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European Child & Adolescent Psychiatry
Published in: European Child & Adolescent Psychiatry 2/2020

Open Access 01-02-2020 | Original Contribution

Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds

Authors: Miranda Wolpert, Victoria Zamperoni, Elisa Napoleone, Praveetha Patalay, Jenna Jacob, Marjolein Fokkema, Marianne Promberger, Luís Costa da Silva, Meera Patel, Julian Edbrooke-Childs

Published in: European Child & Adolescent Psychiatry | Issue 2/2020

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Abstract

Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population. This study examined rates of reliable improvement/deterioration for children in a school sample over time. N = 9074 children (mean age 12; 52% female; 79% white) from 118 secondary schools across England provided self-report mental health (SDQ), quality of life and demographic data (age, ethnicity and free school meals (FSM) at baseline and 1 year and self-report data on access to mental health support at 1 year). Multinomial logistic regressions and classification trees were used to analyse the data. Of 2270 (25%) scoring above threshold for mental health problems at outset, 27% reliably improved and 9% reliably deteriorated at 1-year follow up. Of 6804 (75%) scoring below threshold, 4% reliably improved and 12% reliably deteriorated. Greater emotional difficulties at outset were associated with greater rates of reliable improvement for both groups (above threshold group: OR = 1.89, p < 0.001, 95% CI [1.64, 2.17], below threshold group: OR = 2.23, p < 0.001, 95% CI [1.93, 2.57]). For those above threshold, higher baseline quality of life was associated with greater likelihood of reliable improvement (OR = 1.28, p < 0.001, 95% CI [1.13, 1.46]), whilst being in receipt of FSM was associated with reduced likelihood of reliable improvement (OR = 0.68, p < 0.01, 95% CI [0.53, 0.88]). For the group below threshold, being female was associated with increased likelihood of reliable deterioration (OR = 1.20, p < 0.025, 95% CI [1.00, 1.42]), whereas being from a non-white ethnic background was associated with decreased likelihood of reliable deterioration (OR = 0.66, p < 0.001, 95% CI [0.54, 0.80]). For those above threshold, almost one in three children showed reliable improvement at 1 year. The extent of emotional difficulties at outset showed the highest associations with rates of reliable improvement.
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Metadata
Title
Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds
Authors
Miranda Wolpert
Victoria Zamperoni
Elisa Napoleone
Praveetha Patalay
Jenna Jacob
Marjolein Fokkema
Marianne Promberger
Luís Costa da Silva
Meera Patel
Julian Edbrooke-Childs
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 2/2020
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-019-01334-4

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