Clinical trial NCT06582173: Mapping the Healthcare Pathway to Multidisciplinary Assessment of 12-25 Year Olds with Somatic Symptom Disorder
Official title: Mapping the Healthcare Pathway to Specialised Multidisciplinary Assessment of 12-25 Year Olds with Somatic Symptom Disorder: a Monocentric Descriptive Study Based on Interviews Assisted by a Biographical Grid
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Somatic Symptoms
Medically Unexplained Symptoms
Somatoform Disorders
Keywords: Somatic symptoms
Somatoform disorder
Medically unexplained symptoms
Healthcare pathway
Healthcare trajectory
Care episodes
Health Care Utilization
Adolescent
Young Adult
Lead sponsor: Assistance Publique - Hôpitaux de Paris
Sponsor class: OTHER
First posted: 2024-09-03
Enrollment: 36
Sex: ALL
Minimum age (years): 12
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Participants are selected among patients assessed in the recruiting centre, whatever their course after assessment.

The recruiting centre is an adolescent clinic which is part of a public teaching hospital in Paris, France. The centre provides inpatient and outpatient care delivered by a multidisciplinary team. Patients aged 11 to 18 can be referred to this centre by a healthcare professional or can directly access to care, regardless of their living area.

For each patient included, parents are asked to participate to research interviews to help map the healthcare pathway their child followed.

Brief summary: This study aims to describe the course of successive care events that follow individuals with somatic symptom disorder until they are assessed by a specialized multidisciplinary team. Data is collected during interviews with subjects aged 12 to 25 years old accompanied by their parents. A biographical grid is used to retrospectively identify all care events that occurred from first symptoms until multidisciplinary assessment. Life events and symptoms are collected as well to explore how history of healthcare consumption is linked to other trajectories. A qualitative analysis of the recorded interviews aims to describe the subjective experience of this healthcare pathway.

Detailed description: Somatic symptom disorders (SSD), previously labelled Somatoform disorders, are known to challenge healthcare professionals and systems, as those common conditions reducing quality of life often lead to excessive referrals and investigations before adequate diagnosis and management. Although studies have proved multiple interventions to be effective and cost-effective in various clinical settings, little is known about the accurate healthcare utilization associated with SSD. Such analysis faces the complexity of SSD detection and labelling due to heterogeneous clinical presentations and disputed cross-disciplinary classifications. Even though healthcare is known to be a core theme of patient experience of SSD, the investigators lack data describing the trajectory of care and the expectations, perceived help and triggering events associated with healthcare services use. A better understanding of the healthcare pathway those patients follow will help implement evidence-based treatment effectively.

The aim of this study is to trace back the pathway of care that individuals follow before they eventually undergo a specialised multidisciplinary assessment.

This descriptive study relies on data retrospectively collected from patients and their parents during face-to-face interviews assisted by a biographical grid. Inclusion criteria for patients are to be aged 12 to 25 years old and to be diagnosed with SSD by a specialised multidisciplinary team. Variables measured to describe the healthcare pathway are chosen according to professional experience and literature review. They are collected alongside concomitant life events both to reduce memory bias and to explore determinants and effects of healthcare consumption as a secondary outcome. The subjective experience of this healthcare pathway described by patients and their parents is analysed qualitatively in the verbatim of the audio recorded interview.

Eligibility criteria: Inclusion Criteria:

Criteria relating to the population studied:

* Age between 12 and 25 years old
* Diagnosis of somatic symptom disorder and derivatives (DSM 5) after specialized multidisciplinary evaluation by the team of the Maison des Adolescents of Cochin hospital (Maison de Solenn).

Criteria relating to the additional population participating in the research:

- Being a parent of a subject who has received the diagnosis of somatic symptom disorder and derivatives (DSM 5) after specialized multidisciplinary evaluation at the Maison des Adolescents of Cochin Hospital (Maison de Solenn).

Exclusion Criteria:

Criteria relating to the population studied:

* Age less than 12 years or greater than 25 years at the time of assessment,
* Subject presenting ongoing psychiatric decompensation, that is to say a state of mental health breaking with their baseline state and requiring rapid care which does not allow a research interview to be carried out.

Criteria relating to the additional population participating in the research:

None

Primary outcomes:
measure: Occurrence of healthcare events
timeFrame: Day of inclusion
Secondary outcomes:
measure: Raise of healthcare events occurrence
timeFrame: Day of inclusion
measure: Raise of life events occurrence
timeFrame: Day of inclusion
measure: Decrease of healthcare events occurrence
timeFrame: Day of inclusion
measure: Decrease of life events occurrence
timeFrame: Day of inclusion
measure: Modification of somatic symptoms occurrence
timeFrame: Day of inclusion
measure: Modification of life events occurrence
timeFrame: Day of inclusion
measure: Qualitative analysis of the transcribed interviews
timeFrame: Up to 24 months
Other outcomes:
Locations:
city: Paris
country: France
facility: Maison de Solenn Maison des Adolescents, Cochin Hospital
state: IDF
Study officials:
affiliation: Maison des Adolescents - Cochin Hospital - AP-HP
name: Maude LUDOT-GREGOIRE, MD, PhD
role: PRINCIPAL_INVESTIGATOR
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