Department of Child and Adolescent Psychiatry, New York University School of Medicine, One Park Avenue at East 33rd, New York, NY 10016, USA.
J Am Acad Child Adolesc Psychiatry. 2012 Dec;51(12):1241-1260.e2. doi: 10.1016/j.jaac.2012.09.004.
Child mental health treatment and services research yields more immediate public health benefit when they focus on outcomes of relevance to a broader group of stakeholders. We reviewed all experimental studies of child and adolescent treatment and service effectiveness published in the last 15 years (1996-2011) and compared the distribution and types of outcome domains to a prior review that focused on studies from the prior 15 years (1980-1995).
Studies were included if they focused on children from birth to 18 years of age with specific or general psychiatric conditions, employed randomized designs, and examined intervention effects with a six-month or longer post-treatment assessment in treatment studies or a 6-month or longer post-baseline assessment for services studies. Two hundred (n=200) studies met criteria. Reported outcome measures were coded into conceptual categories drawn from the 1980-1995 review.
There was a five-fold increase in the total number of studies (38 versus 200) across the two 15-year time periods, with the largest increase in the number of studies that focused on consumer-oriented outcomes (from eight to 47 studies, an almost sixfold increase); two new domains, parent symptoms and health-related outcomes, were identified. The majority of studies (more than 95%) continued to focus on symptoms and diagnoses as an outcome. Impact ratings were higher among studies examining four or more outcomes versus one to two outcomes in all categories with the exception of Posttraumatic Stress Disorder.
Given major shifts in health care policy affecting mental health services, the emergence of health and parent-related outcomes as well as greater attention to consumer perspectives parallels emerging priorities in health care and can enhance the relevance of child outcome studies for implementation in the real world.
当儿童心理健康治疗和服务研究侧重于更广泛的利益相关者相关的结果时，会产生更直接的公共卫生效益。我们回顾了过去 15 年（1996-2011 年）发表的所有关于儿童和青少年治疗和服务效果的实验研究，并将结果领域的分布和类型与之前的一项研究进行了比较，该研究重点关注前 15 年（1980-1995 年）的研究。
如果研究侧重于特定或一般精神疾病的 0 至 18 岁儿童，采用随机设计，并在治疗研究中进行了 6 个月或更长时间的治疗后评估，或在服务研究中进行了 6 个月或更长时间的基线后评估，研究则符合纳入标准。共有 200 项研究符合标准。报告的结果测量指标被编码为从 1980-1995 年的研究中得出的概念类别。
在两个 15 年期间，研究总数（从 38 项增加到 200 项）增加了五倍，其中以消费者为导向的结果（从 8 项增加到 47 项，几乎增加了六倍）的研究数量增加最多；确定了两个新的领域，即父母症状和与健康相关的结果。大多数研究（超过 95%）继续将症状和诊断作为结果。在所有类别中，与 PTSD 相比，评估四个或更多结果的研究的影响评分高于评估一到两个结果的研究。
鉴于影响精神卫生服务的医疗保健政策的重大转变，健康和父母相关结果的出现以及对消费者观点的更多关注与医疗保健中的新重点相一致，并可以提高儿童结果研究在现实世界中的相关性。
