Adolescent psychiatric patients and their parents: Comparison with a non-clinical cohort

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.

Impact of Patients’ Psychiatric Hospitalization on Caregivers: A Systematic Review

“…For example, caregivers reported experiencing more distress, as measured by the general severity index of the SCL-90, three days after their adolescent was admitted to the hospital than caregivers of a non-clinical sample (16). In addition, fathers of suicidal adolescents with mood disorders reported more somatic symptoms, hostility, anxiety, and depression than either fathers of non-hospitalized adolescents or fathers of adolescents hospitalized for other reasons, even after controlling for severity of adolescent depression (13).…”

“…Caregivers experience a range of positive and negative reactions to patient hospitalization with negative impacts decreasing over time (37) and greater negative emotional experiences (14) relative to the general population. Several factors may explain differences in caregiver’s experience, including severity of psychiatric problems of the patient.…”

Adolescents’ Perspectives About Brief Psychiatric Hospitalization: What is Helpful and What is Not?

“…Empirical research generally finds that by discharge from brief hospitalization, most adolescents' symptoms and functioning demonstrate sufficient improvement to be transferred to community-based treatment [10][11][12][13][14], though a fraction of patients typically require longer term intervention for complex conditions or complicated family/social situations and are often referred to (the few remaining) state hospitals or residential treatment facilities [3,15,16]. There is evidence that brief and longer-term psychiatric hospitalization yields fairly similar clinical outcomes for youth [3].…”