[From early detection to an integrated cross-setting treatment of young people with emerging affective and psychotic disorders].

BACKGROUND: Affective and psychotic disorders often emerge during adolescence and early adulthood. Early detection and timely treatment of individuals with mental disorders (particularly affective and psychotic disorders) can play a decisive role in improving the course of disease and treatment outcomes. To bridge the gap between early detection and evidence-based, integrated, and cross-setting treatment, there is a need for conceptual advancement and closer coordination of outpatient, day clinic, and inpatient care services, particularly during the transition between child and adolescent psychiatry and adult psychiatry.

METHODS: The aim of this paper is to present the services offered by the "Young People" track at the Carl Gustav Carus University Hospital in Dresden as a potential best-practice example. It addresses established workflows, team structure, and the nature and frequency of interventions. In addition, descriptive data on all individuals seeking help at the Early Detection and Intervention Center between May 2018 and October 2025 as well as those treated in the day clinic between December 2019 and December 2024 are analyzed.

RESULTS: Care is provided through a stepped pathway-starting with an initial general, low-threshold point of contact, moving on to specialized early detection of affective and psychotic disorders, and culminating in targeted referrals to established outpatient, day-care, and inpatient treatment programs for young people. From May 2018 to October 2025, 859 young people made their first visit to the Early Detection and Intervention Center (52.5% female; average age: 24 years). 31.4% did not meet the criteria for a mental disorder, 35.4% fulfilled the criteria of one, 20.6% of two, and 12.6% of at least three diagnoses. N = 63 met the risk criteria for developing bipolar disorder, n = 77 for developing psychosis. More than 100 young people were treated in the outpatient setting. The day clinic treated N = 283 patients (average duration: 7 weeks) with high treatment acceptance and significant improvements in symptom burden, self-management, and quality of life. Initial steps towards establishing a specialized inpatient treatment programme are currently underway with the allocation of six beds for young people, enabling continuous care even in times of increased treatment needs.

DISCUSSION AND CONCLUSION: The services offered by the "Young People" track at Dresden University Hospital bridge potential gaps in care during the transition from adolescent to adult psychiatry. Through low-threshold early detection and risk-adapted, continuous, and cross-setting care, young people-with or without previous treatment experience-receive targeted support. Treatment tailored to their developmental needs facilitates inter alia processes of maturation, career orientation, and the gradual achievement of independence. The accompanying research ensures the continuous, evidence-based development of the integrative and patient-centered care concept, which, as a potential best-practice example in Germany, can represent a decisive step towards an effective and person-centered care system for young people with affective and psychotic disorders.