Abstract

A UNIQUE TRANSITION FROM CHILD MENTAL HEALTH SERVICES (CMHS) TO ADULT SERVICES: AN AUDIT OF THE CLINICAL PROFILE OF PATIENTS PROGRESSING FROM CMHS TO THE FIRST SPECIALISED, MULTIDISCIPLINARY ADULT NEURODEVELOPMENTAL SERVICE IN SINGAPORE

Author(s): Chai Suet Bin, Tang Chao Tian, Wei Ker-Chiah, Ding Liqin

Objective: The transition from child mental health services to adult mental health services can be challenging for patients. Transition is a critical aspect of continuity of care but little is known of the profile of the patients who makes such transitions and their unique characteristics, which could place special demands on subsequent mental health services. The Adult Neurodevelopmental Service at the Institute of Mental Health, Singapore is the first integrated service for adults with neurodevelopmental disorders and psychiatric co-morbidities in Southeast Asia. This audit aims to analyse the profile and characteristics of patients who have made this transition to ensure that the service addresses their specific needs. Methods: The electronic records of 50 patients who were seen in 2015 were analysed in relation to socio-demographics, diagnosis and psychiatric co morbidities, pharmacotherapy, functioning and illness severity scores. Results: All patients except 3(6%) were seen as outpatients. 41(82%) of whom were male and 9(18%) female with the mean age of 21.1 years (SD±2.68). 32(64%) had autistic spectrum disorder, 28(56%) had intellectual disability and 8(16%) had attention deficit/hyperactivity disorder. Co morbid psychiatric disorders included anxiety disorders (16%), mood disorders (14%), psychotic disorders(8%), and obsessive-compulsive disorders(8%). Risperidone and fluoxetine were the most commonly used antipsychotics and antidepressants respectively. The mean initial clinical global impression score was 4.05(SD±0.87) ± 0.87), and the mean global assessment scale was 53.78(SD±9.42) in patients who were scored. Conclusion: Patients in transition from a child to adult mental health services are a complex and vulnerable group which requires services adapted to their unique needs. Analysing the profile of these patients is critical in evolving the service to meet the needs of this group of young patients to achieve an ideal level of care.

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