title: Measuring outcomes in outpatient child psychiatry: reliable improvement, deterioration, and clinically significant improvement.
abstract: Given the increasing interest in demonstrating effectiveness in psychiatric treatment, the current paper seeks to advance outcome measurement in child psychiatry by demonstrating how more informative analytic strategies can be used to evaluate treatment in a real world setting using a brief, standardized parent-report measure. Questionnaires were obtained at intake for 1294 patients. Of these, 695 patients entered treatment and 531 (74%) had complete forms at intake and follow-up. Using this sample, we analyzed the data to determine effect sizes, rates of reliable improvement and deterioration, and rates of clinically significant improvement. Findings highlighted the utility of these approaches for evaluating treatment outcomes. Further suggestions for improving outcome measurement and evaluation are provided.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA Department of Psychiatry, Harvard Medical School, Boston, USA mmurphy6@partners.org.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Murphy
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Blais
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Baer
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA.
authors.forename: Alyssa
authors.initials: A
authors.lastname: McCarthy
authors.affiliation: Department of Psychology, University of Florida, Gainesville, USA.
authors.forename: Hayley
authors.initials: H
authors.lastname: Kamin
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Masek
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, USA Partners Healthcare, Boston, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Jellinek
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000628:therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy; D001714:Bipolar Disorder / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002665:Child Psychiatry; D002675:Child, Preschool; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D018692:Antimanic Agents; D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs
keywords: Child mental health; clinically significant improvement; outcomes measurement; reliable change; reliable deterioration