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Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study.

Authors
  • Eke, Helen1
  • Ford, Tamsin2
  • Newlove-Delgado, Tamsin3
  • Price, Anna4
  • Young, Susan5
  • Ani, Cornelius6
  • Sayal, Kapil7
  • Lynn, Richard M8
  • Paul, Moli9
  • Janssens, Astrid10
  • 1 Postgraduate Research Fellow, University of Exeter Medical School, St. Luke's Campus, UK.
  • 2 Professor of Child and Adolescent Psychiatry, University of Exeter Medical School, St. Luke's Campus, UK.
  • 3 National Institute for Health Research Academic Clinical Lecturer, University of Exeter Medical School, St. Luke's Campus, UK.
  • 4 Associate Research Fellow, University of Exeter Medical School, St. Luke's Campus, UK.
  • 5 Director, Psychology Services Limited, UK.
  • 6 Consultant Child and Adolescent Psychiatrist, Centre for Psychiatry, Imperial College London, UK.
  • 7 Professor of Child and Adolescent Psychiatry, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham; and Professor of Child and Adolescent Psychiatry, CANDAL (Centre for ADHD and Neuro-Developmental Disorders across the Lifespan), Institute of Mental Health, UK.
  • 8 British Paediatric Surveillance Unit, Royal College of Paediatrics and Child Health, UK.
  • 9 Consultant Child and Adolescent Psychiatrist, Coventry and Warwickshire Partnership Trust, UK.
  • 10 Associate Professor, Department of Public Health, University of Southern Denmark, Denmark; and Honorary Associate Professor, University of Exeter Medical School, St. Luke's Campus, UK. , (Denmark)
Type
Published Article
Journal
The British journal of psychiatry : the journal of mental science
Publication Date
Nov 01, 2020
Volume
217
Issue
5
Pages
616–622
Identifiers
DOI: 10.1192/bjp.2019.131
PMID: 31159893
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions. To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition. Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires. Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17-19, incident rate (range adjusted for non-response) of transition need was 202-511 per 100 000 people aged 17-19 per year, with successful transition of 38-96 per 100 000 people aged 17-19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria. As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.

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