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评估一个为长期患有身体疾病的儿童和青少年及其家庭提供简短跨诊断心理评估和治疗的心理健康随时咨询中心:一项单臂、开放、非随机试验。

Evaluation of a mental health drop-in centre offering brief transdiagnostic psychological assessment and treatment for children and adolescents with long-term physical conditions and their families: a single-arm, open, non-randomised trial.

机构信息

UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

出版信息

Evid Based Ment Health. 2021 Feb;24(1):25-32. doi: 10.1136/ebmental-2020-300197. Epub 2020 Nov 26.

Abstract

BACKGROUND

Children and young people with long-term physical conditions have significantly elevated mental health needs. Transdiagnostic, brief psychological interventions have the potential to increase access to evidence-based psychological treatments for patients who attend health services primarily for physical health needs.

OBJECTIVE

A non-randomised study was conducted to assess the impact of brief, transdiagnostic psychological interventions in children and young people presenting at a drop-in mental health centre in the reception area of a paediatric hospital.

METHODS

186 participants attending a transdiagnostic mental health drop-in centre were allocated to assessment and psychological intervention based on a clinical decision-making algorithm. Interventions included signposting, guided self-help based on a modular psychological treatment and referral to the hospital's paediatric psychology service. The primary transdiagnostic mental health outcome measure was the parent-reported Strengths and Difficulties Questionnaire (SDQ), which was given at baseline and 6 months post-baseline.

FINDINGS

There was a significant positive impact of attending the drop-in mental health centre on the SDQ (Cohen's d=0.22) and on the secondary outcome measure of Paediatric Quality of life (Cohen's d=0.55).

CONCLUSIONS

A mental health drop-in centre offering brief, transdiagnostic assessment and treatment may reduce emotional and behavioural symptoms and improve quality of life in children and young people with mental health needs in the context of long-term physical conditions. A randomised controlled trial to investigate the specificity of any effects is warranted.

CLINICAL IMPLICATIONS

Drop-in centres for mental health needs may increase access and have beneficial effects for children and young people with physical conditions.

摘要

背景

患有长期身体疾病的儿童和青少年的心理健康需求明显较高。针对多种病症的简短心理干预措施有可能增加那些主要因身体健康需求而就诊于卫生服务机构的患者获得基于证据的心理治疗的机会。

目的

本非随机研究旨在评估在一家儿童医院接待区的心理健康随诊中心接受简短、跨诊断心理干预对儿童和青少年的影响。

方法

根据临床决策算法,为参加跨诊断心理健康随诊中心的 186 名参与者分配评估和心理干预。干预措施包括转介、基于模块化心理治疗的指导自助以及转至医院的儿科心理学服务。主要的跨诊断心理健康结果测量指标是家长报告的长处与困难问卷(SDQ),该问卷在基线和基线后 6 个月进行评估。

结果

参加心理健康随诊中心对 SDQ(Cohen's d=0.22)和次要结果测量指标儿科生活质量(Cohen's d=0.55)有显著的积极影响。

结论

提供简短、跨诊断评估和治疗的心理健康随诊中心可能会减轻有心理健康需求的患有长期身体疾病的儿童和青少年的情绪和行为症状,并改善其生活质量。有必要进行一项随机对照试验来调查任何效果的特异性。

临床意义

针对心理健康需求的随诊中心可能会增加机会,并对患有身体疾病的儿童和青少年产生有益的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5268/10231601/3b6dece1a4a0/ebmental-2020-300197f01.jpg

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