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1. The importance of clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their mental health services in Europe

Author

van Bodegom, Larissa S., Gerritsen, Suzanne E., Dieleman, Gwendolyn C., Overbeek, Mathilde M., de Girolamo, Giovanni, Scocco, Paolo, Hillegers, Manon H.J., Wolke, Dieter, Rizopoulos, Dimitris, Appleton, Rebecca, Conti, Patrizia, Franić, Tomislav, Margari, Francesco, Madan, Jason, McNicholas, Fiona, Nacinovich, Renata, Pastore, Adriana, Paul, Moli, Purper-Ouakil, Diane, Saam, Melanie C., Santosh, Paramala J., Sartor, Anne, Schulze, Ulrike M.E., Signorini, Giulia, Singh, Swaran P., Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuomainen, Helena, and Maras, Athanasios

Published
2023
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2. Prospective analysis of sex differences and factors associated with suicidal thoughts and behaviours in young people from the MILESTONE Italian sample.

Author

Torino, Gabriele, Leone, Silvia, Cortese, Samuele, Dieleman, Gwen, Gerritsen, Suzanne, Maffezzoni, Deborah, Martella, Donato, Micciolo, Rocco, Singh, Swaran, Street, Cathy, Tuffrey, Amanda, Walker, Leanne, Zamparini, Manuel, de Girolamo, Giovanni, Allibrio, Giovanni, Bertani, Angelo, Ferrari, Sabrina, Conti, Patrizia, Margari, Francesco, and Martinelli, Ottaviano

Subjects
CHILD mental health services, MENTAL health services, TRANSITIONAL care, ATTEMPTED suicide, SUICIDAL ideation
Abstract

Suicide is a significant leading cause of death among young people, particularly those struggling with mental disorders. The present study utilised data from 230 young people (aged 16–18 years) undergoing a transitional care process from Child and Adolescent Mental Health Services to Adult Mental Health Services within the MILESTONE European project (2014–2019), a longitudinal cluster randomised controlled trial. The objectives of this study were to monitor temporal patterns of general health and social functioning over two years, to detect sex differences, and to identify factors associated with Suicidal Thoughts and Behaviours (STB) at the first and last time points. The results demonstrate a decrease in STB over the two-year follow-up period among all participants. Females exhibited a higher prevalence of STB across all time points, whereas males only exhibited STB at the nine-month follow-up. The most influential factors associated with STB were previous suicide attempts and mood disorders at baseline, and mood disorders and relational problems at the end of follow-up. These findings emphasise the importance of monitoring STB and informing young people undergoing a transitional care period about its key risk factors. Moreover, sex differences in STB suggest the need for different preventive strategies for males and females. [ABSTRACT FROM AUTHOR]

Published
2024
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4. The importance of clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their mental health services in Europe

Author

van Bodegom, L, Gerritsen, S, Dieleman, G, Overbeek, M, de Girolamo, G, Scocco, P, Hillegers, M, Wolke, D, Rizopoulos, D, Appleton, R, Conti, P, Franić, T, Margari, F, Madan, J, Mcnicholas, F, Nacinovich, R, Pastore, A, Paul, M, Purper-Ouakil, D, Saam, M, Santosh, P, Sartor, A, Schulze, U, Signorini, G, Singh, S, Street, C, Tah, P, Tanase, E, Tremmery, S, Tuomainen, H, Maras, A, van Bodegom, Larissa S, Gerritsen, Suzanne E, Dieleman, Gwendolyn C, Overbeek, Mathilde M, de Girolamo, Giovanni, Scocco, Paolo, Hillegers, Manon H J, Wolke, Dieter, Rizopoulos, Dimitris, Appleton, Rebecca, Conti, Patrizia, Franić, Tomislav, Margari, Francesco, Madan, Jason, McNicholas, Fiona, Nacinovich, Renata, Pastore, Adriana, Paul, Moli, Purper-Ouakil, Diane, Saam, Melanie C, Santosh, Paramala J, Sartor, Anne, Schulze, Ulrike M E, Signorini, Giulia, Singh, Swaran P, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuomainen, Helena, Maras, Athanasios, van Bodegom, L, Gerritsen, S, Dieleman, G, Overbeek, M, de Girolamo, G, Scocco, P, Hillegers, M, Wolke, D, Rizopoulos, D, Appleton, R, Conti, P, Franić, T, Margari, F, Madan, J, Mcnicholas, F, Nacinovich, R, Pastore, A, Paul, M, Purper-Ouakil, D, Saam, M, Santosh, P, Sartor, A, Schulze, U, Signorini, G, Singh, S, Street, C, Tah, P, Tanase, E, Tremmery, S, Tuomainen, H, Maras, A, van Bodegom, Larissa S, Gerritsen, Suzanne E, Dieleman, Gwendolyn C, Overbeek, Mathilde M, de Girolamo, Giovanni, Scocco, Paolo, Hillegers, Manon H J, Wolke, Dieter, Rizopoulos, Dimitris, Appleton, Rebecca, Conti, Patrizia, Franić, Tomislav, Margari, Francesco, Madan, Jason, McNicholas, Fiona, Nacinovich, Renata, Pastore, Adriana, Paul, Moli, Purper-Ouakil, Diane, Saam, Melanie C, Santosh, Paramala J, Sartor, Anne, Schulze, Ulrike M E, Signorini, Giulia, Singh, Swaran P, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuomainen, Helena, and Maras, Athanasios

Abstract

Background: To study clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their Child and Adolescent Mental Health Service (CAMHS) and its association with mental health indicators, transition recommendations and mental health service (MHS) use. Methods: 763 CAMHS users from eight European countries were assessed using multi-informant and standardised assessment tools at baseline and nine months follow-up. Separate ANCOVA's and pairwise comparisons were conducted to assess whether clinicians' and parents' awareness of young people's suicidal behaviour were associated with mental health indicators, clinician's recommendations to continue treatment and MHS use at nine months follow-up. Results: 53.5 % of clinicians and 56.9 % of parents were unaware of young people's self-reported suicidal behaviour at baseline. Compared to those whose clinicians/parents were aware, unawareness was associated with a 72–80 % lower proportion of being recommended to continue treatment. Self-reported mental health problems at baseline were comparable for young people whose clinicians and parents were aware and unaware of suicidal behaviour. Clinicians' and parents' unawareness were not associated with MHS use at follow-up. Limitations: Aspects of suicidal behaviour, such as suicide ideation, -plans and -attempts, could not be distinguished. Few young people transitioned to Adult Mental Health Services (AMHS), therefore power to study factors associated with AMHS use was limited. Conclusion: Clinicians and parents are often unaware of suicidal behaviour, which decreases the likelihood of a recommendation to continue treatment, but does not seem to affect young people's MHS use or their mental health problems.

Published
2023

5. 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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6. Cohort profile

Author

Gerritsen, Suzanne E., Maras, Athanasios, van Bodegom, Larissa S., Overbeek, Mathilde M., Verhulst, Frank C., Wolke, Dieter, Appleton, Rebecca, Bertani, Angelo, Cataldo, Maria G., Conti, Patrizia, Da Fonseca, David, Davidović, Nikolina, Dodig-Ćurković, Katarina, Ferrari, Cecilia, Fiori, Federico, Franić, Tomislav, Gatherer, Charlotte, De Girolamo, Giovanni, Heaney, Natalie, Hendrickx, Gaëlle, Kolozsvari, Alfred, Levi, Flavia Micol, Lievesley, Kate, Madan, Jason, Martinelli, Ottaviano, Mastroianni, Mathilde, Maurice, Virginie, McNicholas, Fiona, O'Hara, Lesley, Paul, Moli, Purper-Ouakil, Diane, de Roeck, Veronique, Russet, Frédérick, Saam, Melanie C., Sagar-Ouriaghli, Ilyas, Santosh, Paramala J., Sartor, Anne, Schandrin, Aurélie, Schulze, Ulrike M. E., Signorini, Giulia, Singh, Swaran P., Singh, Jatinder, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuffrey, Amanda, Tuomainen, Helena, van Amelsvoort, Therese A. M. J., Wilson, Anna, Walker, Leanne, Dieleman, Gwen C., Adams, Laura, Allibrio, Giovanni, Armando, Marco, Aslan, Sonja, Baccanelli, Nadia, Balaudo, Monica, Bergamo, Fabia, Berriman, Jo, Rethore, Chrystèle Bodier, Bonnet-Brilhault, Frédérique, Boon, Albert, Braamse, Karen, Breuninger, Ulrike, Buttiglione, Maura, Buttle, Sarah, Cammarano, Marco, Canaway, Alastair, Cantini, Fortunata, Cappellari, Cristiano, Carenini, Marta, Carrà, Giuseppe, Charvin, Isabelle, Chianura, Krizia, Coleman, Philippa, Colonna, Annalisa, Conese, Patrizia, Costanzo, Raffaella, Daffern, Claire, Danckaerts, Marina, Giacomo, Andrea de, Dineen, Peter, Ermans, Jean-Pierre, Farmer, Alan, Fegert, Jörg M., Ferrari, Alessandro, Ferrari, Sabrina, Galea, Giuliana, Gatta, Michela, Gheza, Elisa, Goglia, Giacomo, Grandetto, MariaRosa, Griffin, James, Healy, Elaine, Holmes, Keith, Humbertclaude, Véronique, Ingravallo, Nicola, Invernizzi, Roberta, Jardri, Renaud, Keeley, Helen, Kelly, Caoimhe, Killilea, Meghan, Kirwan, James, Klockaerts, Catherine, Kovač, Vlatka, Lida-Pulik, Hélène, Liew, Ashley, Lippens, Christel, Lynch, Fionnuala, Macchi, Francesca, Manenti, Lidia, Margari, Francesco, Margari, Lucia, Martinelli, Paola, McDonald, James, McFadden, Leighton, Menghini, Deny, Migone, Maria, Miller, Sarah, Monzani, Emiliano, Morini, Giorgia, Mutafov, Todor, Nacinovich, Renata, Negrinotti, Cristina, Nelis, Emmanuel, Neri, Francesca, Nikolova, Paulina, Nossa, Marzia, Noterdaeme, Michele, Operto, Francesca, Panaro, Vittoria, Parenti, Aesa, Pastore, Adriana, Pemmaraju, Vinuthna, Pepermans, Ann, Petruzzelli, Maria Giuseppina, Presicci, Anna, Prigent, Catherine, Rinaldi, Francesco, Riva, Erika, Rivolta, Laura, Roekens, Anne, Rogers, Ben, Ronzini, Pablo, Sakar, Vehbi, Salvetti, Selena, Sandhu, Tanveer, Schepker, Renate, Scocco, Paolo, Siviero, Marco, Slowik, Michael, Smyth, Courtney, Spadone, Maria Antonietta, Speranza, Mario, Stagi, Paolo, Stagni, Pamela, Starace, Fabrizio, Stoppa, Patrizia, Tansini, Lucia, Toselli, Cecilia, Trabucchi, Guido, Tubito, Maria, Dam, Arno van, Gutschoven, Hanne Van, West, Dirk van, Vanni, Fabio, Vannicola, Chiara, Varuzza, Cristiana, Varvara, Pamela, Ventura, Patrizia, Vicari, Stefano, Vicini, Stefania, Bentzel, Carolin von, Wells, Philip, Williams, Beata, Zabarella, Marina, Zamboni, Anna, Zanetti, Edda, RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, MUMC+: MA Med Staf Spec Psychiatrie (9), Child and Adolescent Psychiatry / Psychology, Clinical Child and Family Studies, LEARN! - Child rearing, and APH - Mental Health

Subjects
Adult, Internationality, SAMPLE, RJ, child & adolescent psychiatry, ADOLESCENT, Jugendpsychiatrie, Cohort Studies, SDG 3 - Good Health and Well-being, ddc:150, QUALITY-OF-LIFE, Psychiatrische Versorgung, Child psychiatry, Humans, Prospective Studies, SCALE, Demography, Retrospective Studies, Psychiatry, Internationalität, OUTCOMES, DDC 150 / Psychology, Adolescent psychiatry, international health services, General Medicine, WHOQOL-BREF, Europe, Mental Health, Mental health services, CROSS, Adolescent Health Services, EXPERIENCE, Kinderpsychiatrie, adult psychiatry, RA, TRANSITION, RC
Abstract

PurposeThe presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports.ParticipantsSeven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at.Findings to dateThis cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year.Future plansAnalysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared.Trial registration numberNCT03013595., publishedVersion

Published
2021
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7. Transitioning to adult mental health services for young people with ADHD: an Italian-based survey on practices for pediatric and adult services.

Author

Roberti, Elisa, Scarpellini, Francesca, Campi, Rita, Giardino, Michele, Clavenna, Antonio, Bonati, Maurizio, the TransiDEA group, Stoppa, Patrizia, Martinelli, Ottaviano, Morosini, Paola, Capovilla, Giuseppe, Costantino, Maria Antonella, Raviglione, Federico, Conti, Patrizia, Rossi, Giorgio, Giarelli, Maria Teresa, Fazzi, Elisa Maria, Carpanelli, Marialuisa, Canevini, Maria Paola, and Rinaldi, Francesco

Subjects
STRATEGIC planning, TRANSITIONAL care, PEDIATRICS, ATTENTION-deficit hyperactivity disorder, SURVEYS, DESCRIPTIVE statistics, RESEARCH funding, MENTAL health services, MEDICAL needs assessment
Abstract

Background: Supporting young ADHD patients in transition to adult services is essential. Yet, the low percentages of successful referrals and the issues reported by patients and clinicians stress the need for further attention to transitioning practices. The present study assessed the transitioning process of Attention-Deficit/Hyperactivity Disorder (ADHD) patients in Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Italian territory. We asked child and adult psychiatrists to report the current state of services and their observations on limitations and possible future matters that must be addressed. Method: Seventy-seven centers (42 CAMHS, 35 AMHS) filled in a web-based survey in which they reported the number of ADHD patients, how many transitioning patients they had within the past year, and how they structured transition. Results: A fragmented picture emerged from the survey. Lack of resources, training, and communication between services hinder the transition process, and many adult patients remain under CAMHS' care. While some services have a protocol, there is no structured guidance that can help improve integration and continuity of treatment. Conclusion: The observed situation reflects a need for improvement and standard guidelines to enable a successful transition process, considering clinicians' and patients' necessities. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Differences between centers in functional outcome of patients with ADHD after 1 year from the time of diagnosis.

Author

Cartabia, Massimo, Finazzi, Stefano, Bonati, Maurizio, The Lombardy ADHD Group, Raschitelli, Nicoletta, Zanetti, Michele, Conte, Stefano, Renzetti, Valeria, Stoppa, Patrizia, Mauri, Valentina, Molteni, Massimo, Salandi, Antonio, Trabattoni, Sara, Effredi, Paola, Fazzi, Elisa, Filippini, Elena, Pedercini, Elisabetta, Tiberti, Alessandra, Conti, Patrizia, and Libera, Elena Della

Subjects
PSYCHOTHERAPY, RANDOM effects model, ATTENTION-deficit hyperactivity disorder, THERAPEUTICS
Abstract

Although the pharmacological therapy of ADHD has been widely studied, little has been done to compare the different therapeutic approaches (e.g., drug therapy vs. psychological treatments) and even less has been done to compare the outcome of the therapy between centers. This multicenter observational study aims to assess between-center variation in functional outcome of ADHD patients one year after the diagnosis, according to the treatment received. We used the Regional ADHD Registry data on 1429 patients enrolled in 16 ADHD centers in the 2011–2022 period. To evaluate the effectiveness of the therapy we used a generalized linear mixed model with the center as the random effect, including patient condition at diagnosis and center characteristics, weighting by the inverse of the propensity score of the treatment received by the patient. Between-center variation was expressed as the relative difference in odds-ratios between the observed and the expected number of patients whose condition improved, using the Clinical Global Impressions—Improvement Scale (CGI-I), and the relative 95% CI. Patients who received combined treatment were significantly more likely to improve compared to other treatment groups (65.5% vs 54.4% for methylphenidate alone, 53.4% for psychological treatment alone, or 40.5% for no therapy). Adjusted for patients and center characteristics, the log-odds ratio ranged from 0.85 (0.29–1.55 95% CI) to − 0.64 (− 1.17–− 0.18 95% CI). The mean expected probability of improvement after one year of therapy for an average patient with ADHD for each center was 47.7% in a center at the 25th percentile and 61.2% in a center at the 75th percentile of the outcome distribution after adjustments. The wide between-center variation in patient functional improvement one year after the diagnosis of ADHD could be largely explained by center-specific therapeutic approaches or attitudes. More careful and stringent work is needed to reduce differences in responses between centers, as could formal and periodic audit programs within and between centers. [ABSTRACT FROM AUTHOR]

Published
2023
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9. Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Author

Gerritsen, Suzanne E, primary, Maras, Athanasios, additional, van Bodegom, Larissa S, additional, Overbeek, Mathilde M, additional, Verhulst, Frank C, additional, Wolke, Dieter, additional, Appleton, Rebecca, additional, Bertani, Angelo, additional, Cataldo, Maria G, additional, Conti, Patrizia, additional, Da Fonseca, David, additional, Davidović, Nikolina, additional, Dodig-Ćurković, Katarina, additional, Ferrari, Cecilia, additional, Fiori, Federico, additional, Franić, Tomislav, additional, Gatherer, Charlotte, additional, De Girolamo, Giovanni, additional, Heaney, Natalie, additional, Hendrickx, Gaëlle, additional, Kolozsvari, Alfred, additional, Levi, Flavia Micol, additional, Lievesley, Kate, additional, Madan, Jason, additional, Martinelli, Ottaviano, additional, Mastroianni, Mathilde, additional, Maurice, Virginie, additional, McNicholas, Fiona, additional, O'Hara, Lesley, additional, Paul, Moli, additional, Purper-Ouakil, Diane, additional, de Roeck, Veronique, additional, Russet, Frédérick, additional, Saam, Melanie C, additional, Sagar-Ouriaghli, Ilyas, additional, Santosh, Paramala J, additional, Sartor, Anne, additional, Schandrin, Aurélie, additional, Schulze, Ulrike M E, additional, Signorini, Giulia, additional, Singh, Swaran P, additional, Singh, Jatinder, additional, Street, Cathy, additional, Tah, Priya, additional, Tanase, Elena, additional, Tremmery, Sabine, additional, Tuffrey, Amanda, additional, Tuomainen, Helena, additional, van Amelsvoort, Therese A M J, additional, Wilson, Anna, additional, Walker, Leanne, additional, and Dieleman, Gwen C, additional

Published
2021
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10. Cohort profile:Demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Author

Gerritsen, Suzanne E., Maras, Athanasios, Van Bodegom, Larissa S., Overbeek, Mathilde M., Verhulst, Frank C., Wolke, Dieter, Appleton, Rebecca, Bertani, Angelo, Cataldo, Maria G., Conti, Patrizia, Da Fonseca, David, Davidović, Nikolina, Dodig-A †urković, Katarina, Ferrari, Cecilia, Fiori, Federico, Franić, Tomislav, Gatherer, Charlotte, De Girolamo, Giovanni, Heaney, Natalie, Hendrickx, Gaëlle, Kolozsvari, Alfred, Levi, Flavia Micol, Lievesley, Kate, Madan, Jason, Martinelli, Ottaviano, Mastroianni, Mathilde, Maurice, Virginie, McNicholas, Fiona, O'Hara, Lesley, Paul, Moli, Purper-Ouakil, Diane, De Roeck, Veronique, Russet, Frédérick, Saam, Melanie C., Sagar-Ouriaghli, Ilyas, Santosh, Paramala J., Sartor, Anne, Schandrin, Aurélie, Schulze, Ulrike M.E., Signorini, Giulia, Singh, Swaran P., Singh, Jatinder, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuffrey, Amanda, Tuomainen, Helena, Van Amelsvoort, Therese A.M.J., Wilson, Anna, Walker, Leanne, Dieleman, Gwen C., Gerritsen, Suzanne E., Maras, Athanasios, Van Bodegom, Larissa S., Overbeek, Mathilde M., Verhulst, Frank C., Wolke, Dieter, Appleton, Rebecca, Bertani, Angelo, Cataldo, Maria G., Conti, Patrizia, Da Fonseca, David, Davidović, Nikolina, Dodig-A †urković, Katarina, Ferrari, Cecilia, Fiori, Federico, Franić, Tomislav, Gatherer, Charlotte, De Girolamo, Giovanni, Heaney, Natalie, Hendrickx, Gaëlle, Kolozsvari, Alfred, Levi, Flavia Micol, Lievesley, Kate, Madan, Jason, Martinelli, Ottaviano, Mastroianni, Mathilde, Maurice, Virginie, McNicholas, Fiona, O'Hara, Lesley, Paul, Moli, Purper-Ouakil, Diane, De Roeck, Veronique, Russet, Frédérick, Saam, Melanie C., Sagar-Ouriaghli, Ilyas, Santosh, Paramala J., Sartor, Anne, Schandrin, Aurélie, Schulze, Ulrike M.E., Signorini, Giulia, Singh, Swaran P., Singh, Jatinder, Street, Cathy, Tah, Priya, Tanase, Elena, Tremmery, Sabine, Tuffrey, Amanda, Tuomainen, Helena, Van Amelsvoort, Therese A.M.J., Wilson, Anna, Walker, Leanne, and Dieleman, Gwen C.

Abstract

Purpose The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be € markedly ill', € severely ill' or € among the most extremely ill' by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number NCT03013595.

Published
2021

12. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA): Psychometric properties of the Italian version

Author

D'Avanzo, B, Lovaglio, P, Parabiaghi, A, Conti, P, Frigerio, A, Molteni, M, Monzani, E, Rossi, P, Barbato, A, D'Avanzo, Barbara, Lovaglio, Pietro Giorgio, Parabiaghi, Alberto, Conti, Patrizia, Frigerio, Alessandra, Molteni, Massimo, Monzani, Emiliano, Rossi, Piero Ernesto, Barbato, Angelo, D'Avanzo, B, Lovaglio, P, Parabiaghi, A, Conti, P, Frigerio, A, Molteni, M, Monzani, E, Rossi, P, Barbato, A, D'Avanzo, Barbara, Lovaglio, Pietro Giorgio, Parabiaghi, Alberto, Conti, Patrizia, Frigerio, Alessandra, Molteni, Massimo, Monzani, Emiliano, Rossi, Piero Ernesto, and Barbato, Angelo

Abstract

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) assesses mental health and social functioning of people <18 years. We explored the psychometric properties of the HoNOSCA Italian version. Dimensionality was assessed by Exploratory Factor Analysis and validated using Confirmatory Factor Analysis. Internal consistency and reliability of the factorial structure were evaluated. One hundred thirty-four subjects were assessed by HoNOSCA, Clinical Global Impression and Strengths and Difficulties Questionnaire for concurrent validity. Intraclass correlation was computed to evaluate inter-rater reliability using eight vignettes assessed by 35 professionals. Exploratory Factor Analysis identified two correlated subscales and Confirmatory Factor Analysis showed good fit to data. Cronbach's alpha was 0.65. HoNOSCA subscale scores increased with Clinical Global Impression severity and correlated positively with Strengths and Difficulties Questionnaire. Predictive power to discriminate between two Clinical Global Impression groups was good. The minimal difference in total score corresponding to a marked clinical change was 9, the clinically reliable change was 10. This should be considered when using the HoNOSCA as outcome measure. Intraclass correlation coefficient was 0.71 for the total score. The need for a comprehensive assessment for child mental health and behaviour in Italian services can be met by the HoNOSCA if used as cumulative bivariate subscales.

Published
2018

14. Funzionamento Morale in Adolescenti con Diagnosi di Tipo Esternalizzante e Adattamento: Uno studio di Follow-Up [Moral Functioning in Adolescents Referred for Externalizing Disorders and Adjustment: A Follow-Up Study]

Author

Gerbino, Maria, Caprara, Gian Vittorio, Perinelli, Enrico, De Girolamo, Giovanni, Lenti, Carlo, Walder, Mauro, Preda, Cecilia Elena, Bianchi, Silvia, Brunati, Emilio, Marchesini, Gianluca, Conti, Patrizia, Tiberti, Alessandra, Micheletti, Serena, Spada, Silvia, Balottin, Umberto, Nessi, Benedetta, Nonini, Laura, Maraschi, Francesca, Molteni, Silvia, Rossi, Giorgio, Meraviglia, Corrado, Gianatti, Daniela, Libera, Lucrezia, Martinelli, Ottaviano, Galbusera, Daniela, Carenini, Marta, Pizzatti, Tiziana, Steca, Patrizia, Monzani, Dario, Molteni, Massimo, Nobile, Maria, Vanzin, Laura, and Colombo, Paolo

Published
2014

18. Monitoraggio e valutazione dei progetti formativi integrati nei percorsi di obbligo formativo: finalità, strategie e procedure

Author

DEL MUGNAIO A, MARCUCCIO, MASSIMO, Massimo Marcuccio, Anna Del Mugnaio, Francesco Degli Esposti, Angela Verzelli, Ninetta D’Aurizio, Marilena Mattioli, Angela Bacchi, Elena Minelli, Carla Conti, Patrizia Loriai, MARCUCCIO M., and DEL MUGNAIO A

Subjects
Valutazione di progetti, Educational evaluation, Sistema formativo integrato
Abstract

Il capitolo presenta le finalità, le strategie e le procedure delle attività di monitoraggio e valutazione dei progetti formativi integrati nei percorsi di obbligo formativo realizzati nella provincia di Bologna negli aa. ss. 2000-2001 e 2001-2002.

Published
2004

19. Elementi di sfondo: riferimenti normativi, sperimentazioni e azioni messe a bando

Author

MARCUCCIO, MASSIMO, Massimo Marcuccio, Anna Del Mugnaio, Francesco Degli Esposti, Angela Verzelli, Ninetta D’Aurizio, Marilena Mattioli, Angela Bacchi, Elena Minelli, Carla Conti, Patrizia Loria., and MARCUCCIO M.

Subjects
Valutazione di progetti, Educational evaluation, Sistema formativo integrato
Abstract

Il capitolo presenta il contesto normativo-istituzionale dei percorsi integrati nell’obbligo formativo realizzati nella provincia di Bologna negli aa. ss. 2000-2001 e 2001-2002.

Published
2004

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