Factors affecting improvement of children and adolescents who were treated in the child and adolescent psychiatry inpatient unit (original) (raw)
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Evaluating outcomes of the child and adolescent psychiatric unit: A prospective study
International Journal of Mental Health Systems, 2011
Background: The aims of this prospective study are to clarify the outcomes of child psychiatric inpatient treatment and to identify factors associated with patient improvement. Methods: The attending psychiatrist used the Children's Global Assessment Scale (CGAS) to assess youths at admission to and discharge from a child and adolescent psychiatric unit in Japan(N = 126, mean age = 12.8, SD = 1.9). Hospital records gathered sociodemographic and clinical variables. In addition, youths and their primary caregivers assessed themselves using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), respectively. Longitudinal analyses compared each scales' baseline and discharge scores. We also examined factors associated with changes in functioning (CGAS). Results: Longitudinal comparisons revealed that CGAS, CBCL and YSR scores showed improvement over time (CGAS: t =-14.40, p = 0.00; CBCL: t = 3.80, p = 0.00; YSR: t = 2.40, p = 0.02). Linear regressions determined that the factors associated with improvement in CGAS included age, lower CGAS scores at admission, frequency of group therapy and psychiatric diagnosis. Conclusions: This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement.
Assessing outcomes in child psychiatry
The American journal of managed care, 2009
To report on the first year of a program using standardized rating scales within a large, multisite mental health system of care for children and to assess the validity, reliability, and feasibility of these scales. Naturalistic follow-up of clinicians' ratings. Clinicians filled out the Brief Psychiatric Rating Scale for Children (BPRS-C) and the Children's Global Assessment Scale (CGAS) at intake and discharge/90-day follow-up for all new patients. Data were collected on 2396 patients from all 20 sites serving children in the Partners HealthCare network. Mean scores for both BPRS-C and CGAS showed worst functioning at inpatient sites, followed by Acute Residential Treatment, then partial hospital, then outpatient sites. All patients re-rated at discharge or 90-day follow-up showed a significant improvement in scores. Inter-item reliability on the BPRS-C was acceptable, with Cronbach alphas of .78 and .81. Feasibility at intake was demonstrated in that 66% of all patients h...
Variables related to outcome following child psychiatric hospitalization
General hospital psychiatry
Children (N = 110) hospitalized on a child psychiatric unit improved significantly in psychological functioning at discharge and 1- and 6-months follow-up relative to their functioning at admission. Children who were more impaired at admission made more progress during admission but were more impaired at follow-up than children who had milder symptoms at admission. Children without a behavior disorder had a better outcome than children with a behavior disorder. None of the other variables, alone or in combination, was significantly related to admission progress or follow-up outcome, including specific diagnoses, gender, race, age, IQ, family functioning, negative life events, parent education and employment, biological family history, length of hospitalization, parent involvement during admission and follow-up services.
Volume 17, Issue 3, 2019
Objectives: More attention is now paid on the importance of emotional and mental well-being of the youth. To better plan for psychiatric health care and rehabilitation in this age group, we need to shed light on the epidemiological picture of their mental disorders. The present study aimed to evaluate the demographic and clinical characteristics of the referrals to a child and adolescent psychiatric ward during 5 years. Methods: In this prospective observational study, all the youth, who had been admitted to the Roozbeh Hospital for the first time, were recruited. All of the participants were evaluated, using the Roozbeh Hospital Item Sheet as a standard tool for obtaining their demographic and clinical features. The level of global functioning was also assessed, utilizing the Children Global Assessment Scale. Results: Over 55% of the inpatients (n=192) were male with a Mean±SD age of 15.2±2.36years. The average length of admission was 40 days. The most common diagnoses were (in descending sequences): 1. bipolar mood disorder; 2. attention-deficit/hyperactivity disorder; and 3. autism spectrum disorder. The global functioning mean score of the participants was between 29 and 59 out of 100 through the worst and the best situations of the psychiatric condition. Discussion: The study findings highlight the predominance of mood disorders and their complications among this group of inpatients as well as their required and special assessments and interventions. Future annual reports can help with better understanding the trends in mental health issues that potentially aids in policymaking and developing treatment guidelines.
Evaluation and Program Planning, 1982
The Global Assessment Scale for Children (GAS-Children) and the Children's Impairment ScaIe (CIS) were ~amined for inter-rater reiiabi~ity, d~~rimination of out~ti~nts from inpatients, and ciinician acceptance. Forty-four clinicians used the two scales to rate I46 recently admitted children and adolescents in eight mental health programs. An additional study assessed the inter-rater reliability of the two scales compared with the Connors Parent-Teacher ~estionnaire and the correlation of the GAS-Children with both the Connors Parents Questionnaire and Achenbach's Child behavior Checklist. The GAS-Children showed better interrater agreement than any of the four subscales of the CIS, although the sum of the CIS subscales also showed adequate inter-rater reliability. Among adolescents, the GAS-Children correlated highly with the adult GAS, but the scafes showed different mean values. Clinicians slightly preferred the GAS-Children over the CIS. To assess comparability of scale usage across sites, clinicians rated six case vignettes. Inpatient clinicians rated the vignettes as more dysfunctional than did their outpatient counterparts. Bias-adjusted scores still discriminated outpatient from inpatient children. Nevertheless, these rater biases should make evaluators cautious about comparing functioning scores across programs, even when the rating scale is ~tensib~y the same.
Objective: In this study, it was aimed to examine the clinical and sociodemographic characteristics of patients hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit during the pandemic period. Material and Methods: Medical records of children and adolescents who were hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit between March 2021 and March 2022 were retrospectively analyzed. Patients were evaluated in terms of sociodemographic characteristics, clinical diagnosis and treatment, duration of hospitalization, and Clinical Global Impression Scale (CGI) scores at admission and discharge. Results: In our study, the mean age of 132 cases (86 girls, 46 boys) was found 15.1±1.8 years. The main diagnoses of the subjects were 30.3% (n=40) major depressive disorder, 25% (n=33) psychotic disorder, 14.4% (n=19) eating disorders, and the remaining 30.3% (n=40) were other disorders. Comorbidity was found in 63.6% (n=84) of the cases. The presence of eating disorders, comorbidity and antidepressant use were found significantly higher in females. There was a significant differences in major depressive disorder (MDD), bipolar disorder (BD), psychotic disorder, eating disorder, conduct disorder, and post-traumatic stress disorder (PTSD) between admission and discharge CGI-Severity (CGI-S) scores. In addition, there was a significant difference between admission and discharge CGI side effects scores only for BD. Conclusion: In our study, major depressive disorder, psychotic disorder, and eating disorder were the most common diagnoses of cases hospitalized in inpatient unit. There was a comorbidity accompanying two out of every three cases. There are few child and adolescent psychiatry services in our country, and studies on this subject are scarce. It is thought that our study will contribute to the literature on child and adolescent psychiatry inpatient units.
Differences in Younger, Middle, and Older Children Admitted to Child Psychiatric Inpatient Services
Child Psychiatry & Human Development, 2002
Sociodemographic, family-environmental, clinical, and service use differences among younger (3–6 years), middle (7–10 years), and older (11–16 years) children admitted to a child psychiatric inpatient service were examined. Data was collected retrospectively on 327 children using a 152-item chart abstraction form from the children's medical charts in years 1993, 1995, 1996, and 1997. The results suggest that younger children compared
Journal of Nepal Paediatric Society, 2010
Background: Psychiatric morbidity is ubiquitous, affecting children, adolescents and adults. Age factorsplay a great role in pattern of morbidity profile. Psychiatric morbidity profile of children and adolescentsmay indicate different needs and priorities. Objective: This study aims to sort out referral pattern, attitudeabout psychiatric referral and morbidity profile among child and adolescent psychiatric out-patients in atertiary-care general hospital. Methodology: A total of 100 consecutive child and adolescent patientsin psychiatry OPD coming into contact with investigator psychiatrist were enrolled during the studyperiod. Diagnoses were made according to the ICD-10. Results: Fifty three of the subjects were female,majority of the cases (79) were of age between 13-18 years. Main ethnicity-caste groups seeking carewere Mongol, Brahmin, Chhetri and indigenous Terai tribes. People from semi-urban and urban settingspredominated in this study. Great majority (more than 80%) had reach...
Child and Adolescent Mental Health, 2012
Background: This study explored the feasibility and validity of using brief clinician-and parent-rated measures routinely over 6 months in outpatient child psychiatry. Method: All patients under 18 years of age seen for intake in the Child Psychiatry Clinic from 1 August 2007 through 31 July 2010 were eligible for inclusion in the study. Data were collected at intake for 1033 patients and at 3-and 6-month follow-up. Results: ANOVA for repeated measures showed statistically significant improvements in total and subscale scores on all three measures (Brief Psychiatric Rating Scale for Children, ChildrenÕs Global Assessment Scale, and Pediatric Symptom Checklist) at both second and third assessments. Conclusion: The fact that both broadband and narrowband scales showed significant improvements over the first 6 months of care establishes the possibility that these measures could be used in experimental designs studying comparative effectiveness.
Treatment outcome among child psychiatric outpatients in a community mental health center
Community mental health journal, 2000
The study evaluated the effectiveness of mental health center treatments for children aged 5-12 years. The Child Behavior Checklist (CBCL) was administered before and after treatment to the parents of the treatment group (N = 71). The results were analyzed and compared to the results of the pretest and posttest CBCL administered to the parents of a matched group of comparison subjects (N = 33). The results showed that the treatment subjects significantly improved on both the externalizing and internalizing scales of the CBCL. The controls showed no significant change between pretest and posttest scores. As a result, it appears that clinic treatments can help clients with measurable problems decrease problematic behaviors. More data is needed to determine whether clinic treatments such as the ones described in this study can substantially help the most seriously disturbed school-age children.