An interventional study of Managed transition in Psychiatric Disorder and Transition, sponsored by University of Geneva, Switzerland. Status unknown at 1 site in Switzerland. Open to participants aged 16 Years to 18 Years. Per ClinicalTrials.gov, last updated 2020-01-31.
Sponsored by University of Geneva, Switzerland · Not applicable, Interventional, and Supportive care
Disruption of care during transition from child and adolescent mental health (CAMHS) to adult mental health services (AMHS) may adversely affect the health and well-being of service users. Indeed, transition-related discontinuity of care is a major health and societal challenge today. Current evidences show that this transition is not always properly managed and that improving the transition process can have a positive impact on the health and wellbeing of young people. Nevertheless, data available are still inconsistent and only few studies investigated possible models aimed at improving and operationalize the transition. At present, no information concerning the transition in the Geneva Canton is available.
According to this lack of evidence, the current study aims at: 1) mapping the CAMHS/AMHS interface; 2) evaluating the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS; 3) determining the effectiveness of an experimental model of managed transition in improving outcomes, compared with usual care; 4) comparing these results with those of the EU funded MILESTONE study from several other European countries.
The investigators will recruit all patients aged ≥ 16 years and 6 months from the Geneva Canton in charge at CAMHS and they will follow them for up to 24 months. CAMHS will be instructed to provide all their service users at the time of transition either usual care or a novel service called "Managed Transition", which will include the use of a new decision support tool, the Transition Readiness and Appropriateness Measure (TRAM). A nested cohort Randomised Controlled Trial (ncRCT) design will be applied to divide patients into the two groups. The health and wellbeing of the young people will be assessed at baseline and then followed-up for 24 months to see whether they transition to AMHS or are discharged or referred to some other service. The investigators will then evaluate what impact the different transition experiences have on young people's health and wellbeing, and whether the process of Managed Transition has any benefits as compared to usual care.
2,107 studies on the registry are indexed under Mental Disorders; 416 are open to participants now.
This study's planned enrollment of 200 is above the median of 94 across 1,574 interventional studies indexed under Mental Disorders.
Browse Mental Disorders studies →University of Geneva, Switzerland is the lead sponsor of 43 studies on the registry; 15 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Young people in this group will receive usual care and transition as usual, they will be our control group.
Young people in this group will do the managed transition, they will be our experimental group.
Behavioral: Managed transition
Young people, their family and clinicians will receive transition guidelines and will be asked to follow them as much as possible.
Patient's health status (need for care)
Measured at each time point using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) completed by a trained research assistant. Scores will be compared between first and last time point. HoNOSCA is 5 point scale going from 0 = not a problem, 1 = minor issue not requiring intervention, 2 = slightly problematic, 3 = moderately serious problem, 4 = serious to very serious problem, 9= unknown/not applicable. Scores are calculated by adding up all the subscales (9s are not counted) and a higher score means a worse outcome.
Time frame: Before transition compared to after transition (18 months)
Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) self report
Self-report "need for care" status measured by the Health of the Nation Outcome Scale for Children and Adolescents
Time frame: Baseline, 6, 12 and 18 months
Transition Related Outcome Measure (TROM)
Transition Related Outcome Measure to assess outcomes post-transition completed by the young person, parent/carer and clinician
Time frame: 6, 12 or 18 months
Child Behavior Checklist (CBCL) or Adult Behavior Checklist (ABCL)
Emotional and behavioral disturbances measured by the Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Checklist (CBCL) or Adult Behavior Checklist (ABCL) questionnaires (parent/carer version). CBCL targets young people until 17 and ABCL after 17.
Time frame: Baseline and 18 months
Clinical Global Impression Scale (CGIS)
The Clinical Global Impression Scale completed by the clinician assesses patient's ilness severity
Time frame: Baseline, 6, 12 and 18 months
World Health Organisation's quality of life (WHOQOL-BREF)
Young person's quality of life is measured by World Health Organisation's quality of life questionnaire. It is completed by the young person.
Time frame: Baseline and 18 months
EuroQol generic quality of life questionnaire (5Q-5D-5L)
Quality Adjusted Life Years (QALYs) and cost effectiveness are assessed by EuroQol generic quality of life questionnaire completed by the young person.
Time frame: Baseline, 6, 12 and 18 months
On Your Own Feet - Transition Experience Scale (OYOF-TES)
Transition experience and readiness assessed by On Your Own Feet - Transition Experience Scale completed by the young person and parent/carer only once at the time point right after transition
Time frame: 6, 12 or 18 months
Barriers to Care (BtC)
Barriers to care assessed by Barriers to Care checklist completed by the young person if he/she is not using the available services any more
Time frame: 6, 12 and 18 months
Client Service Receipt Inventory (CSRI)
Service use assessed by a Client Service Receipt Inventory adapted from the Milestone study; completed by the young person
Time frame: Baseline, 6, 12 and 18 months
Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) clinician version
Need for care and mental health status measured by Health of the Nation Outcome Scale for Children and Adolescents completed by a trained research assistant with information from the young person, parent/carer and clinician to ensure accuracy
Time frame: Baseline, 6, 12, and 18 months
Kiddie Schedule for Affective Disorders and Schizophrenia-Present State and Lifetime (K-SADS-PL)
Kiddie Schedule for Affective Disorders and Schizophrenia-Present State and Lifetime Version for DSM-IV performed by a trained research assistant
Time frame: Baseline and 18 months
Prodromal questionnaire (PQ-16)
Prodromal questionnaire to assess prodromal symptoms filled by the young person as a self report
Time frame: Baseline and 18 months
General Assessment Scale for Social Functioning (GASC)
General Assessment Scale for Social Functioning assesses patients general functioning filled by the clinician
Time frame: Baseline and 18 months
Reflective Functioning Questionnaire (RFQ and PRFQ) self-report and parent version
Reflective Functioning Questionnaire assesses mentalisation abilities filled by the young person and parent/carer (two versions)
Time frame: Baseline
Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS)
Social abilities are measured by the Anticipatory and Consummatory Interpersonal Pleasure Scale self report and parent/carer version
Time frame: Baseline
Multidimensional Peer Victimization Scale-Revised (MPVS-R)
Multidimensional Peer Victimization Scale-Revised assesses bullying as a self report
Time frame: Baseline and 18 months
Coddington Life Event Scale (CLES)
Important life events is assessed by the Coddington Life Event Scale self-report
Time frame: Baseline, 6, 12 and 18 months
Perceived Stress Reactivity Scale (PSRS)
Young person's stress status is measured by the Perceived Stress Reactivity Scale self report
Time frame: Baseline
This study is status unknown, as verified in Jan 2020. You cannot join it, but the record below documents what was studied.
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University of Geneva, Switzerland