title: Clinical Utility of the 2 New Scales of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA): A Naturalistic, Prospective Study in a Psychiatric Unit for Adolescents.
abstract: OBJECTIVE
  The goal of this study was to assess the clinical usefulness of the emotional symptoms (Emo) and externalizing problems (Ext) scales compared with the Total score on the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA).
  
  
  METHODS
  The HoNOSCA was rated at admission and discharge for 260 adolescent inpatients. The primary outcomes assessed were (a) the sensitivity of the 3 HoNOSCA scores to clinical improvement; and (b) the between diagnoses discriminative value of these scores.
  
  
  RESULTS
  Analyses of variances [2 (time: admission vs. discharge) × 5 (diagnostic groups)] revealed a main effect of time for the 3 scores, a main effect of the diagnostic group for the Total and Ext scores, and an interaction effect between time and diagnosis for the Emo score. A moderate correlation was observed between the change in Ext and Emo scores between admission and discharge.
  
  
  CONCLUSIONS
  These 2 new scales of the HoNOSCA demonstrated good clinical utility and the ability to assess different aspects of clinical improvements. A significant discriminative value of both scores was observed.
  
  
  CONCLUSIONS
  The clinical utility of the 2 new scales on the HoNOSCA was established. These 2 new scales provided a sensitive measure of clinical outcome for assessing improvement between admission and discharge on a psychiatric inpatient unit for adolescents, regardless of diagnostic group, and captured additional information about clinical improvements. Adolescents with psychosis and conduct disorders presented with higher externalizing symptoms than those with other disorders, as rated on the HoNOSCA, at admission and discharge. The Emo score differentiated between clinical improvement in patients with psychosis versus eating disorders.
  
  
  CONCLUSIONS
  The sample in this study represented a homogeneous population of adolescent inpatients, so that further research is needed before these findings can be generalized to outpatients. In addition, the small number of patients in some diagnostic groups did not allow for their inclusion in some of the statistical analyses.
authors.affiliation: URBEN: Research Unit, University Service of Child and Adolescent Psychiatry (USCAP), Lausanne, Switzerland GRAAP and BAIER: Mobile Team for Children and Adolescents, USCAP, Lausanne, Switzerland DYSON and COUROSSE: Psychiatric Inpatient Unit for Adolescents, USCAP, Lausanne, Switzerland HOLZER: Mobile Team for Children and Adolescents and Psychiatric Inpatient Unit for Adolescents, USCAP, Lausanne, Switzerland PINHET: School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Fribourg.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Urben
authors.forename: Sandrine
authors.initials: S
authors.lastname: Pihet
authors.forename: Caroline
authors.initials: C
authors.lastname: Graap
authors.forename: Vanessa
authors.initials: V
authors.lastname: Baier
authors.forename: Chloe
authors.initials: C
authors.lastname: Dyson
authors.forename: Swen
authors.initials: S
authors.lastname: Courosse
authors.forename: Laurent
authors.initials: L
authors.lastname: Holzer
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011567:Psychiatric Department, Hospital; D011569:Psychiatric Status Rating Scales / Q000592:standards*