Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?
Table 2
Factors associated with a continuity recommendation for young people classified with unipolar depressive disorder (descriptives and model summary).
Characteristics (original non-imputed data)
OR (95% CI) (model summary on imputed data)
Discontinuity recommendation ()
Continuity recommendation ()
Model with general factors
Model expanded with risk factors for persistent depression
General factors associated with a recommendation to continue treatment
Clinician-rated severity of psychopathology (M (SD))
2.17 (1.00)
4.18 (1.10)
1.45 (1.03–2.03)
1.47 (1.03–2.10)
Psychotic experiences (% ())
0 or 1 experience(s)
46.3 (19)
53.8 (64)
Ref
Ref
2-16 experiences
31.7 (13)
29.4 (35)
0.51 (0.22–1.19)
0.57 (0.23–1.43)
Missing
22.0 (9)
16.8 (20)
Everyday functional skills (M (SD))
4.43 (0.43)
4.31 (0.46)
0.61 (0.24–1.53)
0.75 (0.27–2.12)
Self-reported need for continued treatment (% ())
No
46.3 (19)
22.7 (27)
Ref
Ref
Yes
51.2 (21)
70.6 (84)
1.68 (0.65–4.30)
1.61 (0.60–4.31)
Missing
2.4 (1)
6.7 (8)
Parent-reported need for continued treatment (% (n))
No
26.8 (11)
5.9 (7)
Ref
Ref
Yes
46.3 (19)
63.9 (76)
2.59 (0.83–8.11)
2.44 (0.74–7.98)
Missing
26.8 (11)
30.3 (36)
Risk factors for persistent depression
Suicidal thoughts and behaviours (% (n))
None
61.0 (25)
47.1 (56)
Ref
Suicidal thoughts and behaviours
36.6 (15)
46.2 (55)
0.71 (0.31–1.63)
Missing
2.4 (1)
6.7 (8)
Lifetime suicide attempt (% (n))
No
41.5 (17)
48.7 (58)
Ref
Yes
56.1 (23)
43.7 (52)
0.8 (0.35–1.80)
Missing
2.4 (1)
7.6 (9)
Peer relationship problems (M (SD))
0.70 (0.91)
1.62 (1.15)
1.25 (0.85–1.82)
Family dysfunction (M (SD))
0.90 (1.02)
1.58 (1.11)
1.00 (0.69–1.44)
Parental psychopathology (% (n))
No psychopathology
34.1 (14)
38.7 (46)
Ref
Psychopathology in one or both biological parents
36.6 (15)
28.6 (34)
1.33 (0.58–3.04)
Missing
29.3 (12)
32.8 (39)
Victim of bullying (% (n))
No
31.7 (13)
26.9 (32)
Ref
Yes
61.0 (25)
63.0 (75)
1.57 (0.68–3.64)
Missing
7.3 (3)
10.1 (12)
Somatic comorbidity1 (% (n))
14.6 (6)
13.4 (16)
1.57 (0.54–4.56)
Psychiatric comorbidity2 (% (n))
22.0 (9)
34.5 (41)
1.11 (0.48–2.56)
Optimism Slope
0.28
0.41
Corrected C-Statistic
0.75
0.74
Note. Penalized logistic regression models were fitted, displaying odds of “continuity recommendation” versus “discontinuity recommendation” as the reference group. Gender, parental education level, and country were added as covariates. changes per imputed dataset. YP = young person; PC = parent/carer. 1Presence of serious somatic problems such as heart diseases and diabetes; 2Presence of classifications of anxiety, personality, and/or substance-use disorders.
