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European Child & Adolescent Psychiatry
Published in: European Child & Adolescent Psychiatry 10/2015

01-10-2015 | Original Contribution

Evaluating change in symptomatic and functional level of children and youth with emotional disorders: a naturalistic observation study

Authors: Toril Sørheim Nilsen, Bjørn-Helge Handegård, Martin Eisemann, Siv Kvernmo

Published in: European Child & Adolescent Psychiatry | Issue 10/2015

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Abstract

The objective of the study is to describe the changes in symptomatic and functional impairment for children and youth with emotional disorders treated at child and adolescent mental health outpatient services (CAMHS) in Norway. The study was of naturalistic observational type in which the treatment can be classified as “treatment as usual” (TAU). The Strengths and Difficulties Questionnaire (SDQ), the Health of the Nation Outcome Scale (HONOSCA) and the Children’s Global Assessment Scale (CGAS) were used as measures of change. The information from multiple informants allowed the evaluation of change from different perspectives. The sample consisted of 84 children and youth with emotional disorders treated at two CAMHS in the North of Norway. The SDQ, the HONOSCA and the CGAS were administered at intake (T0), during assessment (T1) and approximately, 6 months after T1 (T2). Change was analysed by means of the Linear Mixed Models procedure. The results show that children and youth with emotional disorders experience a statistically significant improvement per month during outpatient treatment according to nearly all the measures of change. For the clinician rated scores, change rates during active assessment/treatment were larger than during the waitlist period. Evaluating change from the perspective of clinical significance showed that only a small proportion of the subjects had change scores that were statistically reliable and clinically significant. Whether an actual change has occurred is uncertain for the majority of patients.
Literature
1.
Achenbach TM, Becker A, Dopfner M, Heiervang E, Roessner V, Steinhausen HC, Rothenberger A (2008) Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions. J Child Psychol Psychiatry 49:251–275CrossRefPubMed
2.
Ambrosini PJ (2000) Historical development and present status of the schedule for affective disorders and Schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 39:49–58CrossRefPubMed
3.
Angold A, Costello EJ, Burns BJ, Erkanli A, Farmer EMZ (2000) Effectiveness of nonresidential specialty mental health services for children and adolescents in the “real world”. J Am Acad Child Adolesc Psychiatry 39:154–160CrossRefPubMed
4.
Barkham M, Hardy GE, Mellor-Clark J (2010) Developing and delivering practice-based evidence a guide for the psychological therapies. Wiley, ChichesterCrossRef
5.
Bilenberg N (2003) Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA)–results of a Danish field trial. Eur Child Adolesc Psychiatry 12:298–302CrossRefPubMed
6.
Bird HR, Canino G, Rubio-Stipec M, Ribera JC (1987) Further measures of the psychometric properties of the Children’s Global Assessment Scale. Arch Gen Psychiatry 44:821–824CrossRefPubMed
7.
Brann P, Coleman G (2010) On the meaning of change in a clinician’s routine measure of outcome: HoNOSCA. Aust N Z J Psychiatry 44:1097–1104CrossRefPubMed
8.
Brann P, Coleman G, Luk E (2001) Routine outcome measurement in a child and adolescent mental health service: an evaluation of HoNOSCA. The Health of the Nation Outcome Scales for Children and Adolescents. Aust N Z J Psychiatry 35:370–376CrossRefPubMed
9.
Brøndbo PH, Mathiassen B, Martinussen M, Heiervang E, Eriksen M, Moe TF, Sæther G, Kvernmo S (2011) The strengths and difficulties questionnaire as a screening instrument for norwegian child and adolescent mental health services, application of UK scoring algorithms. Child Adolesc Psychiatry Ment Health 5:32PubMedCentralCrossRefPubMed
10.
Campbell TC (2005) An introduction to clinical significance: an alternative index of intervention effect for group experimental designs. J Early Interv 27:210–227CrossRef
11.
Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844CrossRefPubMed
12.
De Los Reyes A, Alfano C, Beidel D (2010) The relations among measurements of informant discrepancies within a multisite trial of treatments for childhood social phobia. J Abnorm Child Psychol 38:395–404CrossRef
13.
De Los Reyes A, Kazdin AE (2009) Identifying evidence-based interventions for children and adolescents using the range of possible changes model a meta-analytic illustration. Behav Modif 33:583–617CrossRef
14.
De Los Reyes A, Kazdin AE (2005) Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull 131:483–509CrossRef
15.
De Los Reyes A, Thomas SA, Goodman KL, Kundey SMA (2013) Principles underlying the use of multiple informants’ reports. Annu Rev Clin Psychol 9(9):123–149
16.
Garber J, Weersing VR (2010) Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clin Psychol Sci Pract 17:293–306CrossRef
17.
Garland A, Haine-Schlagel R, Brookman-Frazee L, Baker-Ericzen M, Trask E, Fawley-King K (2013) Improving community-based mental health care for children: translating knowledge into action. Adm Policy Ment Health Ment Health Serv Res 40:6–22CrossRef
18.
Garland A, Hough R, McCabe K, Yeh M, Wood P, Aarons G (2001) Prevalence of psychiatric disorders in youths across five sectors of care. J Am Acad Child Adolesc Psychiatry 40:409–418CrossRefPubMed
19.
Garralda ME, Yates P, Higginson I (2000) Child and adolescent mental health service use. HoNOSCA as an outcome measure. Br J Psychiatry 177:52–58CrossRefPubMed
20.
Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345CrossRefPubMed
21.
Goodman R (1999) The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 40:791–799CrossRefPubMed
22.
Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRefPubMed
23.
Gowers S, Levine W, Bailey-Rogers S, Shore A, Burhouse E (2002) Use of a routine, self-report outcome measure (HoNOSCA-SR) in two adolescent mental health services. Health of the Nation Outcome Scale for Children and Adolescents. Br J Psychiatry 180:266–269CrossRefPubMed
24.
Gowers SG, Harrington RC, Whitton A, Lelliott P, Beevor A, Wing J, Jezzard R (1999) Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for children and Adolescents (HoNOSCA). Br J Psychiatry 174:413–416CrossRefPubMed
25.
Hall CL, Moldavsky M, Taylor J, Sayal K, Marriott M, Batty MJ, Pass S, Hollis C (2014) Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective. Eur Child Adolesc Psychiatry 23:239–242PubMedCentralCrossRef
26.
Hanssen-Bauer K, Gowers S, Aalen OO, Bilenberg N, Brann P, Garralda E, Merry S, Heyerdahl S (2007) Cross-national reliability of clinician-rated outcome measures in child and adolescent mental health services. Adm Policy Ment Health 34:513–518CrossRefPubMed
27.
Heiervang E, Goodman A, Goodman R (2008) The Nordic advantage in child mental health: separating health differences from reporting style in a cross-cultural comparison of psychopathology. J Child Psychol Psychiatry 49:678–685CrossRefPubMed
28.
Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebo AK, Plessen KJ, Bjelland I, Lie SA, Gillberg C (2007) Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46:438–447CrossRefPubMed
29.
Holzer L, Tchemadjeu IK, Plancherel B, Bolognini M, Rossier V, Chinet L, Halfon O (2006) Adolescent drug abuse diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement. J Eval Clin Pract 12:482–490CrossRefPubMed
30.
31.
Jacobson NS, Follette WC, Revenstorf D (1984) Psychotherapy outcome research–methods for reporting variability and evaluating clinical-significance. Behav Ther 15:336–352CrossRef
32.
Jacobson NS, Truax P (1991) Clinical-significance–a statistical approach to defining meaningful change in psychotherapy-research. J Consult Clin Psychol 59:12–19CrossRefPubMed
33.
Jensen PS, Hoagwood K, Petti T (1996) Outcomes of mental health care for children and adolescents: II. Literature review and application of a comprehensive model. J Am Acad Child Adolesc Psychiatry 35:1064–1077CrossRefPubMed
34.
Kane RL (2006) Understanding health care outcomes research. Jones and Bartlett Publishers, Sudbury
35.
Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988CrossRefPubMed
36.
Kazdin AE (ed) (2003) Methodological issues and strategies in clinical research. American Psychological Association, Washington, DC
37.
Kisely S, Campbell LA, Cartwright J, Cox M, Campbell J (2010) Do the Health of the Nation Outcome Scales measure outcome? Can J Psychiatry 55:431–439PubMed
38.
Kisely S, Campbell LA, Crossman D, Gleich S, Campbell J (2007) Are the Health of the Nation Outcome Scales a valid and practical instrument to measure outcomes in North America? A three-site evaluation across Nova Scotia. Community Ment Health J 43:91–107CrossRefPubMed
39.
40.
Law D (2013) Goals and goal based outcomes (GBOs). CAMHS Press, London
41.
42.
Lee W, Jones L, Goodman R, Heyman I (2005) Broad outcome measures may underestimate effectiveness: an instrument comparison study. Child Adolesc Mental Health 10:143–144CrossRef
43.
Lewinsohn PM, Seeley JR, Hibbard J, Rohde P, Sack WH (1996) Cross-sectional and prospective relationships between physical morbidity and depression in older adolescents. J Am Acad Child Adolesc Psychiatry 35:1120–1129CrossRefPubMed
44.
Lundh A, Forsman M, Serlachius E, Lichtenstein P, Landen M (2013) Outcomes of child psychiatric treatment. Acta Psychiatr Scand 128:34–44CrossRefPubMed
45.
Lundh A, Kowalski J, Sundberg CJ, Gumpert C, Landen M (2010) Children’s Global Assessment Scale (CGAS) in a naturalistic clinical setting: inter-rater reliability and comparison with expert ratings. Psychiatry Res 177:206–210CrossRefPubMed
46.
Manassis K, Menna R (1999) Depression in anxious children: possible factors in comorbidity. Depress Anxiety 10:18–24CrossRefPubMed
47.
Manderson J, McCune N (2003) The use of HoNOSCA in a child and adolescent mental health service. Irish J Psychol Med 20:52–55
48.
Manteuffel B, Stephens RL, Sondheimer DL, Fisher SK (2008) Characteristics, service experiences, and outcomes of transition-aged youth in systems of care: programmatic and policy implications. J Behav Health Serv Res 35:469–487CrossRefPubMed
49.
Mason WA, Chmelka MB, Thompson RW (2012) Responsiveness of the strengths and difficulties questionnaire (SDQ) in a sample of high-risk youth in residential treatment. Child Youth Care Forum 41:479–492CrossRef
50.
Mathai J, Anderson P, Bourne A (2003) Use of the strengths and difficulties questionnaire as an outcome measure in a child and adolescent mental health service. Australasian Psychiatry 11:334–337CrossRef
51.
Merikangas K, He J, Brody D, Fisher P, Bourdon K, Koretz D (2010) Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics 125:75–81PubMedCentralCrossRefPubMed
52.
Merry S, McDowell H, Hetrick S, Bir J, Muller N (2004) Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database Syst Rev:CD003380
53.
O’Neil KA, Conner BT, Kendall PC (2011) Internalizing disorders and substance use disorders in youth: comorbidity, risk, temporal order, and implications for intervention. Clin Psychol Rev 31:104–112CrossRefPubMed
54.
Obel C, Heiervang E, Rodriguez A, Heyerdahl S, Smedje H, Sourander A, Guethmundsson OO, Clench-Aas J, Christensen E, Heian F, Mathiesen KS, Magnusson P, Njarethvik U, Koskelainen M, Ronning JA, Stormark KM, Olsen J (2004) The strengths and difficulties questionnaire in the Nordic countries. Eur Child Adolesc Psychiatry 13(Suppl 2):32–39
55.
56.
Pirkis JE, Burgess PM, Kirk PK, Dodson S, Coombs TJ, Williamson MK (2005) A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures. Health Qual Life Outcomes 3:76PubMedCentralCrossRefPubMed
57.
Ramsawh HJ, Weisberg RB, Dyck I, Stout R, Keller MB (2011) Age of onset, clinical characteristics, and 15-year course of anxiety disorders in a prospective, longitudinal, observational study. J Affect Disord 132:260–264PubMedCentralCrossRefPubMed
58.
Rey JM, Starling J, Wever C, Dossetor DR, Plapp JM (1995) Interrater reliability of global assessment of functioning in a clinical setting. J Child Psychol Psychiatry 36:787–792CrossRefPubMed
59.
Schorre BE, Vandvik IH (2004) Global assessment of psychosocial functioning in child and adolescent psychiatry. A review of three unidimensional scales (CGAS, GAF, GAPD). Eur Child Adolesc Psychiatry 13:273–286CrossRefPubMed
60.
Shafer D, Gould M, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A childrens global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231CrossRef
61.
Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7:301–317CrossRefPubMed
62.
Singer JD, Willett JB (2003) Applied longitudinal data analysis : modeling change and event occurrence. Oxford University Press, OxfordCrossRef
63.
Strauss CC, Last CG, Hersen M, Kazdin AE (1988) Association between anxiety and depression in children and adolescents with anxiety disorders. J Abnorm Child Psychol 16:57–68CrossRefPubMed
64.
Vostanis P (2006) Strengths and difficulties questionnaire: research and clinical applications. Curr Opin Psychiatry 19:367–372CrossRefPubMed
65.
Weisz JR (2004) Psychotherapy for Children and Adolescents Evidence-Based Treatments and Case Examples. In: Cambridge University Press, Cambridge, p 1 online resource (544 s.)
66.
Wiggins A, Browne MO, Bearsley-Smith C, Villanueva E (2010) Depressive disorders among adolescents managed in a child and adolescent mental health service. Australasian Psychiatry 18:134–141CrossRefPubMed
67.
Metadata
Title
Evaluating change in symptomatic and functional level of children and youth with emotional disorders: a naturalistic observation study
Authors
Toril Sørheim Nilsen
Bjørn-Helge Handegård
Martin Eisemann
Siv Kvernmo
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 10/2015
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-014-0671-3

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