RESUMO
OBJECTIVE: To determine mental health service utilization before and after consultation of a psychiatric liaison service ("Support 25") among youths aged 16-24 years suffering from mental disorders and receiving unemployment benefits. METHODS: Longitudinal registration of mental health service use over a 9-month period (N=148); measurement of possible moderators with questionnaires and rating scales. RESULTS: Mental health service utilization increased from initially 22% to 40% and 47.5% 3 and 6 months after receiving individual treatment recommendation. Low-threshold psychosocial counseling was frequented more often than specific psychiatric or psychotherapeutic treatment. Subjects who contacted mental health services showed a trend towards a lower level of psychosocial functioning than subjects who did not seek treatment. Stigma-related factors did not hinder mental health service use. CONCLUSIONS: Despite a high degree of psychiatric morbidity, the surveyed sample of unemployed youths had problems to successfully enter mental health services. Although a substantial increase in service use was observed after receiving psychoeducational information at a psychiatric liaison service, the use of low-threshold counseling predominated. This finding suggests that the mental health system should adapt better to the specific needs of young unemployed, for example, by expanding low-threshold psychiatric pre-treatment offers at vocational centers.
Assuntos
Aconselhamento , Transtornos Mentais , Serviços de Saúde Mental , Desemprego , Adolescente , Adulto , Alemanha , Humanos , Encaminhamento e Consulta , Adulto JovemRESUMO
Ubiquitin-dependent sorting of membrane proteins in endosomes directs them to lysosomal degradation. In the case of receptors such as the epidermal growth factor receptor (EGFR), lysosomal degradation is important for the regulation of downstream signalling. Ubiquitinated proteins are recognised in endosomes by the endosomal sorting complexes required for transport (ESCRT) complexes, which sequentially interact with the ubiquitinated cargo. Although the role of each ESCRT complex in sorting is well established, it is not clear how the cargo is passed on from one ESCRT to the next. We here show that flotillin-1 is required for EGFR degradation, and that it interacts with the subunits of ESCRT-0 and -I complexes (hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) and Tsg101). Flotillin-1 is required for cargo recognition and sorting by ESCRT-0/Hrs and for its interaction with Tsg101. In addition, flotillin-1 is also required for the sorting of human immunodeficiency virus 1 Gag polyprotein, which mimics ESCRT-0 complex during viral assembly. We propose that flotillin-1 functions in cargo transfer between ESCRT-0 and -I complexes.