King C A, Hovey J D, Brand E, Ghaziuddin N
Department of Psychiatry, University of Michigan, Ann Arbor, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Oct;36(10):1434-42. doi: 10.1097/00004583-199710000-00026.
To identify individual, parent/family, and treatment follow-through predictors of outcome for adolescent psychiatric inpatients 6 months after hospital discharge.
Eighty-nine adolescents participated in a comprehensive baseline evaluation during psychiatric hospitalization. Baseline measures included the Diagnostic Interview Schedule for Children, Social Adjustment Inventory for Children and Adolescents, Reynolds Adolescent Depression Scale (RADS), and Suicidal Ideation Questionnaire-Junior (SIQ-Jr). Structured telephone follow-up interviews assessed treatment follow-through, suicidal behaviors, rehospitalizations, living changes, and social adaptive functioning. The RADS and SIQ-Jr were also readministered.
Baseline indices of adolescent functioning emerged as the strongest predictors of outcomes. Hierarchical multiple regression analyses indicated that baseline depression severity, a cluster of parent/family indices, and medication follow-through were significant predictors of outcome depression severity. Baseline social adaptive functioning, presence/absence of conduct disorder, and medication follow-through were significant predictors of outcome social adaptive functioning.
The nature and course of adolescent psychopathology was difficult to disrupt, with baseline characteristics as the strongest predictors of outcome. Nevertheless, the significance of medication follow-through as a predictor suggests that treatment-related gains are possible.
确定青少年精神科住院患者出院6个月后结局的个体、父母/家庭及治疗依从性预测因素。
89名青少年在精神科住院期间参与了全面的基线评估。基线测量包括儿童诊断访谈量表、儿童及青少年社会适应量表、雷诺兹青少年抑郁量表（RADS）和青少年自杀观念问卷（SIQ-Jr）。通过结构化电话随访访谈评估治疗依从性、自杀行为、再次住院情况、生活变化及社会适应功能。RADS和SIQ-Jr也再次进行了施测。
青少年功能的基线指标是结局的最强预测因素。分层多元回归分析表明，基线抑郁严重程度、一组父母/家庭指标及药物治疗依从性是结局抑郁严重程度的显著预测因素。基线社会适应功能、是否存在品行障碍及药物治疗依从性是结局社会适应功能的显著预测因素。
青少年精神病理学的性质和病程难以改变，基线特征是结局的最强预测因素。然而，药物治疗依从性作为预测因素的重要性表明与治疗相关的改善是可能的。
