Evaluating outcomes of the child and adolescent psychiatric unit: A prospective study

The attending psychiatrist used the Children's Global Assessment Scale (CGAS) to assess youths at admission to and discharge from a child and adolescent psychiatric unit in Japan(N = 126, mean age = 12.8, SD = 1.9). Hospital records gathered sociodemographic and clinical variables. In addition, youths and their primary caregivers assessed themselves using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), respectively. Longitudinal analyses compared each scales' baseline and discharge scores. We also examined factors associated with changes in functioning (CGAS).Longitudinal comparisons revealed that CGAS, CBCL and YSR scores showed improvement over time (CGAS: t = -14.40, p = 0.00; CBCL: t = 3.80, p = 0.00; YSR: t = 2.40, p = 0.02). Linear regressions determined that the factors associated with improvement in CGAS included age, lower CGAS scores at admission, frequency of group therapy and psychiatric diagnosis.This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement.In Japan, youth mental health is a serious issue. Press reports are increasing regarding youth problem behaviors such as sensational crimes, increases in school refusal and social withdrawal, group suicides and self-harming behaviors. Children with psychiatric disorders are responsible for some, but not all, problematic behaviors in society. In a review of epidemiological studies, Roberts et al. reported that as many as one in five children and adolescents have a diagnosable mental disorder [1]. There are no empirical data of the prevalence of psychiatric disorder in child and adolescent in Japan. The national survey estimates, however, that the ratio of child with diagnosable mental disorder seen at outpatient setting has more than doubled in 12 years (from 85 per 10,000 children under 15 years old in 1996 to 182 in 2008) [2].Among current mental disorder interventions for chil