Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-21T14:20:49.308Z Has data issue: false hasContentIssue false

Who attends outpatient adolescent mental health services?

Published online by Cambridge University Press:  13 June 2014

Carol Fitzpatrick
Affiliation:
University College Dublin
McAuley Catherine
Affiliation:
Research Centre, Nelson St, Dublin 7, Ireland
Anne Kehoe
Affiliation:
School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
Nina Devlin
Affiliation:
School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
Sinead Glackin
Affiliation:
School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
Lorna Power
Affiliation:
Children's University Hospital, Temple St, Dublin 1, Ireland
Suzanne Guerin
Affiliation:
Department of Psychology, University College Dublin, Dublin 4, Ireland

Abstract

Objectives: This study set out to profile the diagnoses and level of suicidal behaviour of adolescents aged 12-15 years newly referred to a Child and Adolescent Mental Health Service (CAMHS). Information on the nature and range of disorders and level of functional impairment among adolescents attending outpatient CAMHS is important for service planning and development.

Methods: A total of 100 newly referred adolescents were assessed using the KSADS-PL standardised interview. Overall level of functional impairment was measured using The Clinical Global Impressions Scale and The Children's Global Assessment Scale.

Results: Results showed that the majority of adolescents had more than one disorder, with almost one quarter having four or more disorders. Behavioural disorders were the most common diagnostic category, followed by anxiety disorders, and affective disorders. Although relatively uncommon, levels of functional impairment were highest in those with psychotic disorders, followed by substance abuse disorders. The most common pattern of comorbid disorders were depressive disorders plus anxiety disorders, followed by anxiety disorders plus behavioural disorders and depressive disorders plus behavioural disorders. One quarter of the young people had engaged in suicidal acts in the six months prior to attendance, while this had been the case in over one half of those with a depressive disorder.

Conclusion: This study showed that adolescents attending CAMHS tend to have multiple disorders, high levels of suicidality, and are significantly functionally impaired. These factors need to be taken into account in the development of effective treatments.

Type
Original papers
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References:

1.Meltzer, H, Gatward, R. The mental health of children and adolescents in Great Britain. London: The Stationery Office, 2000.CrossRefGoogle Scholar
2.Lynch, F, Mills, C, Daly, I, Fitzpatrick, C. Challenging Times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. J Adolesc 2006; 29: 555573.CrossRefGoogle ScholarPubMed
3.Zachrisson, HD, Rodje, K, Mykletun, A. Utilization of health services in relation to mental health problems in adolescents: A population based survey. BMC Public Health 2006; 6: 34.CrossRefGoogle ScholarPubMed
4.Caron, C, Rutter, M. Comorbidity in child psychopathology: Concepts, Issues, and Research Strategies. J Child Psychol Psychiat 1991; 32: 10631080.CrossRefGoogle ScholarPubMed
5.Costello, EJ, Farmer, EM, Angold, A, Burns, BJ, Erkanli, A. Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains study. Am J Public Health 1997; 87: 827832.CrossRefGoogle ScholarPubMed
6.Costello, EJ, Mustillo, S, Erkanli, A, Keeler, G, Angold, A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiat 2003; 60: 837844.CrossRefGoogle ScholarPubMed
7.Lauth, B, Levy, S, Juliusdottir, G, Ferrari, P, Petursson, H. Implementing the semi-structured interview Kiddie-SADS-PL into an inpatient adolescent clinical setting: Impact on frequency of diagnoses. Child AdolPsychiat Mental Health 2008; 2: 1424.CrossRefGoogle ScholarPubMed
8.Lewczyk, CM, Garland, AF, Hurlburt, MS, Gearity, J, Hough, RL. Comparing DISC-IV and clinician diagnoses among youths receiving public mental health services. J Am Acad Child Adol Psychiat 2003; 42: 349356.CrossRefGoogle ScholarPubMed
9.Essau, C. Comorbidity of depressive disorders among adolescents in community and clinical settings. Psychiatry Res 2008; 158: 3542.CrossRefGoogle ScholarPubMed
10.Karlsson, L, Pelkonen, M, Ruuttu, Tet al.Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders. Eur Child Adol Psychiat 2006; 15: 220231.CrossRefGoogle ScholarPubMed
11.Central Statistics Office Ireland, 2006.Google Scholar
12.Benway, CB, Hamrin, V, McMahon, TJ. Initial appointment nonattendance in child and family mental health clinics. Am J Orthopsychiatry 2003; 73(4): 419428.CrossRefGoogle ScholarPubMed
13.McKay, M, Pennington, J, Lynn, C, McCadam, K. Understanding urban child mental health services use: Two studies of child, family and environmental correlates. J Behav Health Serv Res 2001; 28(4): 475483.CrossRefGoogle ScholarPubMed
14.Cottrell, D, Hill, P, Walk, D, Dearnaley, J, Ierotheou, A. Factors influencing non-attendance at child psychiatry outpatient appointments. Br J Psychiatry 1988; 152: 201204.CrossRefGoogle Scholar
15.Piacentini, J, Rotheram-Borus, MJ, Gillis, JRet al.Demographic predictors of treatment attendance among adolescent suicide attempters. J Consult Clin Psychol 1995; 63: 469473.CrossRefGoogle ScholarPubMed
16.Kaufman, J, Birmaher, B, Brent, D, Rao, U, Ryan, N. Kiddie-SADS-present and lifetime version (K-SADS-PL). School of Medicine, University of Pittsburgh: Unpublished instrument, 1996.Google Scholar
17.Kaufman, J, Birmaher, B, Brent, Det al.Schedule for affective disorders and schizophrenia for school-aged children – present and lifetime (K-SADS-PL): Initial reliability and validity data. J Am Acad Child Adol Psychiat 1997; 36: 980988.CrossRefGoogle Scholar
18.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: American Psychiatric Association, 1994.Google Scholar
19.Lauth, B, Levy, S, Juliusdottir, G, Ferrari, P, Petursson, H. Implementing the semi-structured interview Kiddie-SADS-PL into an inpatient adolescent clinical setting: Impact on frequency of diagnoses. Child Adol Psychiat Ment Health 2008; 2: 1424.CrossRefGoogle ScholarPubMed
20.Guy, W. Assessment manual for psychopharmacology. 2nd ed. Washington DC: US Government Printing Office, 1976.Google Scholar
21.Shaffer, D, Gould, MS, Brasic, Jet al.A children's global assessment scale (CGAS). Arch Gen Psychiat 1983; 40: 12281231.CrossRefGoogle ScholarPubMed
22.Census of Population. The Irish Social Class Scale. Dublin: Government Publications, 1996; 6.Google Scholar
23.Goodyer, I, Dubicka, B, Wilkinson, Pet al.SSRIs and routine specialist care with and without CBT in adolescents with major depression: randomised controlled trial. BMJ 2007; 335: 142149.CrossRefGoogle ScholarPubMed
24.Roongpraiwan, R, Sewell, J, Mathai, J. Comparison of mental health symptoms between children attending developmental/behavioural paediatric clinics and child and adolescent mental health service. J Paediatr Child Health 2007; 43: 122126.CrossRefGoogle ScholarPubMed
25.Cleary, A, Fitzgerald, M, Nixon, E. From Child to Adult: A longitudinal study of Irish children and their families. Dublin: Department of Social Protection, 2004.Google Scholar
26.Silverman, WK, Pina, AA, Viswesvaran, C. Evidence based psychosocial treatments for phobic and anxiety disorders in children and adolescents: a review and metaanalyses. J Clin Child Adol Psychol 2008; 37: 105130.CrossRefGoogle Scholar
27.March, J, Silva, S, Petrycki, Set al.Fluoextine, cognitive-behavioural therapy, and their combination for adolescents with depression: treatment for adolescents with depression study (TADS) randomized controlled trial. JAMA 2004; 292: 807882.Google ScholarPubMed