Developing from child to adult: Risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy

Long-term effects of a multidisciplinary transition intervention from paediatric to adult care in patients with epilepsy

“…All patients who had an appointment for a visit at the transition clinic were between 15 and 25 years of age. As described in our previous study [11], this age limit was chosen because developmental milestones are often delayed in patients with epilepsy [11,17]. In our opinion, transition is a gradual process, and should not be limited by only reaching the adult age.…”

“…Patients with severe mental disabilities (FS IQ < 50) were not accepted at the transition clinic but referred to a special outpatient clinic for patients with epilepsy and mental disabilities at our epilepsy center. All patients were given appointments with the above mentioned health care workers in three consecutive consultations on the same morning (the 'carousel') [11]. The neurologist and clinical neuropsychologist work together in one consultation, after which all patients had appointments with the social worker, and the educationalist/vocational counselor.…”

“…In our previous study [11], we scored patients who visited the transition clinic on three transitional domains, namely their medical performance, educational/vocational performance and the development of their own independence/separation/identity. Scores are further defined in Table 1.…”

“…provide help for medical, psychosocial and developmental issues during adolescence [8,10]. Although the main objective of an epilepsy transition clinic is to revise the previously made epilepsy diagnosis and treatment options, and to transfer the adolescent to an adult health care system, most transition clinics also provide special attention for the above mentioned developmental agespecific issues of patients with epilepsy [4,8,9,11].…”

“…Several different models of epilepsy transition clinic staffing have been reported, including both paediatricians and adult neurologists, or nurse specialist. Sometimes referral to a psychologist, a social worker or a career adviser is made [8,9,[11][12][13][14][15]. Only little evidence is published about the attempts that have been made to evaluate the effectiveness of transition interventions in chronic disease [16].…”