Walker Graham, Wilson Naomi, Allely Clare S, Thomson Allan, Smith Helen, Lang Jason
University of Glasgow, Scotland, UK.
NHS Scotland, Scotland, UK.
Eur Child Adolesc Psychiatry. 2025 Feb;34(2):519-533. doi: 10.1007/s00787-024-02514-7. Epub 2024 Aug 7.
Outcome measurement in child and adolescent forensic mental health services can support service improvement, research, and patient progress evaluation. This systematic review aimed to identify studies which validate structured instruments available for use as outcome measures in the child and adolescent forensic mental health service cohort and assess the quality of these studies.
A systematic review was conducted following PRISMA guidelines. Studies were identified by searching six online databases in November 2023. The quality and risk of bias of each study meeting inclusion criteria was independently assessed by two authors using the Crowe Critical Appraisal Tool. Results were synthesised narratively.
A total of eight studies were identified which met inclusion criteria. These looked at six instruments which primarily focused on outcome measures in the areas of treatment motivation, level of functioning, psychiatric symptoms, care needs and response to social situations. Papers scored between 17/40 and 30/40 on the Crowe Critical Appraisal Tool. Studies were rated as low (n = 1), moderate (n = 6), high (n = 1) or very high quality (n = 0).
Despite the large number of structured instruments potentially available, evidence for their use as outcome measures in child and adolescent forensic mental health services is limited. Future research should aim to validate current structured instruments for use in the forensic child and adolescent setting, with consideration of whether new instruments should be developed specifically for this group. Such instruments should be developed with both young people as service users and professionals who will be utilising the instrument in mind.
儿童和青少年法医精神卫生服务中的结果测量可支持服务改进、研究及患者进展评估。本系统评价旨在识别验证可用于儿童和青少年法医精神卫生服务队列作为结果测量工具的结构化工具的研究，并评估这些研究的质量。
按照PRISMA指南进行系统评价。通过检索2023年11月的六个在线数据库来识别研究。两名作者使用克罗伊批判性评价工具独立评估每项符合纳入标准的研究的质量和偏倚风险。结果采用叙述性综合。
共识别出八项符合纳入标准的研究。这些研究考察了六种工具，主要关注治疗动机、功能水平、精神症状、护理需求和对社交情境的反应等领域的结果测量。论文在克罗伊批判性评价工具上的得分在17/40至30/40之间。研究被评为低质量（n = 1）、中等质量（n = 6）、高质量（n = 1）或非常高质量（n = 0）。
尽管可能有大量结构化工具可用，但在儿童和青少年法医精神卫生服务中用作结果测量工具的证据有限。未来的研究应旨在验证当前在法医儿童和青少年环境中使用的结构化工具，同时考虑是否应专门为该群体开发新工具。此类工具的开发应兼顾作为服务使用者的年轻人和将使用该工具的专业人员。
