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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

Background: Transitioning from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) raises novel ethical aspects for healthcare professionals, as well as for young people, their parents and carers. Method: Focus groups were conducted in Croatia, Ireland and the United Kingdom with youth mental health groups and youth representatives with no mental health (MH) remit. One hundred and eleven participants, aged from 16 to 60 years, contributed to discussions. Results: Perpetuation of stigma, autonomy and decision-making were central themes as both enablers and deterrents of successful transition. The tension between professional (and at times parental) paternalism and young persons' growing autonomy was well captured in the themes; (a) desired practice, (b) who should decide, (c) the process of decision-making and (d) potential harm(s). Conclusions: This study provides insight into the ethical values, particularly autonomy and collaboratively working, which people expect to underpin the transition between CAMHS and AMHS. Key Practitioner Message: Engaging young people early in making decisions about their future care can enhance trust between practitioner and the young person. In addition to diagnosis, a number of factors (such as moving home; waiting lists and stigma) may need to be taken into account when considering the direction of future health care. When possible, alternatives to AMHS should be considered if considered by the young person to be a less-stigmatising treatment option.

Cilj ovog opservacijskog istraživanja bio je istražiti prijevremeni prekid, neobjavljivanje i vrijeme registracije intervencijskih istraživanja u području mentalnog zdravlja djece, te utvrditi razlike u primarnim ishodima između registra kliničkih ispitivanja i odgovarajućih publikacija, jer one mogu ukazivati na pristranost u izvještavanju o ishodima s ciljem favoriziranja pozitivnih rezultata. Slijedeći istu metodologiju, provedeno je usporedno istraživanje na uzorku registriranih istraživanja u području mentalnog zdravlja odraslih. S obzirom na to da je broj istraživanja na EUCTR registru bio relativno malen i s brojnim nedosljednostima u registru, istraživanje je provedeno koristeći podatke dostupne na ClinicalTrials.gov registru. Za sva „zatvorena“ istraživanja s registra tražena je odgovarajuća publikacija u tri baze podataka (PubMed, Scopus i Google Scholar). Ishodi ovog istraživanja jesu prijevremeno prekidanje istraživanja, izvještavanje o rezultatima u roku od godinu dana nakon završetka istraživanja, objavljivanje članka u znanstvenom časopisu u prosječnom roku za objavljivanje (729 dana) i vrijeme registracije te kvaliteta registracije primarnih ishoda u registru, mijenjanje primarnih ishoda u registru nakon kraja istraživanja, smjer dobivenih rezultata, podudaranje primarnih ishoda s onima u publikaciji te moguća pristranost selektivnog objavljivanja ishoda. Rezultati su pokazali da značajan broj prekinutih istraživanja ne navodi razloge prekidanja u registru te da su upravo istraživanja bihevioralnih intervencija i ona financirana bez industrije češće nepravilno i nepravovremeno registrirana te na koncu i objavljena s nedosljednim podatcima o primarnim ishodima. Usporedbom dobivenih rezultata s rezultatima dobivenima na poduzorku istraživanja u području mentalnog zdravlja odraslih, ne nalaze se značajne razlike osim u broju pozitivnih rezultata kojih je više u uzorku istraživanja provedenih na djeci., The aim of this observational study was to investigate the premature discontinuation, non-publication and registration time of interventional trials in the field of children's mental health, and to identify discrepancies in primary outcomes between the clinical trial registry and relevant publications, as they may indicate bias in outcome reporting. Following the same methodology, a comparative study was conducted on a sample of registered trials in the field of adult mental health. Because the number of studies in the EUCTR registry was relatively small and with numerous inconsistencies in the registry, the research was conducted using data available in the ClinicalTrials.gov registry and in corresponding publications of completed trials indexed in three data bases (PubMed, Scopus and Google Scholar). The outcomes of this research were premature trial cessation, results reporting within a year after the trial completion, publishing an article in a peer-reviewed journal within an average time to publish (729 days), registration time, quality of registration of primary outcomes in the registry, direction of the obtained results, matching of the primary outcomes with those in the publication and possible outcome reporting bias. The results showed that a significant number of discontinued trials does not state the reasons for discontinuation in the registry. Trials on behavioral interventions and those non-industry funded are more often inadequately and untimely registered and eventually more frequently published with inconsistent data on primary outcomes. Comparing these results with the results obtained in the subsample of trials in the field of adult mental health, there were no significant differences except in the number of positive results, which were more frequent in the sample of trials conducted on children.

Background and Objectives: Locus of control (LOC) is a modifiable mediator of symptoms of posttraumatic stress disorder (PTSD) among traumatized individuals and a potential target of intervention. Compared with studies involving adults, the potential mediation effect of LOC on PTSD symptoms among trauma-exposed children and adolescents is relatively under-explored. This study, therefore, assessed the mediation effects of LOC on the association between lifetime cumulative trauma and PTSD symptoms among a large cohort of adolescents from different cultural background. Design: Cross-sectional study. Methods: LOC was determined using the Multi- Dimension Locus of Control Scale ; Posttraumatic stress symptoms using the UCLA PTSD Reaction Index ; and other significant negative life events using the Life Events Checklist. Results: Among 3826 adolescents who completed the study, external LOC explained 24% of variance (R 2 =.24 ; F2, 3823 = 619.01 ; p

Current research trend is the identification of psychosocial variables that moderate and/or mediate the association between stressors and psychopathological symptoms. Research has shown Locus of Control (LoC) is a key cognitive component of this psychological process in adolescents from individualist cultures. It is unclear whether this finding can be generalized to collectivist adolescents given that LoC is argued to be a culturally relative construct. The study examined the moderating and mediating effects of LoC on the relationship between negative events and psychopathological symptoms (anxiety and depressive symptoms) in adolescents from collectivist countries (n = 2800). Consistent with prior research, negative life events and external LoC were associated with more psychopathological symptoms. Unlike past studies with samples from individualist countries, the study did not produce clear evidence that LoC moderated or mediated this relationship. Results are discussed in terms of cultural differences in the (un)desirability of external control.

Objectives: To translate the ESSENCE-Q screening instrument for neurodevelopmental disorders into South Slavic languages, namely Bosnian, Bulgarian, Croatian, Macedonian, Montenegrin, Serbian, and Slovenian. Methods: The ESSENCE-Q (12 items, possible total scores 0-24) was translated into languages abovementioned in a multiple-step process. Afterwards, it was administered via interviews with one parent for a total of 112 children under the age of 6 assessed for developmental difficulties. Forty of the screened children had one or more neurodevelopmental disorders (NDDs). Results: The translated questionnaires have appropriate content and face validity, with sound conceptual, item, semantic, and operational equivalence with the original. Only two items were found to be incomprehensive (“Motor development/milestones” and “Funny spells/absences). Thus, slight modifications were applied, preserving the original meaning. On average, children with NDDs had significantly higher scores than healthy children or children with psychological symptoms not related to NDDs (F(df) = 38.27(2), p < 0.001). Based on receiver operating characteristics analysis, an optimal cut-off of ≥4 had 85% sensitivity and 72.2% specificity. Conclusions: The ESSENCE-Q versions developed in this study have promising measurement properties when screening for children with NDDs in countries speaking South Slavic languages.

International audience; INTRODUCTION: Disruption of care during transition from child and adolescent mental health services (CAMHS) to adult mental health services may adversely affect the health and well-being of service users. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare) study evaluates the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS and determines the effectiveness of the model of managed transition in improving outcomes, compared with usual care. METHODS AND ANALYSIS: This is a cohort study with a nested cluster randomised controlled trial. Recruited CAMHS have been randomised to provide either (1) managed transition using the Transition Readiness and Appropriateness Measure score summary as a decision aid, or (2) usual care for young people reaching the TB. Participants are young people within 1 year of reaching the TB of their CAMHS in eight European countries; one parent/carer and a CAMHS clinician for each recruited young person; and adult mental health clinician or other community-based care provider, if young person transitions. The primary outcome is Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) measuring health and social functioning at 15 months postintervention. The secondary outcomes include mental health, quality of life, transition experience and healthcare usage assessed at 9, 15 and 24 months postintervention. With a mean cluster size of 21, a total of 840 participants randomised in a 1:2 intervention to control are required, providing 89% power to detect a difference in HoNOSCA score of 0.30 SD. The addition of 210 recruits for the cohort study ensures sufficient power for studying predictors, resulting in 1050 participants and an approximate 1:3 randomisation. ETHICS AND DISSEMINATION: The study protocol was approved by the UK National Research Ethics Service (15/WM/0052) and equivalent ethics boards in participating countries. Results will be reported at conferences, in peer-reviewed publications and to all relevant stakeholder groups. TRIAL REGISTRATION NUMBER: ISRCTN83240263; NCT03013595 (pre-results).

The global economic crisis has not only shaken up the economy, but also family functioning, in which the most vulnerable groups took the hardest hit - children and adolescents. The goal of this scientific paper is to examine the role of an adverse socioeconomic family environment and the perception of material deprivation of children in forming an experience of parental acceptance, rejection and control. 610 participants from primary schools of Croatia were involved in the research (51.6% girls and 44.8% boys), with average age being 13.88 years (SD=0.73). Along with the Questionnaires of general data and SES questionnaire, the research included the Scale of material deprivation of students and Scale of perception of parental behavior - SPRP (Macuka, 2008). The results of regression analysis indicate that the bigger the material deprivation of children, the smaller the amount of acceptance, and the larger the rejection of both parents and mother's control. In the case of anticipating the control of the father, it does not have any predictive power. It was indicated that material deprivation of children is a more significant predictor of parental behavior (acceptance, rejection and control) than the socioeconomic status. The conclusion points out the need for creating a family empowerment program and the importance of caring parental behavior, along with the devastating effects of inadequate parental actions.

Cilj ovog istraživanja je utvrditi stavove hrvatskih studenata o osobama homoseksualne orijentacije i usporediti ih sa stavovima prije 10 godina. Kako se tijekom posljednjih 10 godina u hrvatskoj javnosti mnogo otvorenije govori o LGBT populaciji i raspravlja o mnogim problemima s kojima se susreću, željeli smo ispitati jesu li se ove promjene u društvu odrazile i na stavove hrvatskih studenata o osobama homoseksualne orijentacije. Polazeći od istraživanja koje je provela Parmač (2005) u tri hrvatska sveučilišna središta (Zagreb, Rijeka i Split), istom skalom stavova ispitani su sadašnji studenti istih pet fakulteta (medicinski, ekonomski, pravni, građevinski i učiteljski) s navedenih sveučilišta, kao i sa Sveučilišta u Osijeku. Ispitano je ukupno oko 2000 studenata (oko trećina muškaraca i dvije trećine žena), odnosno po oko 500 studenata/ica sa svakog od četiri sveučilišta. Dio sudionika i sudionica (određen po slučaju) izražavao je svoj stav prema muškarcima homoseksualcima, dok je drugi dio izražavao stav prema lezbijkama. Istraživanjem smo ispitali razlikuju li se stavovi studenata i studentica prema gejevima i lezbijkama, te razlikuju li se stavovi studenata iz različitih dijelova Hrvatske. Pokazalo se da muškarci još uvijek imaju značajno negativnije stavove prema osobama homoseksualne orijentacije, a ta razlika proizlazi prvenstveno iz njihovog negativijeg stava prema gej muškarcima. Dobiveni rezultati uspoređeni su s onima iz 2005. godine, kada su studenti iz Splita iskazali značajno negativnije stavove od studenata iz Rijeke i Zagreba. Utvrđen je pomak u rezultatima na skali stavova u odnosu na tadašnje nalaze, kao i današnji odnos među stavovima studenata iz Splita, Rijeke i Zagreba. Također, današnji stavovi studenata iz Osijeka dovedeni su u relaciju sa stavovima studenata iz preostala tri sveučilišta.

Cilj ovog rada, provedenog na 84 muških istospolnih, 140 ženskih istospolnih i 78 raznospolnih prijateljskih dijada, bio je istražiti problem koji je do sada bio aktualan tek u istraživanjima odnosa romantične prirode, a tiče se pozitivnih učinaka idealiziranja naspram pozitivnih učinaka realnog viđenja prijatelja. Murray (1996ab) i Swann (1994, 2010) zastupaju dva suprotna stajališta – potrebu za samouzdizanjem i pozitivnu iluziju s jedne, te potrebu za samopotvrdom i realnim percipiranjem bliskih nam osoba s druge strane. Podaci su prikupljeni baterijom upitnika koja se sastojala od liste pridjeva preuzete iz Watsonove (2004) ljestvice za procjenu diskrepancije između različitih aspekata „vlastitog ja“, Podljestvica za mjerenje bliskosti u odnosu (Love scale) iz upitnika o bliskim odnosima (Relationship Questionnaire, Braiker i Kelley, 1979), čestice koja mjeri zadovoljstvo odnosom te demografskog upitnika o sudioniku i karakteristikama prijateljstva. Dobiveni rezultati potvrđuju da je idealiziranje, tj. pozitivna iluzija prema prijateljima, povezano s većom bliskošću i zadovoljstvom prijateljstvom. U dilemi između Swannove pretpostavke o samopotvrdi i Murrayine pretpostavke o samouzdizanju, naši nalazi idu u prilog potonjoj. U sklonosti iluziji sudionici su se razlikovali po spolu pa su tako sudionice u većem broju slučajeva idealizirale svoje prijatelje, neovisno o spolu prijatelja kojeg su procjenjivale. Žene su također bile sklonije većem idealiziranju od muškaraca. Razlike u veličini iluzije između ispospolnih i raznospolnih prijateljstava nisu se pokazale značajnima.