A PROFILE OF CHILDREN AND ADOLESCENTS IN A PSYCHIATRIC UNIT - MULTIDOMAIN IMPAIRMENT AND RESEARCH IMPLICATIONS

Objective: The scientific literature has not kept pace with the evolut ion of child and adolescent psychiatric inpatient units, including the ir nature, patient profile, philosophical orientation and efficacy. Th is study aims to establish a comprehensive, multimodal description of the population served by an inpatient psychiatric treatment facility f or children and adolescents. Method: A multidisciplinary assessment re gime including psychiatric, medical, speech and language examination, observer rating and patient self-report of psychopathology was used to assess 58 consecutive patients over a 20-month period. Results: In ad dition 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-es teem, intelligence and physical health are reported. Moderate to sever e language handicap was found in 40% of patients. Conclusions: The inp atient population of children and adolescents exhibited not only a hig h rate of disruptive behaviour disorders, frequently comorbid with oth er psychiatric conditions, but also high levels of physical, speech, l anguage and living skills impairment. This finding supports the need f or multimodal, multidisciplinary evaluation and treatment in this popu lation. Outcome research evaluating treatment effectiveness must also account for the wide-ranging disabilities of these children and adoles cents.