title: Outcomes of child psychiatric treatment.
abstract: OBJECTIVE
  The aim of this study was to investigate outcomes of child psychiatric outpatient treatment as usual and to identify outcome predictors, with special regard to attention-deficit/hyperactivity disorder (ADHD), mood disorder, obsessive-compulsive disorder and conduct disorder.
  
  
  METHODS
  Routinely collected data from 12 613 outpatients between July 2006 and January 2010 in Stockholm, Sweden were analysed. The outcome measure was change in Children's Global Assessment Scale (CGAS) ratings between first visit and case closure (∆CGAS).
  
  
  RESULTS
  CGAS improved during the course of treatment across all diagnostic groups, ranging from a mean change of 4 (mental retardation) to 16 (suicide attempts). ∆CGAS was two times higher in the mood disorder group compared with the ADHD group. In the mood disorder group, several psychotherapies were associated with better outcome but not medication. In the ADHD group, psychotherapeutic interventions were also associated with better outcome, but those who received treatment with central stimulants received less non-medical interventions.
  
  
  CONCLUSIONS
  Whereas the functional impairment and the level of improvement in mood disorder corresponded to previous efficacy studies, the ADHD patients were more impaired and improved less after treatment. This should prompt a critical discussion as to whether ADHD patients receive the best available treatment in CAMHS in Stockholm and elsewhere.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. anna.lundh@sll.se
authors.forename: A
authors.initials: A
authors.lastname: Lundh
authors.forename: M
authors.initials: M
authors.lastname: Forsman
authors.forename: E
authors.initials: E
authors.lastname: Serlachius
authors.forename: P
authors.initials: P
authors.lastname: Lichtenstein
authors.forename: M
authors.initials: M
authors.lastname: Landén
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002675:Child, Preschool; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology