User satisfaction in child and adolescent mental health service: Comparison of background, clinical and service predictors for adolescent and parent satisfaction

Background and Objective: To improve quality, child and adolescent mental health services (CAMHS) are expected to quantify families' views on healthcare with user satisfaction measures. As little is known about what influences satisfaction in CAMHS, this study aimed to examine predictors of adolescents' and parents' user satisfaction. Methods: Data from 231 adolescents and 495 parents in treatment at an outpatient clinic who returned a user satisfaction measure, the Experience of Service Questionnaire (ESQ), was analyzed. Registry data on background, clinical and service characteristics were predictors for the ESQ factors general satisfaction, satisfaction with care and satisfaction with environment. Results: In regression models, satisfaction with care for adolescents (r 2 = .12) was significant and was predicted by low parent‐self‐reported mental health burden and low clinician‐rated overall symptom burden at intake. For parents, regression models for general satisfaction (r 2 = .07), satisfaction with care (r 2 = .06) and satisfaction with environment (r 2 = .08) were significant. Parents general satisfaction was predicted by higher levels of hyperactivity, less family stress and longer travelling distances to the service. Satisfaction with care for parents was predicted by higher levels of hyperactivity at intake and longer travelling distances. Satisfaction with environment for parents was more likely if the adolescents was a boy, with low levels of family stress and longer travelling distances. Conclusion: Predictors for adolescent and parent user satisfaction in CAMHS differ. Hence, to improve quality CAMHS should enhance focus on collaborative practice with parents, and person‐centred care for adolescents with moderate to severe mental health illness. Patient or Public Contribution: Representatives from the hospitals' youth panel and the non‐governmental organization called The Change Factory have been consulted regarding study design and results

IQ as a moderator of outcome in severity of children's mental health status after treatment in outpatient clinics

Psychotherapy is an effective treatment for mental health disorders, but even with the most efficacious treatment, many patients do not experience improvement. Moderator analysis can identify the conditions under which treatment is effective or whether there are factors that can attenuate the effects of treatment. In this study, linear mixed model analysis was used to examine whether the Full Scale IQ (FSIQ), Performance IQ (PIQ) and Verbal IQ (VIQ) on the Wechsler Intelligence Scale for Children – Third Edition, moderated outcomes in general functioning and symptom load. A total of 132 patients treated at three outpatient child and adolescent mental health services (CAMHS) were assessed at three different time points. The Children’s Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were used to measure the severity of impairments in general functioning and symptom load. IQ was assessed at the start of treatment. Moderator analysis revealed that the FSIQ × time interaction predicted changes in CGAS scores (p < .01), and that the PIQ × time interaction predicted changes in HoNOSCA scores (p < .05). The slopes and intercepts in HoNOSCA scores covaried negatively and significantly (p < .05). The same pattern was not detected for the CGAS scores (p = .08). FISQ and PIQ moderated change in general functioning and symptom load, respectively. This implies that patients with higher IQ scores had a steeper improvement slope than those with lower scores. The patients with the highest initial symptom loads showed the greatest improvement, this pattern was not found in the improvement of general functioning

Agreement on Web-based Diagnoses and Severity of Mental Health Problems in Norwegian Child and Adolescent Mental Health Services

Objective: This study examined the agreement between diagnoses and severity ratings assigned by clinicians using a structured web-based interview within a child and adolescent mental health outpatient setting. Method: Information on 100 youths was obtained from multiple informants through a web-based Development and Well-Being Assessment (DAWBA). Based on this information, four experienced clinicians independently diagnosed (according to the International Classification of Diseases Revision 10) and rated the severity of mental health problems according to the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (C-GAS). Results: Agreement for diagnosis was κ=0.69-0.82. Intra-class correlation for single measures was 0.78 for HoNOSCA and 0.74 for C-GAS, and 0.93 and 0.92, respectively for average measures. Conclusions: Agreement was good to excellent for all diagnostic categories. Agreement for severity was moderate, but improved to substantial when the average of the ratings given by all clinicians was considered. Therefore, we conclude that experienced clinicians can assign reliable diagnoses and assess severity based on DAWBA data collected online

IQ as a Predictor and Moderator of Children’s Mental Health Status

Paper 2 of the thesis is not available in Munin due to publisher's restrictions: 2. Mathiassen, B., Brøndbo, P. H., Waterloo, K., Martinussen. M., Eriksen, M., Hanssen-Bauer, K., & Kvernmo, S. (2012). IQ as a predictor of cliniciac-rated mental health problems in children and adolescents. British Journal of Clinical Psychology. 51, 185-195. Available at http://dx.doi.org/10.1111/j.2044-8260.2011.02023.

Vurderingssamtaler – en gyllen mulighet for tillit og håp

Source at https://www.dagensmedisin.no/.Gjennom fokus på samvalg, mål og åpen dialog om hjelpebehov er vurderingssamtalen en gyllen mulighet for å skape tillit, engasjement og håp – og sikre at de kommer inn riktig dør til psykisk helsevern for barn og unge (PHBU)

Vurderingssamtaler – en gyllen mulighet for tillit og håp

Gjennom fokus på samvalg, mål og åpen dialog om hjelpebehov er vurderingssamtalen en gyllen mulighet for å skape tillit, engasjement og håp – og sikre at de kommer inn riktig dør til psykisk helsevern for barn og unge (PHBU)

The strengths and difficulties questionnaire as a screening instrument for norwegian child and adolescent mental health services, application of UK scoring algorithms

Background The use of screening instruments can reduce waiting lists and increase treatment capacity. The aim of this study was to examine the usefulness of the Strengths and Difficulties Questionnaire (SDQ) with the original UK scoring algorithms, when used as a screening instrument to detect mental health disorders among patients in the Norwegian Child and Adolescent Mental Health Services (CAMHS) North Study. Methods A total of 286 outpatients, aged 5 to 18 years, from the CAMHS North Study were assigned diagnoses based on a Development and Well-Being Assessment (DAWBA). The main diagnostic groups (emotional, hyperactivity, conduct and other disorders) were then compared to the SDQ scoring algorithms using two dichotomisation levels: 'possible' and 'probable' levels. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (ORD) were calculated. Results Sensitivity for the diagnostic categories included was 0.47-0.85 ('probable' dichotomisation level) and 0.81-1.00 ('possible' dichotomisation level). Specificity was 0.52-0.87 ('probable' level) and 0.24-0.58 ('possible' level). The discriminative ability, as measured by ORD, was in the interval for potentially useful tests for hyperactivity disorders and conduct disorders when dichotomised on the 'possible' level. Conclusions The usefulness of the SDQ UK-based scoring algorithms in detecting mental health disorders among patients in the CAMHS North Study is only partly supported in the present study. They seem best suited to identify children and adolescents who do not require further psychiatric evaluation, although this as well is problematic from a clinical point of view

Examining the psychometric properties of the Norwegian version of the Social Aptitudes Scale in two clinical samples

Abstract Background Few studies have examined the psychometric properties of the Social Aptitudes Scale (SAS). The study aims of the current paper were to examine the internal consistency and the validity of the Norwegian SAS. Methods Parents of children from a clinical neuropediatric sample (N = 257) and from a clinical sample from child and adolescent’s mental health services (N = 804) filled in the SAS. Results Internal consistency for the SAS were good in both samples and correlations between the SAS and different scales were in the expected directions. The results from the Confirmatory Factor Analyses indicated poor model fit. Conclusions Future validity studies should investigate whether SAS is suitable as a screening instrument for detecting autism spectrum disorder

Should Clinicians Split or Lump Psychiatric Symptoms?:The Structure of Psychopathology in Two Large Pediatric Clinical Samples from England and Norway

It has been suggested that the structure of psychiatric phenomena can be reduced to a few symptom dimensions. These proposals, mainly based on epidemiological samples, may not apply to clinical populations. We tested the structure of psychiatric symptoms across two pediatric clinical samples from England (N=8434) and Norway (N=5866). Confirmatory factor analyses of the parent-reported Strengths and Difficulties Questionnaire (SDQ) evaluated the relative fit of several models, including a first-order model, a second-order model with the widely-established broad symptom dimensions of internalizing-externalizing, and two bi-factor models capturing a general psychopathology factor. Predictive value of the SDQ subscales for psychiatric disorders was examined. A first-order five-factor solution better fit the data. The expected SDQ subscale(s) related best to the corresponding psychiatric diagnosis. In pediatric clinical samples, a granular approach to psychiatric symptoms where several dimensions are considered seems to fit the data better than models based on lumping symptoms into internalizing/externalizing dimensions