Wolpert, M;
Zamperoni, V;
Napoleone, E;
Patalay, P;
Jacob, J;
Fokkema, M;
Promberger, M;
... Childs, J; + view all
(2019)
Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds.
European Child and Adolescent Psychiatry
10.1007/s00787-019-01334-4.
(In press).
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Abstract
Objective: Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population This study examined rates of reliable improvement/deterioration for children in a school sample over time. Method: N = 9,074 children (mean age 12; 52% female; 79% white) from 118 secondary schools across England provided self-report mental health (SDQ), quality of life (Kidscreen) and demographic data (age, ethnicity and free school meals (FSM) at baseline and 1 year and self-report data on access to mental health support at 1 year). Multinomial logistic regressions and classification trees were used to analyse the data. Results: Of 2,270 (25%) scoring above threshold for mental health problems at outset, at 1 year follow up: 27% reliably improved and 9% reliably deteriorated. Of 6,804 (85%) scoring below threshold, 4% reliably improved and 12% reliably deteriorated. Greater emotional difficulties at outset were associated with greater rates of reliable improvement for both groups (above threshold group: OR=1.89, p < .001, 95% CI 4 [1.64, 2.17], below threshold group: OR=2.23, p < .001, 95% CI [1.93, 2.57]). For those above threshold, higher baseline quality of life was associated with greater likelihood of reliable improvement (OR=1.28, p < .001, 95% CI [1.13, 1.46]) whilst being in receipt of FSM was associated with reduced likelihood of reliable improvement (OR=0.68, p < .01, 95% CI [0.53, 0.88]). For the group below threshold, being female was associated with increased likelihood of reliable deterioration (OR=1.20, p < .025, 95% CI [1.00, 1.42]), whereas being from a non-white ethnic background was associated with decreased likelihood of reliable deterioration (OR=0.66, p < .001, 95% CI [0.54, 0.80]). Conclusion: For those above threshold, almost 1 in 3 children showed reliable improvement at one year. The extent of emotional difficulties at outset showed the highest associations with rates of reliable improvement.
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