Functional abilities, respiratory and cardiac function in a large cohort of adults with Duchenne muscular dystrophy treated with glucocorticoids.

BACKGROUND AND PURPOSE: The transition to adult services, and subsequent glucocorticoid management, is critical in adults with Duchenne muscular dystrophy. This study aims (1) to describe treatment, functional abilities, respiratory and cardiac status during transition to adulthood and adult stages; and (2) to explore the association between glucocorticoid treatment after loss of ambulation (LOA) and late-stage clinical outcomes. METHODS: This was a retrospective single-centre study on individuals with Duchenne muscular dystrophy (≥16 years old) between 1986 and 2022. Logistic regression, Cox proportional hazards models and survival analyses were conducted utilizing data from clinical records. RESULTS: In all, 112 individuals were included. Mean age was 23.4 ± 5.2 years and mean follow-up was 18.5 ± 5.5 years. At last assessment, 47.2% were on glucocorticoids; the mean dose of prednisone was 0.38 ± 0.13 mg/kg/day and of deflazacort 0.43 ± 0.16 mg/kg/day. At age 16 years, motor function limitations included using a manual wheelchair (89.7%), standing (87.9%), transferring from a wheelchair (86.2%) and turning in bed (53.4%); 77.5% had a peak cough flow <270 L/min, 53.3% a forced vital capacity percentage of predicted <50% and 40.3% a left ventricular ejection fraction <50%. Glucocorticoids after LOA reduced the risk and delayed the time to difficulties balancing in the wheelchair, loss of hand to mouth function, forced vital capacity percentage of predicted <30% and forced vital capacity <1 L and were associated with lower frequency of left ventricular ejection fraction <50%, without differences between prednisone and deflazacort. Glucocorticoid dose did not differ by functional, respiratory or cardiac status. CONCLUSION: Glucocorticoids after LOA preserve late-stage functional abilities, respiratory and cardiac function. It is suggested using functional abilities, respiratory and cardiac status at transition stages for adult services planning.

Description and predictors of self-determination in males and females with fragile X syndrome on the verge of adulthood.

BACKGROUND: Self-determination refers to setting goals and making decisions regarding one's own life with support from others as needed. Research on people with intellectual and developmental disabilities has established the importance of self-determination for quality of life outcomes, such as increased independence and life satisfaction. However, self-determination has not been characterised specifically in fragile X syndrome (FXS), the leading inherited cause of intellectual disability. Relative to youth with other forms of intellectual and developmental disabilities, youth with FXS may face exceptional barriers to the development of self-determined behaviour. In addition to intellectual disability, the FXS behavioural profile is characterised by high rates of autism and anxiety that may further limit opportunities for youth with FXS. The heritable nature of the condition can also yield a distinctive family environment, with siblings and parents also living with fragile X or its associated conditions. Considering these unique challenges, the present study examined self-determination in young adult males and females with FXS and explored whether factors such as language skills, adaptive behaviour and autism traits were associated with self-determination capacity and opportunities. METHODS: The present study included 9 females and 36 males with FXS between the ages of 17 and 25 years. Caregivers (mothers or fathers) completed the American Institute for Research Self-Determination Assessment, which is a questionnaire that yields three scores: self-determination capacity, opportunities for self-determination at home and opportunities for self-determination at school. RESULTS: Caregivers endorsed a wide range of self-determination capacity and opportunities, with ratings for opportunities at home and school exceeding ratings of capacity. Better adaptive behaviour skills were associated with more self-determination capacity, and the presence of more autism traits was associated with fewer opportunities at school. CONCLUSIONS: Results from this study contribute to our understanding of avenues to best support young adults with FXS as they transition to adulthood. Our findings also have implications for practice, such that interventions targeting adaptive behaviours and self-determination may be an effective approach for promoting autonomy and independence for young adults with FXS. Additionally, caregivers and educators should continue to provide opportunities to practise self-determination, regardless of their perception of capacity.

Effects of an Online Health Management Program for South Korean Adolescents with Complex Congenital Heart Disease during Their Transition to Adulthood: A Randomized Controlled Trial.

Adolescents with complex congenital heart disease (CHD) are at risk of experiencing complications later in life. The purpose of this study was to develop an online health management program for adolescents with complex CHD and to evaluate its effects on self-efficacy, health behavior, and health-related quality of life. A randomized controlled trial design was used. A total of 29 adolescents with complex CHD were divided into an experimental group of 15 and a control group of 14. Participants in the intervention group took part in the 4-week online health management program (weekly online group sessions, 1:1 phone coaching, dietary diary feedback, and provision of health information) developed based on self-efficacy theory, while those in the control group received standard medical follow-up. Data were collected from August 2021 to March 2022 using a questionnaire-including the Korean Self-Rated Abilities for Health Practices: Health Self-Efficacy Measure (K-SRAHP) and Pediatric Cardiac Quality of Life Inventory (PCQLI)-and an ActiGraph accelerometer to track physical activity and sleep. The intervention group showed significant improvements in health self-efficacy (p = 0.003), psychosocial impact (p = 0.013), daily step counts (p = 0.011), and moderate to vigorous-intensity physical activity (p = 0.027). Additionally, a decrease in weekend leisure time sedentary behavior (p = 0.035) was observed. However, there were no significant differences in sleep behavior between two groups. The online health management program significantly enhanced self-efficacy, health behavior, and psychosocial impact in adolescents with complex CHD. These findings will inform the development of policies for transitional medical care tailored to adolescents with complex CHD.

How Young Adults with Serious Mental Health Diagnoses Navigate Poverty Post-emancipation: The Complex Roles of Community Mental Health Services & Informal Social Support.

Serious mental health diagnoses are prevalent among youth who "age out" of foster care by reaching the maximum age for child welfare service eligibility. Post-emancipation, little is known about how youth engage in community mental health services, or leverage informal social networks, to navigate independence. Twenty emancipating youth completed three interviews over 16 months. All emancipated into poverty; most lived alone and initially connected to adult community mental health teams. Four service use and informal support profiles emerged from analysis: (1) Navigators (n = 2) actively used mental health services and provided limited informal support; Treaders (n = 9) passively used mental health services and heavily exchanged informal support; Survivors (n = 5) used mental health services when in crisis and heavily provided informal support; and Strugglers (n = 4) avoided mental health services and took resources from informal connections. Findings have implications for both child and adult mental health and social service providers.

The Real Me: Insight into Youths with Physical Disabilities' TranXition to Adulthood through Digital Images.

AIMS: Youths with physical disabilities experience various obstacles in their transition to adulthood which can contribute to poorer health and socioeconomic outcomes in later life, compared to their non-disabled peers. Transitional care offers these youths the necessary support to overcome such obstacles. The objective of this study was to explore participants' experiential learning in the development of life skills within the transitional care program TranXition, and their perceived contribution of the program to their goal attainment. METHODS: Data were collected using photo-elicitation. Five participants were recruited from the TranXition program to audio-visually record (photographs or videos) their meaningful experiences in the program and to reflect on them during interviews. RESULTS: Participants felt the TranXition program helped them build their self-awareness and self-efficacy, and to feel more confident and skilled, whether at home, in school or in the community. Moreover, they appreciated the program's group cohesion which facilitated learning life skills from others in order to achieve their goals. Finally, results suggest that group interventions, while important, may need to be complemented by individual consultations. CONCLUSIONS: Rehabilitation programs in real-world settings, such as the TranXition program, may be a promising adjunct to traditional transitional care for youths with physical disabilities.

Peer perspectives on friendships among peers with and without intellectual and developmental disabilities: A pilot mixed methods study.

BACKGROUND: The benefits of friendships among peers with and without intellectual and developmental disabilities are well supported by research. However, little is known about the nature of these inclusive friendships in inclusive college courses. METHOD: We explored the perspectives of peers on the development of authentic friendships among peers with and without intellectual and developmental disabilities in inclusive college courses in the United States. We used a sequential, explanatory, transformative mixed methods-grounded theory research design. We integrated quantitative (N = 44) and qualitative (N = 8) findings using blended analysis to inform a preliminary grounded theory of inclusive and reciprocal friendships. RESULTS: Quantitative findings suggest two relationships and one predictor of peers' perceived social engagement. Qualitative findings resulted in five themes that promote friendships. CONCLUSIONS: We propose that the context for developing inclusive friendships could be fostered using the preparation and actions stages of the grounded theory model.

Trauma and mental health in young adults who arrived in France as unaccompanied and separated migrant children.

OBJECTIVES: The mental health of unaccompanied and separated minors (UASC) has been widely studied but not their first years of adulthood, often characterised by uncertainty after leaving child protection. The aim of this study was to estimate the prevalence of psychiatric disorders using standardised and validated research instruments and examine the effect of exposure to trauma. METHODS: One hundred and ten youth (92.7% male, median age 19.7 [18.1-22.8]) from Chambery, Montpellier and La Rochelle were recruited to a cross-sectional exploratory study. During a face-to-face interview, somatoform disorder, anxiety, and depression were assessed using the Patient Health Questionnaire (score≥10) and post-traumatic stress disorder (PTSD) with the PTSD Checklist for DSM-5 (score≥33). Traumatic life events were assessed using the Life Events Checklist. RESULTS: Of the youth, 19.3% had a probable somatoform disorder, 17.6% anxiety, 28.7% depression, and 20% PTSD. The number of traumatic life events increased the risk of depression (multi-adjusted OR (95%CI): 1.56 (1.25-1.96)), PTSD (1.60 (1.23-2.08)), somatoform disorder (1.41 (1.10-1.82), and anxiety (1.33 (1.02-1.72)). Physical assault was the type of event positively associated with the most disorders (P≤0.01, except for anxiety), followed by witnessing sudden and violent death (P≤0.01 for depression and PTSD) and sexual assault (P=0.002 for PTSD). CONCLUSION: Our study highlights the high prevalence of psychiatric disorders in young adults who arrived as UASC and the impact on their mental health of cumulative trauma and exposure to interpersonal and violent traumatic life events. A greater focus on their mental health with regular assessments is needed in order to provide rapid and adapted care.

Age 18-30 trajectories of binge drinking frequency and prevalence across the past 30 years for men and women: Delineating when and why historical trends reversed across age.

Historical analyses based on US data indicate that recent cohorts engage in lower binge drinking at age 18 relative to past cohorts, but by the mid- to late-20s the reverse is true: recent cohorts engage in higher binge drinking relative to past cohorts. We pinpoint when - both developmentally and historically - this reversal manifested, examine possible reasons for this reversal, and examine sex convergence in these developmental and historical patterns. As part of the US national Monitoring the Future Study, over 75,000 youths from the high school classes of 1976-2006 were surveyed biennially between ages 18 and 30. We found that the reversal primarily manifested between ages 18 and 24 for men and 18 and 22 for women. We also found that the reversal emerged gradually across the last three decades, suggesting it is the result of a broad and durable historical shift. Our findings indicated that historical variation in social roles and minimum legal drinking age collectively accounted for only a modest amount of the reversal, although marriage was the most influential among the factors examined here. Finally, we found evidence that sex convergence in binge drinking was developmentally limited and far more pronounced at the beginning of the transition to adulthood.

Association between uncertainty regarding right-to-stay and mental health in unaccompanied and separated migrant children (UASC) reaching adulthood: findings from France.

PURPOSE: There is substantial evidence suggesting high levels of mental health problems in unaccompanied and separated children (UASC). However, there is less focus on the first years of adulthood characterised by increased vulnerability and fear of expulsion. We aimed to describe the mental health of UASC on reaching adulthood, and how this was affected by uncertainty regarding their right-to-stay in France. METHODS: One hundred and ten youth aged 18-22 were recruited via child protection reception centres. We administered the Patient Health Questionnaire somatic (PHQ-15), anxiety (GAD-7) and depression (PHQ-9) modules, the Post-Traumatic Stress Disorder Checklist (PCL-5) and Connor-Davidson Resilience Scale (CD-RISC-10). Logistic regression analysis was performed with the dependent variable, a secure (versus uncertain) situation, defined as (1) detaining a residence permit and being in school, an apprenticeship or a salaried job, or (2) waiting for residence permit whilst occupying a salaried job. RESULTS: Of the sample, 19.3% reached criteria for a probable somatic disorder, 17.6% for anxiety and 28.7% for depression (score  ≥ 10); 41.8% were in an uncertain situation regarding their right-to-stay. Uncertainty was associated with higher anxiety ((OR per Interquartile range (95% CI), 1.77 (1.05-2.98)) and post-traumatic stress symptoms (2.05 (1.06-4.00)), lower resilience (0.50 (0.27-0.91)), and participants rating their anxiety (p = 0.02) and depressive symptoms (p = 0.003) as more severe since reaching adulthood. CONCLUSIONS: Our findings suggest uncertainty regarding right-to-stay is associated with increased mental health symptoms, specifically anxiety and trauma-induced stress, thereby highlighting the vulnerability of UASC in their first years of adulthood. This calls for greater support during this transition period with regular symptom monitoring for timely psychological interventions.

Binge drinking and violence in the transition to adulthood.

We analyzed data from the National Longitudinal Study of Adolescent Health (Add Health) to test the hypothesis that binge drinking, rather than frequency of any drinking, would predict violent behavior in the transition from adolescence to adulthood (TAA). In conservative models, accounting for a host of factors relevant to the TAA, we find that binge drinking, but not frequency of drinking, is associated with violent behavior. The models included a control for nonviolent offending, conforming to studies of the "differential etiology of violence" thesis. In addition, we tested whether this association fell away among participants over the age of 21 and found that underage status did not mediate the association between binge drinking and violent behavior.

Parental readiness for the transition to adulthood of children with a chronic disease.

PURPOSE: To investigate parental readiness for their child's transition to adulthood among pediatric patients with chronic disease in Japan. DESIGN AND METHODS: In this cross-sectional study, parents of children with chronic diseases attending a pediatric outpatient hospital completed an anonymous self-administered questionnaire to investigate demographics and parental readiness for children's transition to adulthood. Logistic regression analysis was conducted to determine whether parents' readiness differed according to their children's disease types. RESULTS: A total of 179 parents responded to the survey. Of these, 60% confirmed awareness and knowledge of their children's disease and treatment with their children. They also thought and accepted that there would be a time when their children would move from pediatrics to an adult department. More than half of parents had discussions with their children about the children's interests and would discuss with each other if their children's choice differed from the parents' opinion. <20% of parents had gathered information about the transition and made sure their children saw the outpatient clinic alone or encouraged them to write a record of their visits. The readiness of parents of children with diabetes and of children with cardiovascular disease was higher than those of children with cancer and blood diseases on several items. CONCLUSIONS: Parental readiness to support their children's transitions did not progress well, suggesting the need for relevant interventions. PRACTICE IMPLICATIONS: Children and parents should be supported in acquiring information about the transition to adulthood and in implementing child-oriented outpatient visits.

Timing to a first relationship among youth: Variability by sexual orientation development.

Romantic relationships are developmentally salient across the transition to adulthood, yet the timing to a first relationship for sexual minority youth is largely unknown and is complicated by the developmental timing of sexual orientation development. We use the National Longitudinal Study of Adolescent to Adult Health to predict the timing to a first relationship among heterosexual and sexual minority youth, defined as those with same-sex attraction and/or a sexual minority identity. We examine variability across subgroups of youth with a sexual minority status in adolescence only, in adulthood only, or in both developmental periods, and by gender. Participants with lesbian/gay sexual orientations emerging during adulthood delay a first relationship compared to their heterosexual peers. Those with bisexual orientations only in adulthood enter relationships earlier than their heterosexual peers, particularly women. Results suggest that patterns of dating relationship formations differ by distinct developmental contexts of sexual orientation development.

Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking.

This study articulates the iterative development of an intervention called Strengthening Youth Networks and Coping (SYNC), which is designed to target coping self-efficacy and help-seeking intentions and behaviors among youth in foster care. The overarching goal is to design an intervention that will be a feasible and acceptable enhancement to existing child welfare services, and that will address modifiable determinants among adolescents involved in child welfare system that are related to elevated risk for mental health challenges, limited support network capacity, and service disengagement after exiting foster care. In this paper, we describe our initial needs assessment, explain how we selected proximal intervention mechanisms (i.e., intermediate outcomes) to target, and outline the preliminary intervention development process, including ongoing insights we received from a research advisory group including members with lived experience. Next, we report and discuss the initial acceptability pre-testing data collected from youth (N = 30) as well as feasibility data collected from providers (N = 82), results from which were used to refine the SYNC intervention framework prior to robust efficacy testing. Findings highlight the need and importance of targeting youth coping and help-seeking, integrating programming within existing transition services, delivering this content in a group-based format that includes near-peer mentors and facilitators with lived experience, and developing options that work for the heterogeneous population of young people in foster care. The results also highlight the key objective of capturing youth's interests prior to enrolling in the program (e.g., language used in recruitment materials), holding their interest throughout the program (e.g., creating opportunities for youth to engage with other youth with similar experiences), and suggestions to encourage youth's engagement and participation. This paper articulates the value of this intervention development approach, and the sequential phases of this intervention development process as well as the results, which may be useful to applied researchers and practitioners working with youth in foster care and other priority populations.

Ticket to ride: national and international mobility as a multi-faceted resource in the life courses of young Italian graduates.

This paper looks at the national and international geographic mobility paths of young graduates in Italy and their educational and professional trajectories. By departing from the research fields of youth studies, mobility studies and higher education studies, we aim to highlight the multiple meanings and effects that mobility experiences may have in structuring graduates' future projects and/or desires. On the other hand, we argue that their expectations for both their mobility experiences and careers are also shaped by family socialisation, considering furthermore that the building of embodied and scholastic cultural capitals is spatially differentiated depending on the places where they grow up. The empirical research is based on two rounds of semi-narrative interviews conducted with 51 Italian graduates between 2020 and 2021. For the analysis, we have outlined four types of mobility paths. For each type, we focus on how socio-structural and cultural variables influence the ways the interviewees framed their mobility and professional experiences, desires and projects, focusing furthermore on how the Covid-19 pandemic differently affected their objective possibilities and strategies of mobility between the first and second waves.

Longitudinal associations between adolescents' individualised risk for depression and inflammation in a UK cohort study.

Inflammation is associated with poor physical and mental health including major depressive disorder (MDD). Moreover, there is evidence that childhood adversity - a risk factor for MDD - becomes biologically embedded via elevated inflammation. However, the risk of developing MDD arises from multiple sources and yet there has been little investigation of the links between individuals' constellation of MDD risk and subsequent inflammation. We therefore examined associations between individual risk for MDD calculated in early adolescence and levels of inflammation six years later. We use data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative UK birth cohort of 2,232 children followed to age 18 with 93% retention. Participants' individual risk for developing future MDD was calculated at age 12 using a recently developed prediction model comprising multiple psychosocial factors. Plasma levels of three inflammation biomarkers were measured at age 18: C-reactive protein (CRP), interleukin-6 (IL-6), and a newer biomarker, soluble urokinase plasminogen activator receptor (suPAR), which is thought to reflect the level of systemic chronic inflammation. MDD risk scores calculated at age 12 were positively associated with levels of suPAR (but not CRP or IL-6) at age 18 after adjusting for key covariates (b = 1.70, 95% CI = 0.46 - 2.95, p = 0.007). Adolescents at high risk of MDD (risk scores ≥ 90th centile) had significantly higher mean levels of suPAR six years later than adolescents who had been identified as low risk (risk scores ≤ 10th centile) (b = 0.41, 95% CI = 0.18 - 0.64, p < 0.001). Findings support the notion that childhood psychosocial risk for MDD leads to increased levels of low-grade inflammation. If replicated in studies with repeated assessments of inflammation biomarkers throughout childhood and adolescence, these findings would support targeted interventions to reduce inflammation, as measured by suPAR, for adolescents at high risk of MDD to potentially prevent development of depression and physical health problems related to chronic inflammation.

Unequal Transitions to Adulthood: Widening Disparities in Age at First Union, Sex, and Birth in Many Low- and Middle-Income Countries.

Research on the timing of events during the transition to adulthood, such as first union, sex, and birth in low- and middle-income countries (LMICs), focused predominantly on measures of central tendency, notably median or mean ages. In this report, we adopt a different perspective on this topic by examining disparities in the timing of these events in 46 LMICs spanning four decades. Using Demographic and Health Surveys, we estimate ages at which 25 percent, 50 percent, and 75 percent of women have first union, birth, and sex. We compute interquartile ranges to measure within-country variation and disparities in the timing of sexual initiation and family formation. Variation in the timing of first union, birth, and sex generally increases as the median ages at these events increase. Disparities in the timing of first union and birth grew in West Africa and Latin America, and women who experience these events relatively early increasingly lag behind women who experience them relatively late. Documenting trends in measures of central tendency is insufficient to capture the complexity of ongoing changes because they mask growing disparities in the timing of family formation across many LMICs. These results are important for assessing progress toward the achievement of sustainable development goals related to the reduction of early marriages and pregnancies and highlight a need for more holistic approaches to measure the timing of family formation.

Religiosity and Young Unmarried Women's Sexual and Contraceptive Behavior: New Evidence From a Longitudinal Panel of Young Adult Women.

Drawing on weekly panel data from the Relationship Dynamics and Social Life study, we investigate the relationship between religiosity and young Christian women's premarital intercourse, hormonal contraceptive use, and condom use for a period of up to 2.5 years. Mediation analyses reveal what explains the relationship between baseline religiosity and young women's subsequent reproductive behaviors, with consideration for their normative environments, moral order and learned competencies, attitudes, and anticipated guilt after sex. Results indicate that the more religious a young woman is, the less likely she is to have intercourse and to use hormonal contraception in a given week. However, when having intercourse and not using a hormonal method, the more religious a young woman is, the more likely she is to use condoms. Religiosity's relationship to these behaviors operates largely through women's reproductive attitudes, anticipated feelings of guilt after sex, and past sexual or contraceptive behaviors. Together, these findings highlight the complex relationship between religiosity and premarital sex and contraceptive use, elucidate key pathways through which religiosity operates, and draw attention to the often overlooked role of sexual emotions.

What a (Young) Woman Wants: Concurrent Effects of Desire to Avoid Pregnancy and Desire for Sex on Sexual Intercourse and Contraceptive Use.

Of all pregnancies among young women in the United States, more than 60% are undesired, yet explanations for this phenomenon remain elusive. While research has investigated how pregnancy desires and intentions shape pregnancy-related behavior, only recently have scholars noted that desire for sex influences these same behaviors. Many young women simultaneously experience strong desires for sex alongside a strong desire to avoid pregnancy, but few studies have considered the extent to which young women adapt their reproductive behaviors in response to these potentially competing desires. Using novel weekly panel data, this analysis assesses how desires for sex may moderate the effect of the desire to avoid pregnancy on a young woman's sexual behavior and contraceptive use. Findings suggest that when a woman strongly wants to avoid pregnancy, she is less likely to have sex and more likely to use hormonal or coital contraceptives. As her desire for sex increases, however, she is instead more likely to have sex and use hormonal contraceptives. If she does not use hormonal methods, she is less likely to use coital contraceptives when she has intercourse. These findings highlight the importance of recognizing the desire for sex as a behavioral modifier for avoiding undesired pregnancy in the transition to adulthood.

Microsimulation of Household and Marital Transitions Leading to Childlessness Among Dutch Women Born Between 1971 and 2000.

After reaching historically low levels among the women born in the early 1940s, childlessness has been increasing in most Western countries among women born in the 1950s and 1960s. This increase took place as patterns of transition to adulthood have become increasingly late, protracted, and complex. Yet, it is precisely those women who enter a first relationship late, spend more time as single, and experience union instability who more often remain childless. This suggests that levels of childlessness will continue to increase as younger cohorts complete their childbearing histories. In this study, we use microsimulation to project the household and union formation histories of cohorts of Dutch women born between 1971 and 2000. Results suggest that childlessness will actually decrease among cohorts born between 1971 and 1983 and then increase among those born between 1984 and 2000. The decrease occurs as pathways of household and union formation become later, more protracted, and more complex, but also as cohabiting women start to exhibit a higher propensity to become mothers. The increase, on the other hand, occurs as pathways become somewhat less protracted and complex, but also as the propensity of cohabiting women to become mothers returns to previous levels and as age at leaving the parental home strongly rises. Childlessness levels appear to increasingly depend on the childbearing decisions of cohabiting couples and on age at leaving the parental home.

Healthcare use in commercially insured youth with mental health disorders.

BACKGROUND: The objective of this study is to describe age-related patterns of outpatient healthcare utilization in youth and young adults with mental health disorders. METHOD: We used the IBM® MarketScan® Commercial Database to identify 359,413 youth and young adults (12-27 years) with a mental health disorder continuously enrolled in private health insurance in 2018. Exploratory analysis was used to describe patterns of outpatient healthcare use (e.g., primary, reproductive, mental health care) and therapeutic management (e.g., medication prescriptions, psychotherapy) by age. Period prevalence and median number of visits are reported. Additional analysis explored utilization patterns by mental health disorder. RESULTS: The prevalence of outpatient mental health care and primary care decreased with age, with a larger drop in primary care utilization. While 74.0-78.4% of those aged 12-17 years used both outpatient mental health care and primary care, 53.1-59.7% of those aged 18-27 years did. Most 18-19-year-olds had a visit with an internal medicine or family medicine specialist, a minority had a pediatrician visit. The prevalence of medication management increased with age, while the prevalence of psychotherapy decreased. CONCLUSIONS: Taken together, this descriptive study illustrates age-related differences in outpatient healthcare utilization among those with mental health disorders. Additionally, those with the most severe mental health disorders seem to be least connected to outpatient care. This knowledge can inform efforts to improve utilization of healthcare across the transition to adulthood.