Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, MTFS, Pb. 8905, 7491, Trondheim, Norway.
Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Elgeseter, Postboks 6810, 7433, Trondheim, Norway.
Qual Life Res. 2019 Sep;28(9):2443-2452. doi: 10.1007/s11136-019-02197-7. Epub 2019 May 10.
To investigate, in adolescents referred for psychiatric services, the associations of initial self-esteem and family functioning with level and change of quality of life (QoL) over a 3-year period, over and above the effect of their emotional problems.
Of 1648 eligible 13-18 years old patients attending the child and adolescent psychiatric clinic (CAP) at least once, 717 (54.8% females) were enrolled at baseline (a response rate of 43.5%). Self- and parent reports on the McMaster Family Assessment Device were obtained. Adolescents reported self-esteem on the Rosenberg Scale, and emotional problems on the Symptom Check List-5. Adolescents completed the Inventory of Life Quality in Children and Adolescents (ILC). After 3 years, 570 adolescents again completed the ILC, and for 418 adolescents parent information was available. The longitudinal analysis sample of 418 adolescents was representative of the baseline sample for age, gender, emotional problems, and QoL. We used modified growth-model analysis, adjusted for SES, age, gender and time of contact with CAP, where residual variances for ILC at baseline and follow-up were fixed to 0.
A poorer family functioning at baseline, reported by parents, was significantly associated with worsening QoL during the 3 years follow-up period (p = 0.001).
Parents have important knowledge about their families that may reflect long-term influences on QoL development in adolescent psychiatric patients. Health care providers and policy makers should optimize treatment outcomes by addressing family functioning in adolescents with emotional problems.
在接受精神科服务的青少年中，调查初始自尊和家庭功能与 3 年内生活质量（QoL）水平和变化的关系，超过其情绪问题的影响。
在至少一次参加儿童和青少年精神病诊所（CAP）的 1648 名合格的 13-18 岁患者中，有 717 名（54.8%为女性）在基线时入组（响应率为 43.5%）。通过麦克马斯特家庭评估工具获得自我和父母报告。青少年使用罗森伯格量表报告自尊，使用症状检查表-5 报告情绪问题。青少年完成儿童和青少年生活质量量表（ILC）。3 年后，570 名青少年再次完成 ILC，418 名青少年的父母信息可用。418 名青少年的纵向分析样本在年龄、性别、情绪问题和 QoL 方面与基线样本具有代表性。我们使用修正的增长模型分析，调整了 SES、年龄、性别和与 CAP 的接触时间，其中 ILC 在基线和随访时的剩余方差固定为 0。
基线时父母报告的较差家庭功能与 3 年随访期间 QoL 恶化显著相关（p=0.001）。
父母对其家庭有重要的了解，这可能反映了青少年精神科患者 QoL 发展的长期影响。医疗保健提供者和政策制定者应通过解决有情绪问题的青少年的家庭功能来优化治疗效果。
