Rationale, aims and objectivesClassification of patients with back pain in order to inform treatments is a long-standing aim in medicine. We used latent class analysis (LCA) to classify patients with low back pain and investigate whether different classes responded differently to a cognitive behavioural intervention. The objective was to provide additional guidance on the use of cognitive behavioural therapy to both patients and clinicians.MethodWe used data from 407 participants from the full study population of 701 with complete data at baseline for the variables the intervention was designed to affect and complete data at 12 months for important outcomes. Patients were classified using LCA, and a link between class membership and outcome was investigated. For comparison, the latent class partition was compared with a commonly used classification system called Subgroups for Targeted Treatment (STarT).ResultsOf the relatively parsimonious models tested for association between class membership and outcome, an association was only found with one model which had three classes. For the trial participants who received the intervention, there was an association between class membership and outcome, but not for those who did not receive the intervention. However, we were unable to detect an effect on outcome from interaction between class membership and the intervention. The results from the comparative classification system were similar.ConclusionWe were able to classify the trial participants based on psychosocial baseline scores relevant to the intervention. An association between class membership and outcome was identified for those people receiving the intervention, but not those in the control group. However, we were not able to identify outcome associations for individual classes and so predict outcome in order to aid clinical decision making. For this cohort of patients, the STarT system was as successful, but not superior.
There is some evidence supporting the effectiveness of psychological interventions in EOP. However, most research on adolescents is focused on CRT and its effects on cognitive deficits. More studies on the effects of psychological interventions in EOP are needed.
Aim
The aim of this study was to compare clinical characteristics and treatment outcomes between children with Childhood‐onset schizophrenia spectrum disorders (COSS) and children with other severe non‐psychotic psychiatric conditions (non‐COSS), all admitted to a national mental health inpatient children's unit.
Methods
We conducted a retrospective study of all children discharged from a national children's inpatient unit in the United Kingdom, between 2009 and 2018. We compared functional and treatment outcomes and satisfaction with treatment in COSS with non‐COSS in the whole sample and separately for male and female patients.
Results
A total of 211 children (55% boys) were included in the sample. The mean age on admission was 129.7 months (10.8 years; age range, 6‐12).Twenty cases were diagnosed with COSS (9.5%). In the whole sample, COSS patients had significantly lower Children's Global Assessment Scale (CGAS) scores on admission compared to non‐COSS (P = .006). There was a trend towards children with COSS as a group having a longer admission (M = 194.6 days, SD = 125.4) compared to non‐COSS (M = 135.8 days, SD = 86.2), (P = .053). Females with COSS seemed to have more significant differences compared to females with non‐COSS, in particular, longer admissions (P = .016) and worse CGAS scores at discharge (P = .04), whilst in males, these differences seemed to be attenuated.
Conclusions
Children with COSS have lower functioning at the point of inpatient admission and possibly longer admissions, but similar satisfaction with treatment at discharge from hospital compared with non‐COSS. Females with COSS may have worse functional outcomes compared to non‐COSS at discharge.
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