Evidence map›Paper›PMID 41107439›Full record

Trial reportMolecular psychiatry2026

Mental health trajectories of adolescents treated with psychotropic medications: insights from the european milestone study.

Marta Magno, Donato Martella, Silvia Leone, Giovanni Allibrio, Angelo Bertani, Elisa Caselani, Patrizia Conti, Samuele Cortese, Gwen Dieleman, Tomislav Franic and 23 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Molecular psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03013595 (The Effectiveness of Managed Transition in Improving the Health and Social Outcomes for Young People Transitioning From Child to Adult Mental Health Care), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03013595 naunknown statusnot on this map

The Effectiveness of Managed Transition in Improving the Health and Social Outcomes for Young People Transitioning From Child to Adult Mental Health Care: the MILESTONE Study

TypeinterventionalSponsorUniversity of WarwickRan2015 to 2018Enrolled1,000ConditionsMental Health Impairment, Mental Health DisorderArmsTRAM feedback
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Marta Magno *Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Donato Martella *Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Silvia LeoneUnit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Giovanni AllibrioChild and Adolescent Neuropsychiatry, ASST Bergamo Ovest, Treviglio, Italy.
Angelo BertaniUnit of Youth Psychopathology, ASST Santi Paolo e Carlo, Milan, Italy.
Elisa CaselaniUnit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Patrizia ContiChild and Adolescent Neuropsychiatry, ASST Lariana, Como, Italy.
Samuele CorteseCentre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.ORCID 0000-0001-5877-8075
Gwen DielemanDepartment of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
Tomislav FranicUniversity Hospital of Split, Department of Psychiatry, Medical School University of Split, Split, Croatia.
Suzanne GerritsenDepartment of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
Deborah MaffezzoniUnit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Francesco MargariDept of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy.
Ottaviano MartinelliChild and Adolescent Neuropsychiatry, ASST Lecco, Lecco, Italy.
Fiona McNicholasLucena Clinic, Child and Adolescent Mental Health Services, Saint John of God, Dublin, Ireland.
Rocco MiccioloCentre for Medical Sciences, Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy.
Renata NacinovichSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Diane Purper OuakilUniversity Hospital of Montpellier, MPEA1, Montpellier, France.
Adriana PastorePoliclinico Hospital, Unit of Adolescent Psychiatric Emergency, Bari, Italy.ORCID 0000-0003-4254-4420
Francesco RinaldiChild and Adolescent Neuropsychiatry, ASST Valcamonica, Breno, Italy.
Paramala SantoshInstitute of Psychiatry, Psychology and Neurosciences, King's College London, and the Maudsley Hospital, London, UK.ORCID 0000-0003-4830-5893
Paolo ScoccoSOPROXI Onlus, Padova, Italy.
Ulrike SchulzeUniversity of Ulm, Department of Child and Adolescent Psychiatry/ Psychotherapy, Ulm, Germany.
Swaran SinghWarwick Medical School, University of Warwick, Warwick, United Kingdom. S.P.Singh@warwick.ac.uk.
Antonella SquarciaChild and Adolescent Neuropsychiatry, Department of Mental Health, AUSL di Parma, Parma, Italy.
Paolo StagiChild and Adolescent Neuropsychiatry, Azienda USL Toscana Centro, Firenze, Italy.
Cathy StreetWarwick Medical School, University of Warwick, Warwick, United Kingdom.
Elena ToffolUnit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Helena TuomainenWarwick Medical School, University of Warwick, Warwick, United Kingdom.
Larissa S van BodegomDepartment of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
Stefano VicariAdolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, Rome, 00165, Italy.
Giovanni de GirolamoUnit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.ORCID 0000-0002-1611-8324
on behalf the MILESTONE Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The transition from Child and Adolescent (CAMHS) to Adult Mental Health Services (AMHS) can be challenging. Drawing on the sample of the European MILESTONE project, we explored changes in clinical profiles and treatment outcomes in adolescents transitioning to AMHS over two years, focusing on different pharmacological treatment patterns. The sample (N = 690; mean age: 17.7 years; SD = 0.29) was categorised into three groups based on medication patterns: continuous (Group 1), intermittent (Group 2), and never medicated (Group 3). Participants underwent four evaluations over two years using tools measuring psychopathology and functioning, including the Health of the Nation Outcome Scale for Child and Adolescents (HoNOSCA) and ASEBA Battery. We employed repeated-measures models to analyse clinical rating changes and a two-way mixed ANOVA to assess interaction between time and groups. Group 3 had significantly lower mean HoNOSCA ratings than Groups 1 and 2 (p < 0.001), indicating better mental health. By the last time point (T4), the factors associated with a reduced risk of severe illness included an improvement in the risk of suicide attempts (p = 0.038), enhanced everyday functional skills (p = 0.008), higher quality of life (p = 0.001), and being male (p = 0.020). The ASEBA Battery showed Group 1 had more internalising symptoms, while Group 2 had more externalising symptoms than Group 3. During the transition from CAMHS to AMHS, continuous medication was associated with higher symptom severity than intermittent or no pharmacological treatment. This may reflect either a more severe initial symptomatology requiring sustained pharmacotherapy or a medication-related paradox, whereby symptoms persist or intensify owing to treatment resistance or side effects.

trial registration"MILESTONE study" registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

Indexed as

Mental DisordersPsychotropic DrugsAdolescentChildEuropeFemaleHumansMaleMental HealthMental Health ServicesPsychiatric Status Rating ScalesQuality of LifeSuicide, AttemptedTreatment OutcomePsychotropic Drugs

Identifiers

PMID41107439
PMCPMC12700807

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.