Article
Prediction of Positive Outcomes for Adolescent Psychiatric Inpatients

https://doi.org/10.1097/00004583-199710000-00026Get rights and content

ABSTRACT

Objective

To identify individual, parent/family, and treatment follow-through predictors of outcome for adolescent psychiatric inpatients 6 months after hospital discharge.

Method

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.

Results

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.

Conclusions

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.

REFERENCES (28)

  • JT Barter et al.

    Adolescent suicide attempts: a follow-up study of hospitalized patients

    Arch Gen Psychiatry

    (1968)
  • EJ Costello et al.

    Validity of the NIMH Diagnostic Interview Schedule for Children: a comparison between psychiatric and pediatric referrals

    J Abnorm Child Psychol

    (1985)
  • LR Derogatis

    SCL-90 Manual-1

    (1977)
  • Emslie G (1995), A double-blind placebo-controlled study of fluoxetine in depressed children and adolescents. Presented...
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    The authors thank the multidisciplinary evaluation team of the Adolescent Psychiatry Inpatient Program for their assistance. Funding for this project was provided by the American Suicide Foundation.

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