An observational study in Child Psychiatry, sponsored by Fondation Lenval. Recruiting at 1 site in France. Open to participants aged 17 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-08-10.
Sponsored by Fondation Lenval · Observational
Transitional psychiatry addresses the complex process through which individuals move from adolescence to adulthood, both in terms of developmental stage and mental healthcare systems. This transition includes the shift from pediatric to adult psychiatric services, as well as the evolution from vague or subclinical symptoms to established psychiatric disorders that may become chronic without early intervention.
Psychiatric disorders often emerge early in life: approximately 50% before age 15 and 75% before age 25. Early detection and intervention are therefore crucial to improving long-term mental health outcomes, functional independence, and social integration. However, current healthcare systems frequently fail to meet the needs of adolescents and young adults during this critical transition phase. Organizational discontinuities and clinical complexity lead to several risks:
Studies have shown that nearly half (48%) of young people drop out of psychiatric follow-up for at least three months after reaching adulthood. This interruption increases the likelihood of relapse and involuntary psychiatric admissions. Despite numerous publications over the past decade emphasizing the need for dedicated transitional care models, services remain fragmented in many systems.
One of the largest recent studies in this area, the European MILESTONE longitudinal study, followed 763 patients (mean age 17.5) over two years in eight countries. It found that 11% of participants discontinued care entirely, 41% experienced discontinuity, and only 21% successfully transitioned to adult psychiatry. Continued care was more likely among patients with severe psychiatric disorders who had already accepted treatment. In contrast, those with mood disorders or poorly defined symptoms-despite being at high risk-were less likely to receive ongoing support.
Transitional psychiatry therefore aims to establish integrated practices and systems that ensure the continuity of mental healthcare for youth aged approximately 16 to 25. The main objectives of such services are to:
Despite growing recognition of these needs, no consensus exists in the literature regarding a fixed duration that defines a true care discontinuity, and practices vary significantly between regions and systems.
In this context, the Odyssée 3 project was launched in Nice, France, as a prospective epidemiological study focusing specifically on the real-life transition from child and adolescent psychiatry to adult psychiatry. The study targets a cohort of 17-year-olds who are currently receiving mental health care and will soon face the shift to adult services.
The project is part of the CNR Santé Mentale territorial initiative, supported by the Regional Health Agency (ARS 06). It is co-led by the University Department of Child and Adolescent Psychiatry (SUPEA) at Lenval Pediatric University Hospital and the Department of Psychiatry at the Nice University Hospital (CHU de Nice).
Odyssey 3 has three primary goals:
Ultimately, this study aims to strengthen the healthcare system's ability to detect early warning signs, intervene proactively in emerging psychiatric conditions, and ensure that adolescents already engaged in care do not experience service discontinuities. Its findings will serve as a foundation for building a specialized, coordinated, and sustainable transitional psychiatry structure in Nice, aligned with best practices and international recommendations.
Group of 17-year-old patients living in Nice and receiving psychiatric care
Participants must meet all of the following criteria:
Exclusion criteria
Participants meeting any of the following criteria will be excluded:
Group of 17-year-old patients living in Nice and receiving psychiatric care
Behavioral: Group of 17-year-old patients living in Nice and receiving psychiatric care
Prospective study aiming to determine the annual prevalence of 17-year-old patients living in Nice who attend hospital-based child and adolescent psychiatry services. Secondary objectives include: estimating prevalence among under-18 psychiatric patients; describing clinical and sociodemographic profiles (sample of 100 patients); mapping 1-year care trajectories; evaluating clinical outcomes; assessing transition preparedness (to adult psychiatry); and identifying factors associated with psychiatric care continuity at 12 months.
Annual prevalence of 17-year-old patients living in Nice who consulted hospital-based child and adolescent psychiatry services, calculated against the total number of 17-year-olds in the general population of Nice.
Annual prevalence is defined as the number of 17-year-old patients living in the city of Nice who consult hospital-based child and adolescent psychiatry services within a one-year period, divided by the total number of 17-year-olds in the general population of Nice. The calculation was performed using data from INSEE (French National Institute of Statistics and Economic Studies).
Time frame: one year
Annual Prevalence of 17-Year-Old Adolescents Consulting Child and Adolescent Psychiatric Services in Nice
The annual prevalence is defined as the proportion of 17-year-old adolescents living in the municipality of Nice who consulted the child and adolescent psychiatric hospital services at HPU Lenval during a given year, among all minors (\<18 years) living in Nice who had at least one psychiatric consultation at HPU Lenval during the same year.
Time frame: One year following the first psychiatric consultation during the study period.
Baseline Description of Patient Profiles in a Child and Adolescent Psychiatric Population
This outcome corresponds to a detailed baseline characterization of the study population based on a sample of 100 patients specifically included in the study. Predefined socio-demographic and medical characteristics were collected and analyzed.
Time frame: Baseline
One-Year Psychiatric Care Trajectories in Adolescents
The one-year care trajectory of patients will be assessed according to changes in their psychiatric management during follow-up. At 12 months (M12), patients will be classified into the following categories: continuation of care in child and adolescent psychiatry, transition to adult psychiatry services, discontinuity or interruption/resumption of care, planned termination of care agreed upon by the patient and medical team, or lost to follow-up.
Time frame: 12 months after study inclusion
Clinical Evolution
Clinical evolution will be assessed using the MINI-S questionnaire administered at baseline (M0), 6 months (M6), and 12 months (M12). Descriptive analyses of questionnaire responses will be performed at each study time point. Only items related to the participant's current clinical state will be considered.
Time frame: Baseline (M0), 6 months (M6), and 12 months (M12).
Transition Readiness and Appropriateness Measure (TRAM)
Transition readiness and appropriateness will be assessed using the Transition Readiness and Appropriateness Measure (TRAM), a validated multidimensional questionnaire developed within the MILESTONE project. The Young Person version will be administered. The TRAM evaluates whether a young person is appropriately prepared for transition from child and adolescent mental health services by assessing symptom burden, overall illness severity, functional disruption, risk factors, factors affecting symptoms, barriers to functioning, and transition readiness. Multiple subscale scores will be calculated according to the TRAM scoring manual, with exploratory analyses focusing on the most clinically relevant outcomes.
Time frame: Baseline (M0) and 6 months (M6).
Continuity of Psychiatric Care at 12 Months
Continuity of psychiatric care will be assessed at 12 months (M12). Continuity will be considered achieved if the participant has a defined psychiatric care plan at 12 months or has achieved clinical recovery and no longer requires psychiatric follow-up. The outcome will be recorded as a binary variable (Yes/No) based on the investigator's assessment.
Time frame: 12 months (M12).
WHOQOL-BREF Quality of Life Score
Quality of life will be assessed using the WHOQOL-BREF questionnaire administered at baseline (M0), 6 months (M6), and 12 months (M12). Changes in questionnaire scores over time will be described
Time frame: Baseline (M0), 6 months (M6), and 12 months (M12).
Psychosocial Functioning (Health of the Nation Outcome Scales for Children and Adolescents [HoNOSCA] Total Score
Psychosocial functioning will be assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) questionnaire, administered at baseline (M0), 6 months (M6), and 12 months (M12). The HoNOSCA consists of 15 items, of which 13 clinical items contribute to the total score, each rated from 0 (no problem) to 4 (severe or very severe problem). The total score ranges from 0 to 52, with higher scores indicating greater psychosocial difficulties and poorer psychosocial functioning. Changes in the total HoNOSCA score over time will be described.
Time frame: Baseline (M0), 6 months (M6), and 12 months (M12).
Outcome of Transition to Adult Psychiatric Care (Transition Related Outcome Measure [TROM] Total Score)
Transition outcomes will be assessed using the Transition Related Outcome Measure (TROM), a validated multidimensional questionnaire developed within the MILESTONE project. The Young Person version will be administered at the 12-month follow-up. The TROM evaluates the quality and outcomes of the transition process by assessing changes in symptoms, overall illness severity, functional disruption, risk factors, activities facilitating transition, quality of care and other transition-related outcomes. Multiple subscale scores will be calculated according to the TROM scoring manual, with exploratory analyses focusing on the most clinically relevant outcomes.
Time frame: 12 months (M12).
Plan to share: Yes — Deidentified individual participant data collected during the study will be made available upon reasonable request following publication of the primary results, subject to applicable ethical and legal regulations.
Supporting information: Study protocol, Icf
No publications or documents are linked to this record.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Fondation Lenval