Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study

Anat Rotstein, Judy Goldenberg, Suzan Fund, Stephen Z. Levine, Abraham Reichenberg

Research output: Contribution to journalArticlepeer-review

Abstract

Background The current study aims to overcome past methodological limitations and capture adolescents in need of psychiatric care with psychopathological symptoms in a cohort with unrestricted access to mental health professionals. Methods The study source population consisted of a random sample of adolescents aged 16-17 years (N=1,369) assessed by the Israeli Draft Board. An adapted version of the Brief Symptom Inventory was used to identify clinically relevant psychopathological symptoms with scores categorized as severe if they were in the top 10th percentile of symptoms, otherwise not severe. An independent interview with a subsequent referral to a mental health professional was used to categorize adolescents in need of psychiatric care. To examine the association between severe psychopathological symptoms and the need for psychiatric care, logistic regression models were fitted unadjusted and adjusted for age, sex, and intellectual assessment scores. Adjusted classification measures were estimated to examine the utility of severe psychopathological symptoms for clinical prediction of need for psychiatric care. Results Information on 1,283 adolescents was available in the final analytic sample. Logistic regression modeling showed a statistically significant (p<0.001) association between self-reported severe psychopathological symptoms and the need for psychiatric care (OR adjusted: 4.38; 95% CI: 3.55-5.40). Severe psychopathological symptoms had a classification accuracy of 83% (CI: 81%-85%). Conclusions Severe psychopathological symptoms, although accounting for a fair proportion of treatment seeking, would perhaps be better useful for classification purposes alongside other variables rather than in isolation.

Original languageEnglish
Article numbere76
JournalEuropean Psychiatry
Volume64
Issue number1
DOIs
StatePublished - 29 Nov 2021

Bibliographical note

Publisher Copyright:
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association.

Keywords

  • Classification
  • clinical prediction
  • detection and prevention
  • mental disorders in adolescence
  • referral to a mental health professional
  • the Brief Symptom Inventory

ASJC Scopus subject areas

  • Psychiatry and Mental health

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