Serim Demirgoren Burcu, Ozbek Aylin, Gencer Ozlem
MD, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
J Int Med Res. 2017 Aug;45(4):1318-1323. doi: 10.1177/0300060517713833. Epub 2017 Jun 12.
Objective This study aimed to assess the correlates and predictors of improvement in general functioning of children and adolescents who are treated in the child and adolescent psychiatry (CAMHS) inpatient unit. Methods Hospital records of 308 children and adolescents who were treated for at least 1 month in the CAMHS inpatient unit from 2005-2016 were included. Associations with individual, familial, and clinical variables and the difference in Children's Global Assessment Scale (ΔCGAS) scores at admission and discharge were evaluated. Results Positive predictors of ΔCGAS were older age and lower CGAS scores at admission, whereas high familial risk scores at admission and diagnosis of early-onset schizophrenia negatively predicted ΔCGAS (B = 0.698, p = 0002; B = -0.620, p < 0.001; B = -0.842, p = 0.002; B =-9.184, p = 0.000, respectively). Familial risk scores were significantly and negatively correlated with ΔCGAS (p = 0.004, Spearman's rho = -0.2). Conclusions This study indicates that improvement in general functioning during inpatient treatment in CAMHS is better at an older age and with lower general functioning at admission. However, high familial risks and diagnosis of early-onset schizophrenia weakens this improvement.
目的 本研究旨在评估在儿童和青少年精神病学(CAMHS)住院部接受治疗的儿童和青少年总体功能改善的相关因素及预测指标。方法 纳入2005年至2016年期间在CAMHS住院部接受至少1个月治疗的308名儿童和青少年的医院记录。评估个体、家庭和临床变量与入院和出院时儿童总体评估量表(ΔCGAS)评分差异之间的关联。结果 ΔCGAS的正向预测指标为年龄较大和入院时CGAS评分较低,而入院时较高的家庭风险评分和早发性精神分裂症的诊断对ΔCGAS有负向预测作用(B = 0.698,p = 0.002;B = -0.620,p < 0.001;B = -0.842,p = 0.002;B = -9.184,p = 0.000)。家庭风险评分与ΔCGAS显著负相关(p = 0.004,Spearman等级相关系数rho = -0.2)。结论 本研究表明,CAMHS住院治疗期间总体功能的改善在年龄较大且入院时总体功能较低的情况下更好。然而,高家庭风险和早发性精神分裂症的诊断会削弱这种改善。