BackgroundSubstance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.Methods/designIn a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome – persistence of or desistance from SUD.DiscussionThere are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood.Trial registrationThe Netherlands National Trial Register Trial NL7928. Date of registration January 17, 2019.
Objective: To report the study protocol and baseline characteristics of a prospective cohort study to evaluate longitudinal recovery trajectories of patients recovering from COVID-19 who have visited a primary care allied health professional. Design: Report of the protocol and baseline characteristics for a prospective cohort study with a mixedmethods approach. Patients: Patients recovering from COVID-19 treated by primary care dietitians, exercise therapists, occupational therapists, physical therapists and/or speech and language therapists in the Netherlands. Methods: The prospective study will measure primary outcome domains: participation, health-related quality of life, fatigue, physical functioning, and costs, at baseline, 3, 6, 9 and 12 months. Interviews, on the patients' experiences with allied healthcare, will be held with a subsample of patients and allied health professionals. Results: The cohort comprises 1,451 patients (57% female, mean age 49 (standard deviation 13) years). Preliminary results for the study cohort show that 974 (67%) of the participants reported mild/moderate severity symptoms during the infection period and patients reported severe restrictions in activities of daily living compared with previous research in other patient populations. Both quantitative and qualitative, will provide insight into the recovery of patients who are treated by allied health professionals. Conclusion: In conclusion, this will be the first comprehensive study to longitudinally evaluate the recovery trajectories and related costs of patients recovering from COVID-19 who are treated by allied health professionals in the Netherlands. This study will provide evidence for the optimal strategy to treat patients recovering from COVID-19 infection, including which patients benefit, and to what extent, from treatment, and which factors might impact their recovery course over time. The preliminary results of this study demonstrated the severity of restrictions and complaints at the start of therapy are substantial.
Objectives The aim of this study was to examine the reciprocal association between work–family conflict and depressive complaints over time. Methods Cross-lagged structural equation modeling (SEM) was used and three-wave follow-up data from the Maastricht Cohort Study with six years of follow-up [2416 men and 585 women at T1 (2008)]. Work–family conflict was operationalized by distinguishing both work–home interference and home–work interference, as assessed with two subscales of the Survey Work–Home Interference Nijmegen. Depressive complaints were assessed with a subscale of the Hospital Anxiety and Depression scale. Results The results showed a positive cross-lagged relation between home–work interference and depressive complaints. The results of the χ 2 difference test indicated that the model with cross-lagged reciprocal relationships resulted in a significantly better fit to the data compared to the causal (Δχ 2 (2)=9.89, P=0.001), reversed causation model (Δχ 2 (2)=9.25, P=0.01), and the starting model (Δχ 2 (4)=16.34, P=0.002). For work–home interference and depressive complaints, the starting model with no cross-lagged associations over time had the best fit to the empirical data. Conclusions The findings suggest a reciprocal association between home–work interference and depressive complaints since the concepts appear to affect each other mutually across time. This highlights the importance of targeting modifiable risk factors in the etiology of both home–work interference and depressive complaints when designing preventive measures since the two concepts may potentiate each other over time.
