Cohort profile: the Brain and Mind CentreOptymisecohort: tracking multidimensional outcomes in young people presenting for mental healthcare

Abstract

PurposeThe Brain and Mind Centre (BMC)Optymisecohort assesses multiple clinical and functional domains longitudinally in young people presenting for mental health care and treatment. Longitudinal tracking of this cohort will allow investigation of the relationships between multiple outcome domains across the course of care. Subsets ofOptymisehave completed detailed neuropsychological and neurobiological assessments, permitting investigation of associations between these measures and longitudinal course.ParticipantsYoung people (aged 12–30) presenting to clinics coordinated by the BMC were recruited to a research register (n=6743) progressively between June 2008 and July 2018. To date, 2767 individuals have been included inOptymisebased on the availability of at least one detailed clinical assessment.MeasuresTrained researchers use a clinical research proforma to extract key data from clinical files to detail social and occupational functioning, clinical presentation, self-harm and suicidal thoughts and behaviours, alcohol and other substance use, physical health comorbidities, personal and family history of mental illness, and treatment utilisation at the following time points: baseline, 3, 6, 12, 24, 36, 48, and 60 months, and time last seen.Findings to dateThere is moderate to substantial agreement between raters for data collected via the proforma. While wide variations in individual illness course are clear, social and occupational outcomes suggest that the majority of cohort members show no improvement in functioning over time. Differential rates of longitudinal transition are reported between early and late stages of illness, with a number of baseline factors associated with these transitions. Furthermore, there are longitudinal associations between prior suicide attempts and inferior clinical and functional outcomes.Future plansFuture reports will detail the longitudinal course of each outcome domain and examine multidirectional relationships between these domains both cross-sectionally and longitudinally, and explore in subsets the associations between detailed neurobiological measures and clinical, social and functional outcomes.

Prevalence of self‐reported subthreshold phenotypes of major mental disorders and their association with functional impairment, treatment and full‐threshold syndromes in a community‐residing cohort of young adults

“…These self‐rated STS all closely resemble criteria used for identifying individuals who meet “at risk” criteria for mood or psychotic syndromes (eg, Bechdolf et al, 2014; Lewinsohn, Shankman, Gau, & Klein, 2004; Yung et al, 2009). The test‐retest reliability of STS ratings is good (inter‐class correlations = 0.8) (Scott et al, 2017), and when ratings of the same items are completed by a researcher the inter‐rater reliability (weighted kappas) is about 0.75 for each STS (Carpenter, Iorfino, Cross, & Hickie, 2019).…”

Clinical Stage Transitions in Persons Aged 12 to 25 Years Presenting to Early Intervention Mental Health Services With Anxiety, Mood, and Psychotic Disorders

“…More detailed descriptions about the proforma, including the interrater reliability are reported in the supplement and cohort article. 48 The measures used here include (eAppendix in the Supplement); demographic features, social and occupational functioning (including the Social and Occupational Functioning Assessment Scale [SOFAS], 49 a clinician-rated measure that assesses functioning on a 0 to 100 scale, with lower scores suggesting functional impairment. The instructions emphasize that the rater should avoid confounding the rating with clinical symptoms, [47][48][49] and Not in Education, Employment or Training [NEET] status as a measure of participation and engagement with education or work), psychiatric disorder diagnoses, clinical stage, at-risk mental states, self-harm, suicidal thoughts and behaviors, physical health comorbidities, personal mental illness history, and treatment use.…”

Predicting self-harm within six months after initial presentation to youth mental health services: A machine learning study

“…Participants are drawn from a cohort of 6743 individuals aged 12-30 who presented to the Brain and Mind Centre's youth mental health clinics in Sydney and recruited to a research register between June 2008 and July 2018 [31]. These clinics include primary care services (i.e.…”

“…Data were extracted from clinical files, and code inputs according to proforma (i.e. standardised form) [31,34]. The proforma records information at predetermined time points.…”

“…The proforma was used to record specific illness course characteristics. More detailed descriptions about the proforma, including the interrater reliability, are reported in the supplement and cohort paper [31]. The measures used here include (see S1 Data); demographics, social and occupational functioning (including, the Social and Occupational Functioning Assessment Scale (SOFAS; [35]), and Not in Education, Employment or Training (NEET) as a measure of participation and engagement with education or work), mental disorder diagnoses, clinical stage, at-risk mental states, self-harm, suicidal thoughts and behaviours, physical health comorbidities, personal mental illness history, and treatment utilisation.…”