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The British Journal of Psychiatry (2000) 177: 52-58
© 2000 The Royal College of Psychiatrists

Child and adolescent mental health service use

HoNOSCA as an outcome measure

M. E. GARRALDA, MD, Professor of Child and Adolescent Psychiatry and P YATES, MRCPsych, Clinical Research Fellow

Academic Unit of Child and Adolescent Psychiatry, Imperial College School of Medicine and Dentistry, London

I HIGGINSON, PhD, Professor of Palliative Care and Policy

King's College School of Medicine and Dentistry and St Christopher's Hospice, London

Correspondence: P. Yates, Clinical Research Fellow, Academic Unit of Child and Adolescent Psychiatry, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 IPG, UK

Declaration of interest The study was funded by the North Thames Regional Health Authority.

Background HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) is a recently developed measure of outcome for use in child and adolescent mental health services (CAMHS).

Aims To examine HoNOSCA's sensitivity to change, convergent validity and clinical usefulness.

Method Prospective study of new CAMHS attenders. Questionnaires completed by clinicians, parents and referrers at initial assessment and after 6 months.

Results Follow-up HoNOSCAs on 203 children indicated statistically significant change. There were significant associations between change in HoNOSCA scores, changes in other clinician- and parent-rated scales (r=0.51 to 0.32) and in global outcome ratings by referrers, parents and clinicians. Intraclass correlation coefficients for the summated HoNOSCA scores were high. HoNOSCA change was positively correlated with initial HoNOSCA score (r-0.46, P<0.001) and it was linked to psychiatric diagnosis.

Conclusions HoNOSCA is a sensitive, valid measure of change among CAMHS attenders.




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