Are We Comparing Apples with Oranges? Assessing Improvement Across Symptoms, Functioning, and Goal Progress for Adolescent Anxiety and Depression.

Strategies for comparing routinely collected outcome data across services or systems include focusing on a common indicator (e.g., symptom change) or aggregating results from different measures or outcomes into a comparable core metric. The implications of either approach for judging treatment succe...

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Publicado en:Child Psychiatry & Human Development Vol. 53; no. 4; pp. 737 - 754
Autores principales: Krause, Karolin Rose, Edbrooke-Childs, Julian, Singleton, Rosie, Wolpert, Miranda
Formato: Artículo
Publicado: Springer Nature Aug2022
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Acceso en línea:Ver este registro en EBSCOhost
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        10.1007/s10578-021-01149-y
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        atl: Are We Comparing Apples with Oranges? Assessing Improvement Across Symptoms, Functioning, and Goal Progress for Adolescent Anxiety and Depression.
      aug:
        au:
          Krause, Karolin Rose
          Edbrooke-Childs, Julian
          Singleton, Rosie
          Wolpert, Miranda
        affil:
          Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, WC1E 6BT, London, UK
          Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4–8 Rodney Street, N1 9JH, London, UK
          Wellcome Trust, 215 Euston Rd, Bloomsbury, NW1 2BE, London, UK
      su:
        England
        Depression in adolescence
        Mental health services
        Young adults
        Mental depression
        Symptoms
      sug:
        subj:
          Depression in adolescence
          Mental health services
          Young adults
          Mental depression
          England
          Offices of Mental Health Practitioners (except Physicians)
          Psychiatric and Substance Abuse Hospitals
          Residential Mental Health and Substance Abuse Facilities
          Symptoms
      keyword:
        Adolescents
        Anxiety
        Depression
        Functioning
        Outcome
        Personalized measures
        Adolescents
        Anxiety
        Depression
        Functioning
        Outcome
        Personalized measures
      ab: Strategies for comparing routinely collected outcome data across services or systems include focusing on a common indicator (e.g., symptom change) or aggregating results from different measures or outcomes into a comparable core metric. The implications of either approach for judging treatment success are not fully understood. This study drew on naturalistic outcome data from 1641 adolescents with moderate or severe anxiety and/or depression symptoms who received routine specialist care across 60 mental health services in England. The study compared rates of meaningful improvement between the domains of internalizing symptoms, functioning, and progress towards self-defined goals. Consistent cross-domain improvement was observed in only 15.6% of cases. Close to one in four (24.0%) young people with reliably improved symptoms reported no reliable improvement in functioning. Inversely, one in three (34.8%) young people reported meaningful goal progress but no reliable symptom improvement. Monitoring systems that focus exclusively on symptom change risk over- or under-estimating actual impact, while aggregating different outcomes into a single metric can mask informative differences in the number and type of outcomes showing improvement. A move towards harmonized outcome measurement approaches across multiple domains is needed to ensure fair and meaningful comparisons.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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