A Profile of Children and Adolescents in a Psychiatric Unit: Multidomain Impairment and Research Implications

Abstract

Objective: The scientific literature has not kept pace with the evolution of child and adolescent psychiatric inpatient units, including their nature, patient profile, philosophical orientation and efficacy. This study aims to establish a comprehensive, mul-timodal description of the population served by an inpatient psychiatric treatment facility for children and adolescents. Method: A multidisciplinary assessment regime including psychiatric, medical, speech and language examination, observer rating and patient self-report of psy-chopathology was used to assess 58 consecutive patients over a 20-month period. Results: In addition to a prevalence of disruptive behaviour disorders of 67% and a high rate of comorbidity with other psychiatric conditions, a breadth of impairment was demonstrated in many areas. Significantly decreased measures of socialisation, communication, daily living skills, self-esteem, intelligence and physical health are reported. Moderate to severe language handicap was found in 40% of patients. Conclusions: The inpatient population of children and adolescents exhibited not only a high rate of disruptive behaviour disorders, frequently cornorbid with other psychiatric conditions, but also high levels of physical, speech, language and living skills impairment. This finding supports the need for multimodal, multidisciplinary evaluation and treatment in this population. Outcome research evaluating treatment effectiveness must also account for the wide-ranging disabilities of these children and adolescents.