Regional Centre 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, Trondheim, Norway.
Department of Children and Youth, Clinic of Mental Health Care, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.
BMC Psychiatry. 2021 Aug 19;21(1):411. doi: 10.1186/s12888-021-03417-6.
We aimed to examine symptom load in a clinical adolescent population at three-year follow-up and explore associations with standard care treatment procedures and resilience factors upon first presenting at Child and Adolescent Mental Health Services.
This study is part of a prospective longitudinal cohort study: The Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. A clinical population of 717 (43.5% of eligible) adolescents aged 13-18 years participated in the first study visit (T, 2009-2011). Of these, 447 adolescents with psychiatric disorders, with treatment history from medical records and self-reported resilience factors (Resilience Scale for Adolescents; READ) at T, reported symptom load (Achenbach System of Empirically Based Assessment - Youth Self Report; YSR) three years later aged 16-21 years (T).
At T, 93.0% received individual treatment. The frequency of psychotherapy and medication varied by disorder group and between genders. Overall, psychotherapy was more frequent among girls, whereas medication was more common among boys. Total READ mean value (overall 3.5, SD 0.8), ranged from patients with mood disorders (3.0, SD 0.7) to patients with Attention Deficit Hyperactivity disorder (3.7, SD 0.7), and was lower for girls than boys in all diagnostic groups. At T, the YSR Total Problem mean T-score ranged across the diagnostic groups (48.7, SD 24.0 to 62.7, SD 30.2), with highest symptom scores for those with mood disorders at T, of whom 48.6% had T-scores in the borderline/clinical range (≥60) three years later. Number of psychotherapy sessions was positively associated and Total READ score was negatively associated with the YSR Total Problems T-score (regression coefficient β = 0.5, CI (0.3 to 0.7), p < 0.001 and β = - 15.7, CI (- 19.2 to - 12.1), p < 0.001, respectively). The subscale Personal Competence was associated with the lowest Total Problem score for both genders.
Self-reported symptom load was substantial after three years, despite comprehensive treatment procedures. Higher self-reported resilience characteristics were associated with lower symptom load after three years. These results highlight the burden of adolescent psychiatric disorders, the need for extensive interventions and the importance of resilience factors for a positive outcome.
我们旨在研究三年随访时临床青少年人群的症状负荷，并探讨其与标准护理治疗程序以及首次就诊于儿童和青少年心理健康服务时的适应力因素之间的关系。
本研究为一项前瞻性纵向队列研究：挪威圣奥拉夫医院儿童和青少年健康调查。共有 717 名（符合条件者的 43.5%）年龄在 13-18 岁的青少年参加了第一次研究访问（T 期，2009-2011 年）。其中，447 名患有精神障碍的青少年在 T 期有医疗记录中的治疗史和自我报告的适应力因素（青少年适应力量表；READ），在 16-21 岁（T 期）时报告了症状负荷（Achenbach 系统经验性评估量表-青少年自评量表；YSR）。
T 期时，93.0%的患者接受了个体治疗。心理治疗和药物治疗的频率因疾病组和性别而异。总体而言，女孩接受心理治疗的频率更高，而男孩接受药物治疗的频率更高。总体 READ 平均值（整体为 3.5，标准差 0.8），从情绪障碍患者（3.0，标准差 0.7）到注意力缺陷多动障碍患者（3.7，标准差 0.7），且所有诊断组中女孩的分数均低于男孩。T 期时，YSR 总分均值 T 分数分布在各诊断组之间（48.7，标准差 24.0 至 62.7，标准差 30.2），情绪障碍患者的症状评分最高，其中 48.6%的患者 T 分数处于边缘/临床范围（≥60），三年后。心理治疗次数与 YSR 总分问题 T 分数呈正相关，而总 READ 分数与 YSR 总分问题 T 分数呈负相关（回归系数β=0.5，CI（0.3 至 0.7），p<0.001和β=−15.7，CI（−19.2 至−12.1），p<0.001）。对于两性，个人能力亚量表与总分问题的最低分数相关。
尽管进行了全面的治疗程序，但三年后自我报告的症状负荷仍然很大。较高的自我报告适应力特征与三年后较低的症状负荷相关。这些结果突出了青少年精神障碍的负担，需要广泛的干预措施，以及适应力因素对积极结果的重要性。
