Researchers investigated the predictive factors for patient transfer from primary to specialized mental health services, and the results of the longitudinal study were published in the Journal of Affective Disorders.

Researchers extracted demographic and clinical data from The Netherlands Study of Depression and Anxiety on 701 adult patients with a clinical diagnosis of an anxiety and/or depressive disorder. Baseline patient information was obtained per self-report questionnaires and the Composite International Diagnostic Interview. Transition to specialized mental healthcare was captured using self-report resource use questionnaires at 1-, 2-, 4-, and 6-year follow-up.  

During the 6-year study follow-up period, 28.3% of patients transitioned from no care or primary mental healthcare to specialized mental health services. Demographic characteristics predictive of transfer to specialized services included younger age (P =.03) and higher education level (P =.003). Multivariate analyses also identified suicidal ideation (P <.001), openness to experiences (P =.046), prior use of psychotropic medications (P =.033), prior mental health treatment through primary care (P =.006), and perceived unmet need for help (P =.004) as factors correlated with transfer to specialized treatment. Of note, symptom severity and co-morbidity of disorders were not predictive of transfer to specialized care.

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The study data indicate that demographic and clinical factors were predictive of transfer to specialized treatment and indicate the diversity of patients in need of treatment, which may influence clinicians in their assessment of specific patient needs.


Kooistra LC, Wiersma JE, Ruwaard JJ, Riper H, Penninx BWJH, van Oppen P. Six-year healthcare trajectories of adults with anxiety and depressive disorders: determinants of transition to specialised mental healthcare [published online July 23, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.07.072