Comprehensive Description of Adolescents Admitted to a Public Psychiatric Inpatient Unit and their Families

Abstract

Objective: Adolescents accessing inpatient psychiatric services typically have severe and complex disturbance. The aim of the present study was to provide a comprehensive description of an adolescent inpatient sample by examining their psychiatric diagnosis, symptomatology and functioning and associated parental mental health, family functioning and cultural and socioeconomic factors. Few studies have described all these factors and existing studies have reported varying results. Methods: Participants were 88 adolescents (37 male) aged 12–18 years (mean=15.4 years) consecutively recruited through a small number of case clinicians from a regional metropolitan public inpatient unit over a 5 year period. Adolescents and parents participated in clinical interviews and completed psychometric measures. Case clinicians provided diagnostic information. Results: In contrast to previous studies, adolescents were from a cross-section of socioeconomic backgrounds. Results showed a high rate of comorbid Axis I diagnoses with depressive disorders the most common principal diagnosis. Two-thirds of adolescents experienced clinical levels of internalizing problems. Clinical levels of thought disturbance and externalizing problems were reported for most adolescents, although adolescents self-reported fewer of these symptoms. Educational and social difficulties were common. A salient result was the high level of family dysfunction reported by multiple informants. Most parents reported minimal personality or psychological disturbance but results contradicted other studies and may reflect response bias. In a preliminary finding, non-English-speaking background and low socioeconomic status were associated with a psychosis-related principal diagnosis. Conclusion: Findings indicate the multiplicity of issues facing adolescent inpatients including psychiatric symptoms, impaired personal and family functioning and family cultural and background factors. Treatment that focuses on only some of these factors may have limited effectiveness.