Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs / Jonathan GREEN in Journal of Child Psychology and Psychiatry, 48-12 (December 2007)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1259–1267 Titre : Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs Type de document : Texte imprimé et/ou numérique Auteurs : Jonathan GREEN, Auteur ; Jennifer BEECHAM, Auteur ; Brian JACOBS, Auteur ; Graham DUNN, Auteur ; Leo KROLL, Auteur ; Catherine TOBIAS, Auteur ; Jackie BRISKMAN, Auteur Année de publication : 2007 Article en page(s) : p.1259–1267 Langues : Anglais (eng) Mots-clés : Child adolescent psychiatry inpatient outcomes costs Index. décimale : PER Périodiques Résumé : Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results: We found a significant (p < .001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size .92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size .27). Health needs assessment showed similar gain (p < .001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was £24,100; pre-admission and post-discharge support costs were similar. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01802.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=310 [article] Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs [Texte imprimé et/ou numérique] / Jonathan GREEN, Auteur ; Jennifer BEECHAM, Auteur ; Brian JACOBS, Auteur ; Graham DUNN, Auteur ; Leo KROLL, Auteur ; Catherine TOBIAS, Auteur ; Jackie BRISKMAN, Auteur . - 2007 . - p.1259–1267. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1259–1267 Mots-clés : Child adolescent psychiatry inpatient outcomes costs Index. décimale : PER Périodiques Résumé : Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results: We found a significant (p < .001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size .92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size .27). Health needs assessment showed similar gain (p < .001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was £24,100; pre-admission and post-discharge support costs were similar. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01802.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=310

Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: the SPOKES project / Stephen SCOTT in Journal of Child Psychology and Psychiatry, 51-1 (January 2010)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 51-1 (January 2010) . - p.48-57 Titre : Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: the SPOKES project Type de document : Texte imprimé et/ou numérique Auteurs : Stephen SCOTT, Auteur ; Sabine LANDAU, Auteur ; Brian JACOBS, Auteur ; Kathy SYLVA, Auteur ; Moira DOOLAN, Auteur ; Jenny PRICE, Auteur ; Carolyn CROOK, Auteur Année de publication : 2010 Article en page(s) : p.48-57 Langues : Anglais (eng) Mots-clés : Aggression antisocial-behaviour parent-training prevention randomised-trial Index. décimale : PER Périodiques Résumé : Background: There is a pressing need for cost-effective population-based interventions to tackle early-onset antisocial behaviour. As this is determined by many factors, it would seem logical to devise interventions that address several influences while using an efficient means of delivery. The aim of this trial was to change four risk factors that predict poor outcome: ineffective parenting, conduct problems, attention deficit/hyperactivity disorder (ADHD) symptoms, and low reading ability. Methods: A randomised controlled trial was carried out in eight schools in London, England. Nine hundred and thirty-six (936) 6-year-old children were screened for antisocial behaviour, then parents of 112 high scorers were randomised to parenting groups held in schools or control; 109 were followed up a year later. The intervention lasted 28 weeks and was novel as it had components to address both child behaviour (through the Incredible Years programme) and child literacy (through a new 'SPOKES' programme to help parents read with their children). Fidelity of implementation was emphasised by careful training of therapists and weekly supervision. Controls received an information helpline. Assessment of conduct problems was by parent interview, parenting by direct observation and child reading by psychometric testing. Results: At follow-up parents allocated to the intervention used play, praise and rewards, and time out more often than controls, and harsh discipline less; effect sizes ranged from .31 to .59 sd (p-values .046 to .005). Compared to control children, whose behaviour didn't change, intervention children's conduct problems reduced by .52sd, (p < .001), dropping from the 80th to the 61st percentile; oppositional-defiant disorder (ODD) halved from 60% to 31% (p = .003). ADHD symptoms reduced by .44sd (p = .002), and reading age improved by six months (.36sd, p = .027). Teacher-rated behaviour didn't change. The programme cost £2,380 ($3,800) per child. Conclusions: Effective population-based early intervention to improve the functioning of with antisocial behaviour is practically feasible by targeting multiple risk factors and emphasising implementation fidelity. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02127.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=939 [article] Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: the SPOKES project [Texte imprimé et/ou numérique] / Stephen SCOTT, Auteur ; Sabine LANDAU, Auteur ; Brian JACOBS, Auteur ; Kathy SYLVA, Auteur ; Moira DOOLAN, Auteur ; Jenny PRICE, Auteur ; Carolyn CROOK, Auteur . - 2010 . - p.48-57. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 51-1 (January 2010) . - p.48-57 Mots-clés : Aggression antisocial-behaviour parent-training prevention randomised-trial Index. décimale : PER Périodiques Résumé : Background: There is a pressing need for cost-effective population-based interventions to tackle early-onset antisocial behaviour. As this is determined by many factors, it would seem logical to devise interventions that address several influences while using an efficient means of delivery. The aim of this trial was to change four risk factors that predict poor outcome: ineffective parenting, conduct problems, attention deficit/hyperactivity disorder (ADHD) symptoms, and low reading ability. Methods: A randomised controlled trial was carried out in eight schools in London, England. Nine hundred and thirty-six (936) 6-year-old children were screened for antisocial behaviour, then parents of 112 high scorers were randomised to parenting groups held in schools or control; 109 were followed up a year later. The intervention lasted 28 weeks and was novel as it had components to address both child behaviour (through the Incredible Years programme) and child literacy (through a new 'SPOKES' programme to help parents read with their children). Fidelity of implementation was emphasised by careful training of therapists and weekly supervision. Controls received an information helpline. Assessment of conduct problems was by parent interview, parenting by direct observation and child reading by psychometric testing. Results: At follow-up parents allocated to the intervention used play, praise and rewards, and time out more often than controls, and harsh discipline less; effect sizes ranged from .31 to .59 sd (p-values .046 to .005). Compared to control children, whose behaviour didn't change, intervention children's conduct problems reduced by .52sd, (p < .001), dropping from the 80th to the 61st percentile; oppositional-defiant disorder (ODD) halved from 60% to 31% (p = .003). ADHD symptoms reduced by .44sd (p = .002), and reading age improved by six months (.36sd, p = .027). Teacher-rated behaviour didn't change. The programme cost £2,380 ($3,800) per child. Conclusions: Effective population-based early intervention to improve the functioning of with antisocial behaviour is practically feasible by targeting multiple risk factors and emphasising implementation fidelity. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02127.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=939

The effect of inpatient care on measured Health Needs in children and adolescents / Brian JACOBS in Journal of Child Psychology and Psychiatry, 50-10 (October 2009)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 50-10 (October 2009) . - p.1273-1281 Titre : The effect of inpatient care on measured Health Needs in children and adolescents Type de document : Texte imprimé et/ou numérique Auteurs : Brian JACOBS, Auteur ; Jonathan GREEN, Auteur ; Graham DUNN, Auteur ; Catherine TOBIAS, Auteur ; Jacqueline A. BRISKMAN, Auteur ; Leopold KROLL, Auteur Année de publication : 2009 Article en page(s) : p.1273-1281 Langues : Anglais (eng) Mots-clés : Inpatient needs child adolescent outcome Index. décimale : PER Périodiques Résumé : Background: The concept of 'health need' relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured 'Health Needs' in children and adolescents admitted to UK inpatient units. Methods: A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. Results: Total patient 'Cardinal Problems' reduced highly significantly (p < .001) from 8.5 at admission to 5.7 at discharge (effect size .81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of 'Health Needs' increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. Conclusions: Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02093.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=838 [article] The effect of inpatient care on measured Health Needs in children and adolescents [Texte imprimé et/ou numérique] / Brian JACOBS, Auteur ; Jonathan GREEN, Auteur ; Graham DUNN, Auteur ; Catherine TOBIAS, Auteur ; Jacqueline A. BRISKMAN, Auteur ; Leopold KROLL, Auteur . - 2009 . - p.1273-1281. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 50-10 (October 2009) . - p.1273-1281 Mots-clés : Inpatient needs child adolescent outcome Index. décimale : PER Périodiques Résumé : Background: The concept of 'health need' relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured 'Health Needs' in children and adolescents admitted to UK inpatient units. Methods: A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. Results: Total patient 'Cardinal Problems' reduced highly significantly (p < .001) from 8.5 at admission to 5.7 at discharge (effect size .81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of 'Health Needs' increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. Conclusions: Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02093.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=838

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