, F, Margari, L, Martinelli, P, Mcfadden, L, Menghini, D, Miller, S, Monzani, E, Morini, G, Mutafov, T, O'Hara, L, Negrinotti, C, Nelis, E, Neri, F, Nikolova, P, Nossa, M, Cataldo, M, Noterdaeme, M, Operto, F, Panaro, V, Pastore, A, Pemmaraju, V, Pepermans, A, Petruzzelli, M, Presicci, A, Prigent, C, Rinaldi, F, Riva, E, Roekens, A, Rogers, B, Ronzini, P, Sakar, V, Salvetti, S, Martinelli, O, Sandhu, T, Schepker, R, Siviero, M, Slowik, M, Smyth, C, Conti, P, Spadone, M, Starace, F, Stoppa, P, Tansini, L, Toselli, C, Trabucchi, G, Tubito, M, van Dam, A, van Gutschoven, H, van West, D, Vanni, F, Vannicola, C, Varuzza, C, Varvara, P, Ventura, P, Vicari, S, Vicini, S, von Bentzel, C, Wells, P, Williams, B, Zabarella, M, Zamboni, A, Zanetti, E, Gerritsen S. E., van Bodegom L. S., Dieleman G. C., Overbeek M. M., Verhulst F. C., Wolke D., Rizopoulos D., Appleton R., van Amelsvoort T. A. M. J., Bodier Rethore C., Bonnet-Brilhault F., Charvin I., Da Fonseca D., Davidovic N., Dodig-Curkovic K., Ferrari A., Fiori F., Franic 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 M. C., Sagar-Ouriaghli I., Santosh P. J., Sartor A., Schulze U. M. E., Scocco P., Signorini G., Singh S. P., 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., Adams L., Allibrio G., Armando M., Aslan S., Baccanelli N., Balaudo M., Bergamo F., Bertani A., Berriman J., Boon A., Braamse K., Breuninger U., Buttiglione M., Buttle S., Schandrin A., Cammarano M., Canaway A., Cantini F., Cappellari C., Carenini M., Carra G., Ferrari C., Chianura K., Coleman P., Colonna A., Conese P., Costanzo R., Daffern C., Danckaerts M., de Giacomo A., Ermans J. -P., Farmer A., Fegert J. M., Ferrari S., Galea G., Gatta M., Gheza E., Goglia G., Grandetto M. R., Griffin J., Levi F. M., Humbertclaude V., Ingravallo N., Invernizzi R., Kelly C., Killilea M., Kirwan J., Klockaerts C., Kovac V., Liew A., Lippens C., Macchi F., Manenti L., Margari F., Margari L., Martinelli P., McFadden L., Menghini D., Miller S., Monzani E., Morini G., Mutafov T., O'Hara L., Negrinotti C., Nelis E., Neri F., Nikolova P., Nossa M., Cataldo M. G., Noterdaeme M., Operto F., Panaro V., Pastore A., Pemmaraju V., Pepermans A., Petruzzelli M. G., Presicci A., Prigent C., Rinaldi F., Riva E., Roekens A., Rogers B., Ronzini P., Sakar V., Salvetti S., Martinelli O., Sandhu T., Schepker R., Siviero M., Slowik M., Smyth C., Conti P., Spadone M. A., Starace F., Stoppa P., Tansini L., Toselli C., Trabucchi G., Tubito M., van Dam A., van Gutschoven H., van West D., Vanni F., Vannicola C., Varuzza C., Varvara P., Ventura P., Vicari S., Vicini S., von Bentzel C., Wells P., Williams B., Zabarella M., Zamboni A., Zanetti E., Gerritsen, S, van Bodegom, L, Dieleman, G, Overbeek, M, Verhulst, F, Wolke, D, Rizopoulos, D, Appleton, R, van Amelsvoort, T, Bodier Rethore, C, Bonnet-Brilhault, F, Charvin, I, Da Fonseca, D, Davidovic, N, Dodig-Curkovic, K, Ferrari, A, Fiori, F, Franic, 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, M, Sagar-Ouriaghli, I, Santosh, P, Sartor, A, Schulze, U, Scocco, P, Signorini, G, Singh, S, 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, Adams, L, Allibrio, G, Armando, M, Aslan, S, Baccanelli, N, Balaudo, M, Bergamo, F, Bertani, A, Berriman, J, Boon, A, Braamse, K, Breuninger, U, Buttiglione, M, Buttle, S, Schandrin, A, Cammarano, M, Canaway, A, Cantini, F, Cappellari, C, Carenini, M, Carra, G, Ferrari, C, Chianura, K, Coleman, P, Colonna, A, Conese, P, Costanzo, R, Daffern, C, Danckaerts, M, de Giacomo, A, Ermans, J, Farmer, A, Fegert, J, Ferrari, S, Galea, G, Gatta, M, Gheza, E, Goglia, G, Grandetto, M, Griffin, J, Levi, F, Humbertclaude, V, Ingravallo, N, Invernizzi, R, Kelly, C, Killilea, M, Kirwan, J, Klockaerts, C, Kovac, V, Liew, A, Lippens, C, Macchi, F, Manenti, L, Margari, F, Margari, L, Martinelli, P, Mcfadden, L, Menghini, D, Miller, S, Monzani, E, Morini, G, Mutafov, T, O'Hara, L, Negrinotti, C, Nelis, E, Neri, F, Nikolova, P, Nossa, M, Cataldo, M, Noterdaeme, M, Operto, F, Panaro, V, Pastore, A, Pemmaraju, V, Pepermans, A, Petruzzelli, M, Presicci, A, Prigent, C, Rinaldi, F, Riva, E, Roekens, A, Rogers, B, Ronzini, P, Sakar, V, Salvetti, S, Martinelli, O, Sandhu, T, Schepker, R, Siviero, M, Slowik, M, Smyth, C, Conti, P, Spadone, M, Starace, F, Stoppa, P, Tansini, L, Toselli, C, Trabucchi, G, Tubito, M, van Dam, A, van Gutschoven, H, van West, D, Vanni, F, Vannicola, C, Varuzza, C, Varvara, P, Ventura, P, Vicari, S, Vicini, S, von Bentzel, C, Wells, P, Williams, B, Zabarella, M, Zamboni, A, Zanetti, E, Gerritsen S. E., van Bodegom L. S., Dieleman G. C., Overbeek M. M., Verhulst F. C., Wolke D., Rizopoulos D., Appleton R., van Amelsvoort T. A. M. J., Bodier Rethore C., Bonnet-Brilhault F., Charvin I., Da Fonseca D., Davidovic N., Dodig-Curkovic K., Ferrari A., Fiori F., Franic 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 M. C., Sagar-Ouriaghli I., Santosh P. J., Sartor A., Schulze U. M. E., Scocco P., Signorini G., Singh S. P., 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., Adams L., Allibrio G., Armando M., Aslan S., Baccanelli N., Balaudo M., Bergamo F., Bertani A., Berriman J., Boon A., Braamse K., Breuninger U., Buttiglione M., Buttle S., Schandrin A., Cammarano M., Canaway A., Cantini F., Cappellari C., Carenini M., Carra G., Ferrari C., Chianura K., Coleman P., Colonna A., Conese P., Costanzo R., Daffern C., Danckaerts M., de Giacomo A., Ermans J. -P., Farmer A., Fegert J. M., Ferrari S., Galea G., Gatta M., Gheza E., Goglia G., Grandetto M. R., Griffin J., Levi F. M., Humbertclaude V., Ingravallo N., Invernizzi R., Kelly C., Killilea M., Kirwan J., Klockaerts C., Kovac V., Liew A., Lippens C., Macchi F., Manenti L., Margari F., Margari L., Martinelli P., McFadden L., Menghini D., Miller S., Monzani E., Morini G., Mutafov T., O'Hara L., Negrinotti C., Nelis E., Neri F., Nikolova P., Nossa M., Cataldo M. G., Noterdaeme M., Operto F., Panaro V., Pastore A., Pemmaraju V., Pepermans A., Petruzzelli M. G., Presicci A., Prigent C., Rinaldi F., Riva E., Roekens A., Rogers B., Ronzini P., Sakar V., Salvetti S., Martinelli O., Sandhu T., Schepker R., Siviero M., Slowik M., Smyth C., Conti P., Spadone M. A., Starace F., Stoppa P., Tansini L., Toselli C., Trabucchi G., Tubito M., van Dam A., van Gutschoven H., van West D., Vanni F., Vannicola C., Varuzza C., Varvara P., Ventura P., Vicari S., Vicini S., von Bentzel C., Wells P., Williams B., Zabarella M., Zamboni A., and Zanetti E.

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.

Published
2022

2. Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study

Author

Santosh, P. (Paramala), Singh, J. (Jatinder), Adams, L. (Laura), Mastroianni, M. (Mathilde), Heaney, N. (Natalie), Lievesley, K. (Kate), Sagar-Ouriaghli, I. (Ilyas), Allibrio, G. (Giovanni), Appleton, R. (Rebecca), Davidović, N. (Nikolina), de Girolamo, G. (Giovanni), Dieleman, G.C. (Gwen), Dodig-Ćurković, K. (Katarina), Franić, T. (Tomislav), Gatherer, C. (Charlotte), Gerritsen, S.E. (Suzanne), Gheza, E. (Elisa), Madan, J. (Jason), Manenti, L. (Lidia), Maras, A. (Athanasios), Margari, F. (Francesco), McNicholas, F. (Fiona), Pastore, A. (Adriana), Paul, M. (Moli), Purper-Ouakil, D. (Diane), Rinaldi, F. (Francesco), Sakar, V. (Vehbi), Schulze, U. (Ulrike), Signorini, G. (Giulia), Street, C. (Cathy), Tah, P. (Priya), Tremmery, S. (Sabine), Tuffrey, A. (Amanda), Tuomainen, H. (Helena), Verhulst, F.C. (Frank), Warwick, J. (Jane), Wilson, A. (Anna), Wolke, D. (Dieter), Fiori, F. (Federico), Singh, S.P. (Swaran), Santosh, P. (Paramala), Singh, J. (Jatinder), Adams, L. (Laura), Mastroianni, M. (Mathilde), Heaney, N. (Natalie), Lievesley, K. (Kate), Sagar-Ouriaghli, I. (Ilyas), Allibrio, G. (Giovanni), Appleton, R. (Rebecca), Davidović, N. (Nikolina), de Girolamo, G. (Giovanni), Dieleman, G.C. (Gwen), Dodig-Ćurković, K. (Katarina), Franić, T. (Tomislav), Gatherer, C. (Charlotte), Gerritsen, S.E. (Suzanne), Gheza, E. (Elisa), Madan, J. (Jason), Manenti, L. (Lidia), Maras, A. (Athanasios), Margari, F. (Francesco), McNicholas, F. (Fiona), Pastore, A. (Adriana), Paul, M. (Moli), Purper-Ouakil, D. (Diane), Rinaldi, F. (Francesco), Sakar, V. (Vehbi), Schulze, U. (Ulrike), Signorini, G. (Giulia), Street, C. (Cathy), Tah, P. (Priya), Tremmery, S. (Sabine), Tuffrey, A. (Amanda), Tuomainen, H. (Helena), Verhulst, F.C. (Frank), Warwick, J. (Jane), Wilson, A. (Anna), Wolke, D. (Dieter), Fiori, F. (Federico), and Singh, S.P. (Swaran)

Abstract

OBJECTIVE: Young people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16-18 years of age in Europe). The objective of this study was to develop and

Published
2020
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3. Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study

Author

Santosh, P, Singh, J, Adams, L, Mastroianni, M, Heaney, N, Lievesley, K, Sagar-Ouriaghli, I, Allibrio, G, Appleton, R, Davidovic, N, de Girolamo, G, Dieleman, Gwen, Dodig-Curkovic, K, Franic, T, Gatherer, C, Gerritsen, Suzanne, Gheza, E, Madan, J, Manenti, L, Maras, Athanasios, Margari, F, McNicholas, F, Pastore, A, Paul, M, Purper-Ouakil, D, Rinaldi, F, Sakar, V, Schulze, U, Signorini, G, Street, C, Tah, P, Tremmery, S, Tuffrey, A, Tuomainen, H, Verhulst, Frank, Warwick, J, Wilson, A, Wolke, D, Fiori, F, Singh, S, Santosh, P, Singh, J, Adams, L, Mastroianni, M, Heaney, N, Lievesley, K, Sagar-Ouriaghli, I, Allibrio, G, Appleton, R, Davidovic, N, de Girolamo, G, Dieleman, Gwen, Dodig-Curkovic, K, Franic, T, Gatherer, C, Gerritsen, Suzanne, Gheza, E, Madan, J, Manenti, L, Maras, Athanasios, Margari, F, McNicholas, F, Pastore, A, Paul, M, Purper-Ouakil, D, Rinaldi, F, Sakar, V, Schulze, U, Signorini, G, Street, C, Tah, P, Tremmery, S, Tuffrey, A, Tuomainen, H, Verhulst, Frank, Warwick, J, Wilson, A, Wolke, D, Fiori, F, and Singh, S

Published
2020

8. Demographic, clinical, and service-use characteristics related to the clinician’s recommendation to transition from child to adult mental health services

Author

Gerritsen, S. E., van Bodegom, L. S., Dieleman, G. C., Overbeek, M. M., Verhulst, F. C., Wolke, Dieter, Rizopoulos, D., Appleton, R., van Amelsvoort, T. A. M. J., 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, M. C., Sagar-Ouriaghli, I., Santosh, P. J., Sartor, A., Schulze, U. M. E., Scocco, P., Signorini, G., Singh, S. P., 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., Adams, Laura, Allibrio, Giovanni, Armando, Marco, Aslan, Sonja, Baccanelli, Nadia, Balaudo, Monica, Bergamo, Fabia, Bertani, Angelo, Berriman, Jo, Boon, Albert, Braamse, Karen, Breuninger, Ulrike, Buttiglione, Maura, Buttle, Sarah, Schandrin, Aurélie, Cammarano, Marco, Canaway, Alastair, Cantini, Fortunata, Cappellari, Cristiano, Carenini, Marta, Carrà, Giuseppe, Ferrari, Cecilia, Chianura, Krizia, Coleman, Philippa, Colonna, Annalisa, Conese, Patrizia, Costanzo, Raffaella, Daffern, Claire, Danckaerts, Marina, de Giacomo, Andrea, Ermans, Jean-Pierre, Farmer, Alan, Fegert, Jörg M., Ferrari, Sabrina, Galea, Giuliana, Gatta, Michela, Gheza, Elisa, Goglia, Giacomo, Grandetto, MariaRosa, Griffin, James, Levi, Flavia Micol, Humbertclaude, Véronique, Ingravallo, Nicola, Invernizzi, Roberta, Kelly, Caoimhe, Killilea, Meghan, Kirwan, James, Klockaerts, Catherine, Kovač, Vlatka, Liew, Ashley, Lippens, Christel, Macchi, Francesca, Manenti, Lidia, Margari, Francesco, Margari, Lucia, Martinelli, Paola, McFadden, Leighton, Menghini, Deny, Miller, Sarah, Monzani, Emiliano, Morini, Giorgia, Mutafov, Todor, O’Hara, Lesley, Negrinotti, Cristina, Nelis, Emmanuel, Neri, Francesca, Nikolova, Paulina, Nossa, Marzia, Cataldo, Maria Giulia, Noterdaeme, Michele, Operto, Francesca, Panaro, Vittoria, Pastore, Adriana, Pemmaraju, Vinuthna, Pepermans, Ann, Petruzzelli, Maria Giuseppina, Presicci, Anna, Prigent, Catherine, Rinaldi, Francesco, Riva, Erika, Roekens, Anne, Rogers, Ben, Ronzini, Pablo, Sakar, Vehbi, Salvetti, Selena, Martinelli, Ottaviano, Sandhu, Tanveer, Schepker, Renate, Siviero, Marco, Slowik, Michael, Smyth, Courtney, Conti, Patrizia, Spadone, Maria Antonietta, Starace, Fabrizio, Stoppa, Patrizia, Tansini, Lucia, Toselli, Cecilia, Trabucchi, Guido, Tubito, Maria, van Dam, Arno, van Gutschoven, Hanne, van West, Dirk, Vanni, Fabio, Vannicola, Chiara, Varuzza, Cristiana, Varvara, Pamela, Ventura, Patrizia, Vicari, Stefano, Vicini, Stefania, von Bentzel, Carolin, Wells, Philip, Williams, Beata, Zabarella, Marina, Zamboni, Anna, Zanetti, Edda, HASH(0x5651c9679ff8), RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, MUMC+: MA Med Staf Spec Psychiatrie (9), Child and Adolescent Psychiatry / Psychology, Epidemiology, Clinical Child and Family Studies, LEARN! - Child rearing, APH - Mental Health, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier de Versailles André Mignot (CHV), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Lille, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, The MILESTONE project was funded by EU FP7 programme under grant number 602442. SPS is part-funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (NIHR CLAHRC WM), now recommissioned as NIHR Applied Research Collaboration West Midlands. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. PS is the co-inventor of the HealthTrackerTM and is the Chief Executive Officer and shareholder in HealthTracker Ltd. FF is a Chief Technical Officer and AK is the Chief Finance Officer employed by HealthTracker Ltd, respectively. FCV publishes the Dutch translations of ASEBA, from which he receives remuneration. AM was a speaker and advisor for Neurim, Shire, Infectopharm, and Lilly (all not related to transition research)., European Project: 602442,EC:FP7:HEALTH,FP7-HEALTH-2013-INNOVATION-1,MILESTONE(2014), The Milestone Consortium, Gerritsen, S, van Bodegom, L, Dieleman, G, Overbeek, M, Verhulst, F, Wolke, D, Rizopoulos, D, Appleton, R, van Amelsvoort, T, Bodier Rethore, C, Bonnet-Brilhault, F, Charvin, I, Da Fonseca, D, Davidovic, N, Dodig-Curkovic, K, Ferrari, A, Fiori, F, Franic, 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, M, Sagar-Ouriaghli, I, Santosh, P, Sartor, A, Schulze, U, Scocco, P, Signorini, G, Singh, S, 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, Adams, L, Allibrio, G, Armando, M, Aslan, S, Baccanelli, N, Balaudo, M, Bergamo, F, Bertani, A, Berriman, J, Boon, A, Braamse, K, Breuninger, U, Buttiglione, M, Buttle, S, Schandrin, A, Cammarano, M, Canaway, A, Cantini, F, Cappellari, C, Carenini, M, Carra, G, Ferrari, C, Chianura, K, Coleman, P, Colonna, A, Conese, P, Costanzo, R, Daffern, C, Danckaerts, M, de Giacomo, A, Ermans, J, Farmer, A, Fegert, J, Ferrari, S, Galea, G, Gatta, M, Gheza, E, Goglia, G, Grandetto, M, Griffin, J, Levi, F, Humbertclaude, V, Ingravallo, N, Invernizzi, R, Kelly, C, Killilea, M, Kirwan, J, Klockaerts, C, Kovac, V, Liew, A, Lippens, C, Macchi, F, Manenti, L, Margari, F, Margari, L, Martinelli, P, Mcfadden, L, Menghini, D, Miller, S, Monzani, E, Morini, G, Mutafov, T, O'Hara, L, Negrinotti, C, Nelis, E, Neri, F, Nikolova, P, Nossa, M, Cataldo, M, Noterdaeme, M, Operto, F, Panaro, V, Pastore, A, Pemmaraju, V, Pepermans, A, Petruzzelli, M, Presicci, A, Prigent, C, Rinaldi, F, Riva, E, Roekens, A, Rogers, B, Ronzini, P, Sakar, V, Salvetti, S, Martinelli, O, Sandhu, T, Schepker, R, Siviero, M, Slowik, M, Smyth, C, Conti, P, Spadone, M, Starace, F, Stoppa, P, Tansini, L, Toselli, C, Trabucchi, G, Tubito, M, van Dam, A, van Gutschoven, H, van West, D, Vanni, F, Vannicola, C, Varuzza, C, Varvara, P, Ventura, P, Vicari, S, Vicini, S, von Bentzel, C, Wells, P, Williams, B, Zabarella, M, Zamboni, A, and Zanetti, E

Subjects
Adult mental health service, Adult, Mental Health Services, Parents, Health (social science), Child and adolescent mental health service, Social Psychology, RJ, Epidemiology, ADOLESCENT, Child and adolescent mental health services, Adult mental health services, Young adults, Transition, SDG 3 - Good Health and Well-being, PEOPLE, SCHIZOPHRENIA, Humans, Family, Child, Demography, Mental Disorders, CARE, Psychiatry and Mental health, Young adult, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, RA
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.

Published
2022
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9. Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study.

Author

Santosh P, Singh J, Adams L, Mastroianni M, Heaney N, Lievesley K, Sagar-Ouriaghli I, Allibrio G, Appleton R, Davidović N, de Girolamo G, Dieleman G, Dodig-Ćurković K, Franić T, Gatherer C, Gerritsen S, Gheza E, Madan J, Manenti L, Maras A, Margari F, McNicholas F, Pastore A, Paul M, Purper-Ouakil D, Rinaldi F, Sakar V, Schulze U, Signorini G, Street C, Tah P, Tremmery S, Tuffrey A, Tuomainen H, Verhulst F, Warwick J, Wilson A, Wolke D, Fiori F, and Singh S

Subjects
Adolescent, Adult, Child, Europe, Female, Health Services Research, Humans, Male, Prospective Studies, Mental Health Services, Transition to Adult Care
Abstract

Objective: Young people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16-18 years of age in Europe). The objective of this study was to develop and validate the Transition Readiness and Appropriateness Measure (TRAM) for assessing a young person's readiness for transition, and their outcomes at the transfer boundary., Design: MILESTONE prospective study., Setting: Eight European Union (EU) countries participating in the EU-funded MILESTONE study., Participants: The first phase (MILESTONE validation study) involved 100 adolescents (pre-transition), young adults (post-transition), parents/carers and both CAMHS and AMHS clinicians. The second phase (MILESTONE cohort study and nested cluster randomised trial) involved over 1000 young people., Results: The development of the TRAM began with a literature review on transitioning and a review of important items regarding transition by a panel of 34 mental health experts. A list of 64 items of potential importance were identified, which together comprised the TRAM. The psychometric properties of the different versions of the TRAM were evaluated and showed that the TRAM had good reliability for all versions and low-to-moderate correlations when compared with other established instruments and a well-defined factor structure. The main results of the cohort study with the nested cluster randomised trial are not reported., Conclusion: The TRAM is a reliable instrument for assessing transition readiness and appropriateness. It highlighted the barriers to a successful transition and informed clinicians, identifying areas which clinicians on both sides of the transfer boundary can work on to ease the transition for the young person., Trial Registration Number: ISRCTN83240263 (Registered 23 July 2015), NCT03013595 (Registered 6 January 2017); Pre-results., Competing Interests: Competing interests: PS is the co-inventor of the HealthTracker and is the Chief Executive Officer and shareholder in HealthTracker. FF is a Chief Technical Officer and KL is a Project Manager employed by HealthTracker. FV is the Dutch distributor of ASEBA from which he receives remuneration. SPS is part-funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care WM (NIHR CLAHRC WM)., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2020
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10. Secrecy versus disclosure of mental illness among adolescents: I. The perspective of adolescents with mental illness.

Author

Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, and Krumm S

Subjects
Adolescent, Female, Focus Groups, Humans, Male, Psychology, Adolescent statistics & numerical data, Social Stigma, Stereotyping, Confidentiality, Decision Making, Mental Disorders psychology, Truth Disclosure
Abstract

Background: Many adolescents with mental illness (MI) struggle with the decision whether to disclose their condition. They may decide to keep their MI secret, whether due to fear of public stigma or due to self-stigma and shame. Secrecy may protect against discrimination, but has often negative long-term consequences such as social isolation., Aim: To explore personal views of adolescents with MI on secrecy and disclosure of their MI., Method: Six focus groups consisting of 39 adolescents with MI were recorded, transcribed, and analyzed by qualitative content analysis to identify major themes deductively and inductively., Results: Participants described MI as a stigmatized condition and stressed both the benefits and risks of secrecy. Disadvantages included fear of stigma and loss of friendships, benefits included emotional support and relief. Adolescents underlined the importance of individual disclosure decisions (DDs). The majority preferred selective disclosure. Additionally, the role of other adolescents with and without MI was emphasized., Conclusions: DDs are individual and depend on social factors since stigma and fear of discrimination remain significant concerns for adolescents with MI. Implications for future interventions to support adolescents with MI are discussed.

Published
2019
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11. Secrecy versus disclosure of mental illness among adolescents: II. The perspective of relevant stakeholders.

Author

Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, and Krumm S

Subjects
Adolescent, Adult, Aged, Female, Focus Groups, Humans, Male, Middle Aged, Psychology, Adolescent statistics & numerical data, Social Stigma, Social Support, Stereotyping, Young Adult, Confidentiality, Decision Making, Mental Disorders psychology, Truth Disclosure
Abstract

Background: The burden of mental illness (MI) is exacerbated when adolescents with MI are confronted with stigma and social exclusion. Adolescents face the difficult decision whether or not to disclose their MI. Focus groups (FGs) were conducted with parents of adolescents with MI as well as with teachers, mental health professionals (MHPs) and adolescents without MI., Aim: To collect information from relevant stakeholders on secrecy versus disclosure of MI among adolescents., Methods: Thirteen FG sessions with 87 participants were recorded, transcribed and analyzed using qualitative content analysis to identify major themes., Results: Selective disclosure and social media as a potential way of disclosure emerged as dominant themes. Negative aspects of disclosure on social media were discussed. Stigma and labeling were seen as disadvantages of disclosure. Social support was perceived as one advantage of disclosure. Distinctive features of adolescence, such as self-discovery, appeared as specific problems. Parents, teachers, MHPs and adolescents without MI were considered important for disclosure. Participants discussed how to help adolescents with their dilemma between disclosure and secrecy., Conclusions: The findings suggest that disclosure decisions are personal and influenced by the individual's environment. Implications for interventions that aim to support adolescents with MI in this regard are discussed.

Published
2019
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12. Honest, Open, Proud for adolescents with mental illness: pilot randomized controlled trial.

Author

Mulfinger N, Müller S, Böge I, Sakar V, Corrigan PW, Evans-Lacko S, Nehf L, Djamali J, Samarelli A, Kempter M, Ruckes C, Libal G, Oexle N, Noterdaeme M, and Rüsch N

Subjects
Adolescent, Female, Follow-Up Studies, Germany, Humans, Male, Pilot Projects, Treatment Outcome, Depression psychology, Disclosure, Mental Disorders psychology, Patient Acceptance of Health Care psychology, Psychotherapy methods, Quality of Life psychology, Social Stigma, Stress, Psychological therapy
Abstract

Background: Due to public stigma or self-stigma and shame, many adolescents with mental illness (MI) struggle with the decision whether to disclose their MI to others. Both disclosure and nondisclosure are associated with risks and benefits. Honest, Open, Proud (HOP) is a peer-led group program that supports participants with disclosure decisions in order to reduce stigma's impact. Previously, HOP had only been evaluated among adults with MI., Methods: This two-arm pilot randomized controlled trial included 98 adolescents with MI. Participants were randomly assigned to HOP and treatment as usual (TAU) or to TAU alone. Outcomes were assessed pre (T0/baseline), post (T1/after the HOP program), and at 3-week follow-up (T2/6 weeks after T0). Primary endpoints were stigma stress at T1 and quality of life at T2. Secondary outcomes included self-stigma, disclosure-related distress, empowerment, help-seeking intentions, recovery, and depressive symptoms. The trial is registered on ClinicalTrials (NCT02751229; http://www.clinicaltrials.gov)., Results: Compared to TAU, adolescents in the HOP program showed significantly reduced stigma stress at T1 (d = .92, p < .001) and increased quality of life at T2 (d = .60, p = .004). In a longitudinal mediation model, the latter effect was fully mediated by stigma stress reduction at T1. HOP further showed significant positive effects on self-stigma, disclosure-related distress, secrecy, help-seeking intentions, attitudes to disclosure, recovery, and depressive symptoms. Effects at T1 remained stable or improved further at follow-up. In a limited economic evaluation HOP was cost-efficient in relation to gains in quality of life., Conclusions: As HOP is a compact three-session program and showed positive effects on stigma and disclosure variables as well as on symptoms and quality of life, it could help to reduce stigma's negative impact among adolescents with MI., (© 2017 Association for Child and Adolescent Mental Health.)

Published
2018
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13. [Psychiatric disorders and neurological comorbidity in children with intellectual disability].

Author

Wriedt E, Wiberg A, Sakar V, and Noterdaeme M

Subjects
Adolescent, Adolescent Psychiatry, Child, Child Psychiatry, Child, Preschool, Comorbidity, Cross-Sectional Studies, Education, Special, Female, Germany, Humans, Male, Referral and Consultation, Residential Treatment, Young Adult, Intellectual Disability epidemiology, Mental Disorders epidemiology, Nervous System Diseases epidemiology
Abstract

Introduction: This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany)., Method: The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated., Results: About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions., Conclusions: The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.

Published
2010
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14. Activation of primary and secondary somatosensory regions following tactile stimulation of the face.

Author

Kopietz R, Sakar V, Albrecht J, Kleemann AM, Schöpf V, Yousry I, Linn J, Fesl G, and Wiesmann M

Subjects
Adult, Brain Mapping, Chin innervation, Female, Forehead innervation, Functional Laterality, Humans, Male, Physical Stimulation, Reference Values, Young Adult, Face innervation, Face physiology, Somatosensory Cortex physiology, Touch, Trigeminal Nerve physiology
Abstract

Background: Since the work of Penfield & Rasmussen it is well established that the human primary somatosensory cortex is organized somatotopically. However, the order of the representation of the face is still a matter of discussion, i.e., it is yet unclear whether the face is represented upside-down or vice versa in the somatosensory cortex., Material and Methods: In a functional magnetic resonance imaging study (n = 30), tactile stimuli to three different locations on each side of the face were applied using a pneumatic device. Locations of stimulation corresponded to the three branches of the trigeminal nerve (forehead, cheek, chin). To determine the representation of the face on primary and secondary somatosensory cortices, peak coordinates within these regions were analyzed subjectwise., Results: Contralateral activation of the primary somatosensory cortex following tactile stimulation of the face was found, whereas the secondary somatosensory cortices were activated bilaterally. However, differences between activation coordinates of different tactile stimuli applied to one side of the face were not statistically significant., Conclusion: Tactile stimulation of the face leads to contralateral activation of primary and bilateral activation of secondary somatosensory cortices. Using the authors' methodological approach it was not possible to detect a somatotopic organization related to different facial areas.

Published
2009
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15. Activation of olfactory and trigeminal cortical areas following stimulation of the nasal mucosa with low concentrations of S(-)-nicotine vapor--an fMRI study on chemosensory perception.

Author

Albrecht J, Kopietz R, Linn J, Sakar V, Anzinger A, Schreder T, Pollatos O, Brückmann H, Kobal G, and Wiesmann M

Subjects
Adult, Brain Mapping, Cerebral Cortex drug effects, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Smoking, Nasal Mucosa drug effects, Nicotine pharmacology, Nicotinic Agonists pharmacology, Olfactory Bulb drug effects, Olfactory Perception physiology, Trigeminal Caudal Nucleus drug effects
Abstract

Applied to the nasal mucosa in low concentrations, nicotine vapor evokes odorous sensations (mediated by the olfactory system) whereas at higher concentrations nicotine vapor additionally produces burning and stinging sensations in the nose (mediated by the trigeminal system). The objective of this study was to determine whether intranasal stimulation with suprathreshold concentrations of S(-)-nicotine vapor causes brain activation in olfactory cortical areas or if trigeminal cortical areas are also activated. Individual olfactory detection thresholds for S(-)-nicotine were determined in 19 healthy occasional smokers using a computer-controlled air-dilution olfactometer. Functional magnetic resonance images were acquired using a 1.5T MR scanner with applications of nicotine in concentrations at or just above the individual's olfactory detection threshold. Subjects reliably perceived the stimuli as being odorous. Accordingly, activation of brain areas known to be involved in processing of olfactory stimuli was identified. Although most of the subjects never or only rarely observed a burning or painful sensation in the nose, brain areas associated with the processing of painful stimuli were activated in all subjects. This indicates that the olfactory and trigeminal systems are activated during perception of nicotine and it is not possible to completely separate olfactory from trigeminal effects by lowering the concentration of the applied nicotine. In conclusion, even at low concentrations that do not consistently lead to painful sensations, intranasally applied nicotine activates both the olfactory and the trigeminal system.

Published
2009
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