FC27-03 - A follow-up study of former child and adolescent psychiatric patients’ psychiatric care in adulthood

Abstract

Introduction

In Sweden there are three psychiatric disciplines, general psychiatry (GenP), forensic psychiatry and child and adolescent psychiatry (CAP). There are many similarities between GenP and CAP, but despite this, there is a virtual lack of information regarding possible early symptoms of mental disorders, and how they change during the process of maturing from childhood to adulthood.

Aims and objectives

An overall aim was to provide information about CAP-patients and their outcome as adults. This study describes and discusses the transition between CAP and GenP and illustrates the question if and which CAP-patients will proceed as patients within GenP.

Methods

1,400 patients, originally treated as in- and outpatients by CAP services were subsequently followed-up into mid-adulthood using official registries and hospital records.

Results

At least a third of all CAP patients were later admitted to GenP. However, this group constituted only eleven percent of the corresponding age groups of GenP-patients. There seems to be a weak connection between diagnoses given to patients in CAP and later in GenP care.

Conclusions

At least three different pathways for becoming in need of GenP care as adults were identified. First, a “developmental trajectory” with early symptoms of parental neglect, later need of unspecific paediatric hospital treatment, school failure, behavioral problems and referral to CAP. Another way relates to the relatively uncommon development of psychotic disorders. However, the most common way relates to “adult problems” in the categories neurotic and stress-related disorders where the problems seem to have developed from accumulated stressful life-events.