Heterogeneity in youth symptom trajectories following psychiatric crisis: predictors and placement outcome.
The authors examined heterogeneity in symptom trajectories among youths following psychiatric crises as well as the psychosocial correlates and placement outcomes associated with identified trajectories. Using semiparametric mixture modeling with 156 youths approved for psychiatric hospitalization, the authors identified 5 trajectories based on symptoms over the 16 months following crisis: high improved, high unimproved, borderline improved, borderline unimproved, and subclinical. Membership in unimproved symptom groups was associated with less suicidality, younger age, more youth hopelessness, and more caregiver empowerment. Improved symptom group membership predicted long-term decreases in days in out-of-home placements. More important, and in contrast with general impressions from the existing literature, findings suggest that a substantive proportion of youths with serious emotional disturbance sustain high levels of symptomatology following intensive mental health services.
Halliday-Boykins
Colleen A
CA
Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite CPP, Box 250861, Charleston, SC 29425, USA. hallidca@musc.edu
Henggeler
Scott W
SW
Rowland
Melisa D
MD
Delucia
Christian
C
D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011613:Psychotherapy / Q000706:statistics & numerical data