Journal article
Personalising care options in youth mental health: using multidimensional assessment, clinical stage, pathophysiological mechanisms, and individual illness trajectories to guide treatment selection
Medical Journal of Australia, Vol.211(Supplement 9), pp.S32-S41
2019
Appears in Thompson Institute Research Collection
Abstract
New models of mental health care for young people require that interventions be matched to illness type, clinical stage, underlying pathophysiological mechanisms and individual illness trajectories. Narrow syndrome-focused classifications often direct clinical attention away from other key factors such as functional impairment, self-harm and suicidality, alcohol or other substance misuse, and poor physical health. By contrast, we outline a treatment selection guide for early intervention for adolescent-onset mood and psychotic syndromes (ie, active treatments and indicated and more specific secondary prevention strategies). This guide is based on experiences with the Brain and Mind Centre's highly personalised and measurement-based care model to manage youth mental health. The model incorporates three complementary core concepts: A multidimensional assessment and outcomes framework including: social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness trajectory. Clinical stage. Three common illness subtypes (psychosis, anxious depression, bipolar spectrum) based on three underlying pathophysiological mechanisms (neurodevelopmental, hyperarousal, circadian). These core concepts are not mutually exclusive and together may facilitate improved outcomes through a clinical stage-appropriate and transdiagnostic framework that helps guide decisions regarding the provision of appropriate and effective care options. Given its emphasis on adolescent-onset mood and psychotic syndromes, the Brain and Mind Centre's model of care also respects a fundamental developmental perspective -categorising childhood problems (eg, anxiety and neurodevelopmental difficulties) as risk factors and respecting the fact that young people are in a period of major biological and social transition. Based on these factors, a range of social, psychological and pharmacological interventions are recommended, with an emphasis on balancing the personal benefit-to-cost ratio.
Details
- Title
- Personalising care options in youth mental health: using multidimensional assessment, clinical stage, pathophysiological mechanisms, and individual illness trajectories to guide treatment selection
- Authors
- Cathrin Rohleder (Corresponding Author) - University of SydneyJacob J Crouse (Author) - University of SydneyJoanne S Carpenter (Author) - University of SydneyFrank Iorfino (Author) - University of SydneyShane P Cross (Author) - University of SydneyTracey A Davenport (Author) - University of SydneyDaniel F Hermens (Author) - University of the Sunshine Coast - Thompson InstituteAdam J Guastella (Author) - University of SydneyF Markus Leweke (Author) - University of SydneyDagar Koethe (Author) - University of SydneySharon L Naismith (Author) - University of SydneyElizabeth M Scott (Author) - University of SydneyIan B Hickie (Author) - University of Sydney
- Publication details
- Medical Journal of Australia, Vol.211(Supplement 9), pp.S32-S41
- Publisher
- Wiley-Blackwell Publishing Asia
- Date published
- 2019
- DOI
- 10.5694/mja2.50383
- ISSN
- 0025-729X
- Organisation Unit
- Thompson Institute; University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99450835902621
- Output Type
- Journal article
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- Domestic collaboration
- International collaboration
- Web Of Science research areas
- Psychiatry
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Source: InCites