Changes in child and adolescent inpatient psychiatric admission diagnoses between 1995 and 2000.
ABSTRACT This study examined changes in the prevalence of psychiatric diagnoses at admission among children and adolescents treated for mental health problems in psychiatric inpatient settings between 1995 and 2000. Using a large, nationwide database (MarketScan) of private health insurance claims, our sample consisted of 5,346 children under the age of 18 who received psychiatric inpatient services, out of a total of 1,723,681 covered children. Odds ratios were used to measure changes in the prevalence of specific mental health disorders between 1995 and 2000. The study identified several significant changes, most notably, that the proportion of hospitalized children treated for bipolar or eating disorder doubled between 1995 and 2000. Significant decreases were observed for adjustment, anxiety, oppositional, and substance abuse disorders. This study lends support to recent concerns that the prevalence of bipolar disorder among the youth is increasing. Further research is needed to identify the underlying reasons for these observed changes.
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ABSTRACT: The study compared the psychiatric symptoms, coping skills, and family functioning of adolescent psychiatric inpatients and their primary caretakers with a non-clinical comparison group of adolescents and their primary caretakers. Participants completed measures of psychiatric symptoms, life experiences, problem-solving ability, family functioning, and anger. MANOVAs compared the adolescents and caretakers across the normative and clinical samples. A discriminate function analysis predicted membership in the clinical and non-clinical sample. Primary caretakers for the hospitalized adolescents reported significant differences in self-reported family functioning, life stress, psychiatric symptoms, and ratings of adolescent problem behaviors. These variables successfully classified 78% of the sample as inpatient or non-clinical comparison subjects. Adolescents hospitalized for psychiatric reasons did not differ from their non-clinical counterparts on self-report measures of psychiatric symptoms, distress, problem behaviors, problem solving, or trait anger. Independent of psychiatric status, adolescent self-reported family functioning and adolescent problem solving skills predicted the number of problems adolescents endorsed, the number of symptoms adolescents endorsed, and adolescent levels of trait anger. Although a brief psychiatric hospitalization seemed effective in treating adolescent mental health patients, the primary caretakers remained more symptomatic than a non-clinical cohort. Continuing to focus on the development of health care policies that are sensitive to needs of the primary caretakers will likely enhance long-term outcomes.International journal of adolescent medicine and health 01/2008; 20(4):405-18. DOI:10.1515/IJAMH.2008.20.4.405
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ABSTRACT: Over the years since the inception of clinical psychology, the role of the clinical psychologist has evolved tremendously. Clinical psychology has grown from a profession that in many aspects was founded within a medical model of treatment, and de facto, relegated to a subservient role in the treatment of persons with mental health disorders. Over the decades, since the formal beginnings of clinical psychology, the role of the clinical psychologist has gained in credibility, scope, and autonomy of practice. In recent decades, the role of clinical psychology in relation to pharmacological treatments has grown – albeit with much debate and little clarity as to what role clinical psychologists should play in the pharmacological treatment of persons with mental health disorders (Gutierrez & Silk, 1998). This chapter presents a model for clinical psychologists with phasmacological training in the supervision of mental health practitioners with phasmacological training.