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The value of measuring impact alongside symptoms in children and adolescents: a longitudinal assessment in a community sample.

Stringaris A, Goodman R - J Abnorm Child Psychol (2013)

Bottom Line: Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline.Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders.More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, PO 85, Denmark Hill, London, SE5 8AF, UK. argyris.stringaris@kcl.ac.uk

ABSTRACT
The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n = 4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR = 2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR = 1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.

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Related in: MedlinePlus

The association between mean impact and adverse outcomes by reporting source. Standardized (Cohen’s d) mean scores for impact are presented on the y axis
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Fig1: The association between mean impact and adverse outcomes by reporting source. Standardized (Cohen’s d) mean scores for impact are presented on the y axis

Mentions: As shown in Fig. 1, impact, as rated by any informant, was higher in those who had experienced contact with psychiatric services, self harm, truancy and contact with police compared with those who had not experienced such outcomes. Table 3 presents the odds ratios of the association between each of these outcomes and impact. As can be seen, impact rated by any of the three informants was a significant predictor of psychiatric service use, even after adjustment for baseline total SDQ score. However, neither teacher- nor self-report were significant predictors of self harm after adjustment for baseline symptoms. Similarly, neither parent- nor teacher-report was significantly associated with police contact once adjusted for baseline symptoms.Fig. 1


The value of measuring impact alongside symptoms in children and adolescents: a longitudinal assessment in a community sample.

Stringaris A, Goodman R - J Abnorm Child Psychol (2013)

The association between mean impact and adverse outcomes by reporting source. Standardized (Cohen’s d) mean scores for impact are presented on the y axis
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3755220&req=5

Fig1: The association between mean impact and adverse outcomes by reporting source. Standardized (Cohen’s d) mean scores for impact are presented on the y axis
Mentions: As shown in Fig. 1, impact, as rated by any informant, was higher in those who had experienced contact with psychiatric services, self harm, truancy and contact with police compared with those who had not experienced such outcomes. Table 3 presents the odds ratios of the association between each of these outcomes and impact. As can be seen, impact rated by any of the three informants was a significant predictor of psychiatric service use, even after adjustment for baseline total SDQ score. However, neither teacher- nor self-report were significant predictors of self harm after adjustment for baseline symptoms. Similarly, neither parent- nor teacher-report was significantly associated with police contact once adjusted for baseline symptoms.Fig. 1

Bottom Line: Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline.Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders.More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, PO 85, Denmark Hill, London, SE5 8AF, UK. argyris.stringaris@kcl.ac.uk

ABSTRACT
The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n = 4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR = 2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR = 1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.

Show MeSH
Related in: MedlinePlus