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Review
. 2012 Dec;51(12):1241-1260.e2.
doi: 10.1016/j.jaac.2012.09.004.

Outcome domains in child mental health research since 1996: have they changed and why does it matter?

Kimberly Eaton Hoagwood  1 , Peter S Jensen, Mary C Acri, S Serene Olin, R Eric Lewandowski, Rachel J Herman
Affiliations
Review

Outcome domains in child mental health research since 1996: have they changed and why does it matter?

Kimberly Eaton Hoagwood et al. J Am Acad Child Adolesc Psychiatry. 2012 Dec.

Abstract

Objective: Child mental health treatment and services research yields more immediate public health benefit when they focus on outcomes of relevance to a broader group of stakeholders. We reviewed all experimental studies of child and adolescent treatment and service effectiveness published in the last 15 years (1996-2011) and compared the distribution and types of outcome domains to a prior review that focused on studies from the prior 15 years (1980-1995).

Method: Studies were included if they focused on children from birth to 18 years of age with specific or general psychiatric conditions, employed randomized designs, and examined intervention effects with a six-month or longer post-treatment assessment in treatment studies or a 6-month or longer post-baseline assessment for services studies. Two hundred (n=200) studies met criteria. Reported outcome measures were coded into conceptual categories drawn from the 1980-1995 review.

Results: There was a five-fold increase in the total number of studies (38 versus 200) across the two 15-year time periods, with the largest increase in the number of studies that focused on consumer-oriented outcomes (from eight to 47 studies, an almost sixfold increase); two new domains, parent symptoms and health-related outcomes, were identified. The majority of studies (more than 95%) continued to focus on symptoms and diagnoses as an outcome. Impact ratings were higher among studies examining four or more outcomes versus one to two outcomes in all categories with the exception of Posttraumatic Stress Disorder.

Conclusions: Given major shifts in health care policy affecting mental health services, the emergence of health and parent-related outcomes as well as greater attention to consumer perspectives parallels emerging priorities in health care and can enhance the relevance of child outcome studies for implementation in the real world.

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Conflict of interest statement

Disclosure: Dr. Jensen has received honoraria for invited lectures and keynote presentations from Shire, Inc., and Janssen-Cilag, Ltd., as well as charitable donations from Shire, Inc. He is also a part owner and shareholder of CATCH Services, Inc. Drs. Hoagwood, Acri, Olin, and Lewandowski, and Ms. Herman report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Search history and results.
Figure 2
Figure 2
Growth in studies of outcome domains in child psychiatric randomized controlled trials, 1980–2011 (N=238).
Figure 3
Figure 3
Percent of studies examining 7 outcome domains from 1980–1995 vs. 1996–2011 (N=238).
See this image and copyright information in PMC

References

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    1. Jensen PS, Hoagwood K, Petti T. Outcomes of mental health care for children and adolescents: II. Literature review and application of a comprehensive model. J Am Acad Child Adolesc Psychiatry. 1996;35(8):1064–1077. - PubMed
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    1. President’s New Freedom Commission on Mental Health. Achieving the Promise: Transforming Mental Health Care in America (DHHS Publication No. SMA-03-3832) Rockville, MD: U.S. Department of Health and Human Services; 2003.
    1. Institute of Medicine. Improving the Quality of Health Care for Mental and Substance-Use Conditions. Washington, DC: National Academies Press; 2005. - PubMed

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