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. 2018 Sep 10;18(1):291.
doi: 10.1186/s12888-018-1874-9.

Factors associated with treatment intensification in child and adolescent psychiatry: a cross-sectional study

Richard Vijverberg  1   2   3 , Robert Ferdinand  4 , Aartjan Beekman  5   6 , Berno van Meijel  5   6   7   8   9
Affiliations

Factors associated with treatment intensification in child and adolescent psychiatry: a cross-sectional study

Richard Vijverberg et al. BMC Psychiatry. .

Abstract

Background: More knowledge about characteristics of children and adolescents who need intensive levels of psychiatric treatment is important to improve treatment approaches. These characteristics were investigated in those who need youth Assertive Community Treatment (youth-ACT).

Method: A cross-sectional study among children/adolescents and their parents treated in either a regular outpatient clinic or a youth-ACT setting in a specialized mental health treatment center in the Netherlands.

Results: Child, parent and family/social context factors were associated with treatment intensification from regular outpatient care to youth-ACT. The combination of the child, parent, and family/social context factors adds substantially to the predictive power of the model (Nagelkerke R2 increasing from 36 to 45% for the three domains separately, to 61% when all domains are combined). The strongest predictors are the severity of psychiatric disorders of the child, parental stress, and domestic violence.

Conclusions: Using a wide variety of variables that are potentially associated with treatment intensification from regular outpatient clinic to youth-ACT, we constructed a regression model illustrating a relatively strong relation between the predictor variables and the outcome (Nagelkerke R2 = 0.61), with three strong predictors, i.e. severity of psychiatric disorders of the child, parental stress, and domestic violence. This emphasizes the importance of a system-oriented approach with primary attention for problem solving and stress reduction within the system, in addition to the psychiatric treatment of the child, and possibly also the parents.

Keywords: Assertive community treatment; Assertive outreach; Child and adolescent psychiatry; Predictors; Risk factors.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Medical Ethics Committee on Research Involving Human Subjects of the VU University Medical Centre, Amsterdam (protocol no. 2015.245). Participants received written and oral information, separately for children and parents, about the study and were included after the parents provided written informed consent. Children above the age of 12 were included when both the parents and the child provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Participant flow diagram
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